11 Temmuz 2012 Çarşamba
10 Temmuz 2012 Salı
8 Temmuz 2012 Pazar
When Was the Last Time I Asked the Government to do Nothing?
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In 1999, an animal shelter mandate known as the “Hayden Bill” wasenacted, among other things, to increase holding periods for stray cats anddogs in shelters, create behavior assessments for cats appearing to be feral,and to extend these holding periods to pocket pets as well. In exchange forperforming these additional “mandates”, the state was required to reimbursecities and counties for these extra costs.
Against the landscape of a poor economy, these mandates have been suspended as a cost savingsmeasure since 2009. Now, inhis FY 2012-13 Budget, Governor Jerry Brown has proposed to permanently repealthem. Many of you have been subjected to hysterical calls for action andmisinformed assertions by the media and concerned citizens that animals will beeuthanized en masse upon repeal of these sections of the law. I am sure most ofyou didn’t know that California sheltershave been struggling to operate without being reimbursed for these suspended mandatesfor the past few years.
Your spcaLA, and its president, who also serves as the legislativechair of the State Humane Association of California (SHAC), have been workingclosely with Sacramento to protect the remaining language in the law and toensure that minimum holding periods be added back into the bill text.California Animal Directors Association (CACDA) has also been part of thesenegotiations. SHAC represents the collective voice of California’s humanesocieties and societies for the prevention of cruelty to animals (SPCAs), whileCACDA represents the municipal shelters in California.
That said. I strongly urge that the governor maintain the statusquo and not permanently repeal these mandates. I remain confident that oureconomy will eventually improve and enable these protections for our pets torevive as well.
The stewardship of our stray, abused and unwanted pets shouldbe a priority in this state – the first to be funded and the last to be cut.Sadly that is not the case.
Please call ((916) 445-2841) and/or email our governor and tell him thatwe are sure he will turn California’s economy around and to not repeal thesemandates.
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| courtesy Google images |
Against the landscape of a poor economy, these mandates have been suspended as a cost savingsmeasure since 2009. Now, inhis FY 2012-13 Budget, Governor Jerry Brown has proposed to permanently repealthem. Many of you have been subjected to hysterical calls for action andmisinformed assertions by the media and concerned citizens that animals will beeuthanized en masse upon repeal of these sections of the law. I am sure most ofyou didn’t know that California sheltershave been struggling to operate without being reimbursed for these suspended mandatesfor the past few years.
Your spcaLA, and its president, who also serves as the legislativechair of the State Humane Association of California (SHAC), have been workingclosely with Sacramento to protect the remaining language in the law and toensure that minimum holding periods be added back into the bill text.California Animal Directors Association (CACDA) has also been part of thesenegotiations. SHAC represents the collective voice of California’s humanesocieties and societies for the prevention of cruelty to animals (SPCAs), whileCACDA represents the municipal shelters in California.
That said. I strongly urge that the governor maintain the statusquo and not permanently repeal these mandates. I remain confident that oureconomy will eventually improve and enable these protections for our pets torevive as well.
The stewardship of our stray, abused and unwanted pets shouldbe a priority in this state – the first to be funded and the last to be cut.Sadly that is not the case.
Please call ((916) 445-2841) and/or email our governor and tell him thatwe are sure he will turn California’s economy around and to not repeal thesemandates.
Obama to Decide Whether to Expand Military's Animal Cruelty Policy
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The Department of Defense is asking President Obama for permission to expand the military's current animal cruelty policy to include abandonment and to also apply to personal pets rather than just those owned by the military. The constant relocation and reassignment of military families has resulted in many pets simply being left behind, abandoned, and unattended. Stars and Stripes is reporting that the problem is so great in places like Hawaii and Germany that local shelters are reluctant to adopt pets to Americans and/or military families at all.
The military is further concerned that the problem will worsen as United Airlines, the airline contracted to transport military personnel, refuses to permit certain breeds of dogs, such as American Staffordshire Terriers, on their planes, and will not waive this restriction for the Defense Department.
While I fully support holding those who choose to have a pet responsible for caring for that pet and accountable to the authorities for not doing so, I would also suggest that the military drop United Airlines and contract with another carrier so those with "banned" family dogs can travel without the additional heartbreak of the loss of a pet or the expense of funding their own flights on another airline. It seems an unnecessary stressor for those who would otherwise not abandon their pet.
In fact, if all pet lovers chose, in sympathy, to fly with different airlines - maybe we would see an attitude change from United.
The president is expected to decide this spring.
The Department of Defense is asking President Obama for permission to expand the military's current animal cruelty policy to include abandonment and to also apply to personal pets rather than just those owned by the military. The constant relocation and reassignment of military families has resulted in many pets simply being left behind, abandoned, and unattended. Stars and Stripes is reporting that the problem is so great in places like Hawaii and Germany that local shelters are reluctant to adopt pets to Americans and/or military families at all.The military is further concerned that the problem will worsen as United Airlines, the airline contracted to transport military personnel, refuses to permit certain breeds of dogs, such as American Staffordshire Terriers, on their planes, and will not waive this restriction for the Defense Department.
While I fully support holding those who choose to have a pet responsible for caring for that pet and accountable to the authorities for not doing so, I would also suggest that the military drop United Airlines and contract with another carrier so those with "banned" family dogs can travel without the additional heartbreak of the loss of a pet or the expense of funding their own flights on another airline. It seems an unnecessary stressor for those who would otherwise not abandon their pet.
In fact, if all pet lovers chose, in sympathy, to fly with different airlines - maybe we would see an attitude change from United.
The president is expected to decide this spring.
"Something's Happening Here - What It Is Ain't Exactly Clear..."
To contact us Click HERE
I wasn’t going to write about this – but – it has beenbothering me. Last week, the aspca (NOTa national umbrella organization) subsidized adoptions across the country for acouple of days. The subsidy allowed some shelters to give away pets, or tocharge 10 or 20 dollars for the pet. So whyhas this been nagging at me?
I began to wonder why they are really doing this. Promoting adoptions is the obvious answer butis it the correct one? You and I will never know – but here is what I think.The aspca has been and is under fire for fundraising in everyone’s neighborhoodand amassing approximately 188,024,402 million dollars in New Yorkto the detriment of all the other spcas and the animals they serve. They getaway with it because consumers believe that they are the “national office” and thatevery spca in the country is a chapter which receives funding from them. Not true. Each spca is a separate and independent legalentity and it could affect the aspca’s ability to raise funds if they disclosedthat. In fact, out of that near 185,000,000million dollars, they grant out fewerthan 6 million but spend over 25 million on fundraising.
So, they throw pocket change at this adoption promotion,publicize the hell out of it and generate more smoke for the mirrors.
But was it a good event that helped animals? In Californiathey worked mostly with government pounds where adopters are not screened andall one needs is the fee to take home an animal. At no charge or even with anominal charge many animals very likely went to hoarders, backyard sellers, and other entitiesthat had only plans to resell the pets at a huge mark up. How many sales werean impulse grab where the pet was returned or simply turned out? It is easy to empty ashelter but not so easy to have the adoption stick and actually find the pet ahome. It is neither a success nor even an adoption if the pet is not kept. Doyou think the aspca is tracking that or is even concerned about that? I don't know, but if so, the event business model would have been different. Of course there are those of us who would cherish a pet for life that we found on the street or received at no cost. I am not talking about us.
I think that my disquietude comes from the fear that manyof these animals might be in awful places as a result of the aspca’s publicrelations effort to appear to be funding animals in areas in which they solicitdonations and provide nothing in return.
They could be throwing couch cushion change to seem to besomething they are not, while perhaps tossing pets to the very real wolves.
Please donate locally.
I wasn’t going to write about this – but – it has beenbothering me. Last week, the aspca (NOTa national umbrella organization) subsidized adoptions across the country for acouple of days. The subsidy allowed some shelters to give away pets, or tocharge 10 or 20 dollars for the pet. So whyhas this been nagging at me?
 |
| Courtesy spcaL |
So, they throw pocket change at this adoption promotion,publicize the hell out of it and generate more smoke for the mirrors.
But was it a good event that helped animals? In Californiathey worked mostly with government pounds where adopters are not screened andall one needs is the fee to take home an animal. At no charge or even with anominal charge many animals very likely went to hoarders, backyard sellers, and other entitiesthat had only plans to resell the pets at a huge mark up. How many sales werean impulse grab where the pet was returned or simply turned out? It is easy to empty ashelter but not so easy to have the adoption stick and actually find the pet ahome. It is neither a success nor even an adoption if the pet is not kept. Doyou think the aspca is tracking that or is even concerned about that? I don't know, but if so, the event business model would have been different. Of course there are those of us who would cherish a pet for life that we found on the street or received at no cost. I am not talking about us.
I think that my disquietude comes from the fear that manyof these animals might be in awful places as a result of the aspca’s publicrelations effort to appear to be funding animals in areas in which they solicitdonations and provide nothing in return.
They could be throwing couch cushion change to seem to besomething they are not, while perhaps tossing pets to the very real wolves.
Please donate locally.
Stop the Cruel and Bullying "Sport"of Hounding California's Bears and Bobcats
To contact us Click HERE
Senate Bill 1221 will stop the cruel and bullying pastime of “hounding” bears and bobcats.
"Hounding" is a hunting practice where dogs are first sprayed with a bear attractant and fitted with high‐tech radio collars, that permit the hunters to hunt remotely. The dogs can chase the bear or bobcats for miles until they are treed or exhausted, at which time the tip-switch on the collars alerts the hunters, who, arrive and shoot a weary animal at point blank range. Essentially, the hounds take all the risks while the "sport" hunter lounges around in the park waiting for the signal to exert him or herself enough to shoot a trapped, immobilized animal.
Notwithstanding the terrifying ordeal suffered by the target animal, the hounds don't fare much better. They are not treated as pets but as working animals. They get injured running, hit by cars, and are often wounded or killed by the target animal or any other wildlife (such as deer) that they may encounter. There are reports of shelters receiving these dogs dehydrated, skinny and injured after they are no longer any use to the "sportsman".
I respectfully submit that this form of hunting is neither sport nor sportsman like. As comedian Paul Rodriguez said: "In a sport both sides should know they are in the game".
Not only do the animals not know they are playing - the bullies are cheating.
It is time to end this practice in California. Please contact your representatives http://www.leginfo.ca.gov/yourleg.html and urge them to pass SB 1221.
Thank you.
Senate Bill 1221 will stop the cruel and bullying pastime of “hounding” bears and bobcats.
 |
| Courtesy Google Images |
 |
| Courtesy Google Images |
I respectfully submit that this form of hunting is neither sport nor sportsman like. As comedian Paul Rodriguez said: "In a sport both sides should know they are in the game".
Not only do the animals not know they are playing - the bullies are cheating.
It is time to end this practice in California. Please contact your representatives http://www.leginfo.ca.gov/yourleg.html and urge them to pass SB 1221.
Thank you.
Rihanna's Dog Got "Minxed"
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The latest trend in manicures and pedicures is the minx manicure. It is a process where pictures and patterns are painted onto fingernails and toenails thereby instantly transforming ordinary fingers and toes into works of art.
It was only a matter of time before this new art form appeared on a pet. In this case it was Rihanna's dog. She posted a photo of her dog with the caption "Bitch got minx."
The product is said to be toxic, odorless, chemical free and perfectly safe for natural nails. However, before you try something like this on your pet, use common sense. When in doubt, ask a veterinarian - is this safe for pets? Procedures and materials deemed safe for people may still have adverse effect on animals.
If it's safe - make sure it's something your pet tolerates and is comfortable doing. If your dog needs a sedative to do it, it most likely should not be done.
Need I say- don't even think about this for a cat!
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| Courtesy Instagram |
It was only a matter of time before this new art form appeared on a pet. In this case it was Rihanna's dog. She posted a photo of her dog with the caption "Bitch got minx."
The product is said to be toxic, odorless, chemical free and perfectly safe for natural nails. However, before you try something like this on your pet, use common sense. When in doubt, ask a veterinarian - is this safe for pets? Procedures and materials deemed safe for people may still have adverse effect on animals.
If it's safe - make sure it's something your pet tolerates and is comfortable doing. If your dog needs a sedative to do it, it most likely should not be done.
Need I say- don't even think about this for a cat!
7 Temmuz 2012 Cumartesi
Designing Isn't Just for Adults..
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I think that our field kind of has some negative views sometimes. People don't really know what we do or understand what we do. They think that we simply "fluff pillows and pick paint chips."
However, we know that this isn't the case. We know that we do much more than this. People don't understand that we are going to school to make their lives better and more comfortable. We know stuff that could make a difference in the way that they live.
It never ceases to amaze me the amount of knowledge I learn everyday about our field of choice. When I gave my presentation last week it amazed me the certain things we could do to even improve a newborns room by putting in sound systems. Or even when Marcene did the presentation on health care environments and she talked about how they were painting their machines bright colors or making them look like something cool and not a big scary MRI machine. It's amazing how even just those small touches can improve the way a child might behave and not be scared to go to the doctor.
There is all sorts of knowledge out there for us to learn how to design and it's not just for adults and elderly. It's very useful for children too.
However, we know that this isn't the case. We know that we do much more than this. People don't understand that we are going to school to make their lives better and more comfortable. We know stuff that could make a difference in the way that they live.
It never ceases to amaze me the amount of knowledge I learn everyday about our field of choice. When I gave my presentation last week it amazed me the certain things we could do to even improve a newborns room by putting in sound systems. Or even when Marcene did the presentation on health care environments and she talked about how they were painting their machines bright colors or making them look like something cool and not a big scary MRI machine. It's amazing how even just those small touches can improve the way a child might behave and not be scared to go to the doctor.
There is all sorts of knowledge out there for us to learn how to design and it's not just for adults and elderly. It's very useful for children too.
"Something's Happening Here - What It Is Ain't Exactly Clear..."
To contact us Click HERE
I wasn’t going to write about this – but – it has beenbothering me. Last week, the aspca (NOTa national umbrella organization) subsidized adoptions across the country for acouple of days. The subsidy allowed some shelters to give away pets, or tocharge 10 or 20 dollars for the pet. So whyhas this been nagging at me?
I began to wonder why they are really doing this. Promoting adoptions is the obvious answer butis it the correct one? You and I will never know – but here is what I think.The aspca has been and is under fire for fundraising in everyone’s neighborhoodand amassing approximately 188,024,402 million dollars in New Yorkto the detriment of all the other spcas and the animals they serve. They getaway with it because consumers believe that they are the “national office” and thatevery spca in the country is a chapter which receives funding from them. Not true. Each spca is a separate and independent legalentity and it could affect the aspca’s ability to raise funds if they disclosedthat. In fact, out of that near 185,000,000million dollars, they grant out fewerthan 6 million but spend over 25 million on fundraising.
So, they throw pocket change at this adoption promotion,publicize the hell out of it and generate more smoke for the mirrors.
But was it a good event that helped animals? In Californiathey worked mostly with government pounds where adopters are not screened andall one needs is the fee to take home an animal. At no charge or even with anominal charge many animals very likely went to hoarders, backyard sellers, and other entitiesthat had only plans to resell the pets at a huge mark up. How many sales werean impulse grab where the pet was returned or simply turned out? It is easy to empty ashelter but not so easy to have the adoption stick and actually find the pet ahome. It is neither a success nor even an adoption if the pet is not kept. Doyou think the aspca is tracking that or is even concerned about that? I don't know, but if so, the event business model would have been different. Of course there are those of us who would cherish a pet for life that we found on the street or received at no cost. I am not talking about us.
I think that my disquietude comes from the fear that manyof these animals might be in awful places as a result of the aspca’s publicrelations effort to appear to be funding animals in areas in which they solicitdonations and provide nothing in return.
They could be throwing couch cushion change to seem to besomething they are not, while perhaps tossing pets to the very real wolves.
Please donate locally.
I wasn’t going to write about this – but – it has beenbothering me. Last week, the aspca (NOTa national umbrella organization) subsidized adoptions across the country for acouple of days. The subsidy allowed some shelters to give away pets, or tocharge 10 or 20 dollars for the pet. So whyhas this been nagging at me?
|
| Courtesy spcaL |
So, they throw pocket change at this adoption promotion,publicize the hell out of it and generate more smoke for the mirrors.
But was it a good event that helped animals? In Californiathey worked mostly with government pounds where adopters are not screened andall one needs is the fee to take home an animal. At no charge or even with anominal charge many animals very likely went to hoarders, backyard sellers, and other entitiesthat had only plans to resell the pets at a huge mark up. How many sales werean impulse grab where the pet was returned or simply turned out? It is easy to empty ashelter but not so easy to have the adoption stick and actually find the pet ahome. It is neither a success nor even an adoption if the pet is not kept. Doyou think the aspca is tracking that or is even concerned about that? I don't know, but if so, the event business model would have been different. Of course there are those of us who would cherish a pet for life that we found on the street or received at no cost. I am not talking about us.
I think that my disquietude comes from the fear that manyof these animals might be in awful places as a result of the aspca’s publicrelations effort to appear to be funding animals in areas in which they solicitdonations and provide nothing in return.
They could be throwing couch cushion change to seem to besomething they are not, while perhaps tossing pets to the very real wolves.
Please donate locally.
Stop the Cruel and Bullying "Sport"of Hounding California's Bears and Bobcats
To contact us Click HERE
Senate Bill 1221 will stop the cruel and bullying pastime of “hounding” bears and bobcats.
"Hounding" is a hunting practice where dogs are first sprayed with a bear attractant and fitted with high‐tech radio collars, that permit the hunters to hunt remotely. The dogs can chase the bear or bobcats for miles until they are treed or exhausted, at which time the tip-switch on the collars alerts the hunters, who, arrive and shoot a weary animal at point blank range. Essentially, the hounds take all the risks while the "sport" hunter lounges around in the park waiting for the signal to exert him or herself enough to shoot a trapped, immobilized animal.
Notwithstanding the terrifying ordeal suffered by the target animal, the hounds don't fare much better. They are not treated as pets but as working animals. They get injured running, hit by cars, and are often wounded or killed by the target animal or any other wildlife (such as deer) that they may encounter. There are reports of shelters receiving these dogs dehydrated, skinny and injured after they are no longer any use to the "sportsman".
I respectfully submit that this form of hunting is neither sport nor sportsman like. As comedian Paul Rodriguez said: "In a sport both sides should know they are in the game".
Not only do the animals not know they are playing - the bullies are cheating.
It is time to end this practice in California. Please contact your representatives http://www.leginfo.ca.gov/yourleg.html and urge them to pass SB 1221.
Thank you.
Senate Bill 1221 will stop the cruel and bullying pastime of “hounding” bears and bobcats.
|
| Courtesy Google Images |
|
| Courtesy Google Images |
I respectfully submit that this form of hunting is neither sport nor sportsman like. As comedian Paul Rodriguez said: "In a sport both sides should know they are in the game".
Not only do the animals not know they are playing - the bullies are cheating.
It is time to end this practice in California. Please contact your representatives http://www.leginfo.ca.gov/yourleg.html and urge them to pass SB 1221.
Thank you.
Baby Chimp Killed at Zoo While Visitors Watched
To contact us Click HERE
The first chimpanzee baby born at the Los Angeles Zoo in 13 years was killed by an adult male chimp while visitors watched. It is alleged that the male took the baby from the mother Tuesday afternoon, and after a skirmish the infant was dead and the mother despondent.
Despite the fact that zoo officials asserted that the attack "came out of the blue" there are other reports of fights that occurred in the exhibit days before the fatal attack that could have served as a portend of things to come. Craig Stanford, a USC professor who studies chimps, defended the zoo with his assertion that aggressive behavior in chimps occurs both in the wild and in captivity and that, in fact, "chimps can be very nasty animals. They abuse females, and they attack babies”. This actually suggests that no violent behavior between chimps could ever be "out of the blue" or a surprise to zoo personnel particularly when the introduction of a new baby stresses and further complicates the population dynamics in a confined space.
It seems easy to achieve and reasonable to expect, that in captivity, where the exhibit is constantly monitored and controlled by zoo keepers familiar with chimp behavior, that hyper vigilance is warranted and extra care mandated upon the birth of a baby. Erring on the side of caution may have yielded a different result. After all - they are not in the wild. We can and must intervene.
spcaLA, has called for a full investigation by city officials, the Department of Fish and Game and the USDA into the matter to determine if this tragedy could have been avoided, and to put remedial protocols in place to prevent or reduce the likelihood of future incidents involving chimps or any other animal held in captivity.
Sure, in the wild animals resolve their own issues and have ways to retreat from confrontation. Once we trap them in a cage we have a duty to protect them.
Article first published as Infant Chimp Killed At Zoo While Visitors Watched on Technorati.
Despite the fact that zoo officials asserted that the attack "came out of the blue" there are other reports of fights that occurred in the exhibit days before the fatal attack that could have served as a portend of things to come. Craig Stanford, a USC professor who studies chimps, defended the zoo with his assertion that aggressive behavior in chimps occurs both in the wild and in captivity and that, in fact, "chimps can be very nasty animals. They abuse females, and they attack babies”. This actually suggests that no violent behavior between chimps could ever be "out of the blue" or a surprise to zoo personnel particularly when the introduction of a new baby stresses and further complicates the population dynamics in a confined space.
It seems easy to achieve and reasonable to expect, that in captivity, where the exhibit is constantly monitored and controlled by zoo keepers familiar with chimp behavior, that hyper vigilance is warranted and extra care mandated upon the birth of a baby. Erring on the side of caution may have yielded a different result. After all - they are not in the wild. We can and must intervene.
spcaLA, has called for a full investigation by city officials, the Department of Fish and Game and the USDA into the matter to determine if this tragedy could have been avoided, and to put remedial protocols in place to prevent or reduce the likelihood of future incidents involving chimps or any other animal held in captivity.
Sure, in the wild animals resolve their own issues and have ways to retreat from confrontation. Once we trap them in a cage we have a duty to protect them.
Article first published as Infant Chimp Killed At Zoo While Visitors Watched on Technorati.
Finally -Stronger California Regulations Governing Captive Wildlife
To contact us Click HERE
Stronger state regulations dealingwith the inspection of places that house wild animals have finally beenapproved by the California Department of Fish and Game Commission. As a member of the state-appointed Departmentof Fish and Game Captive Animal Advisory Committee that developed these newregulations I am happy to report that some progress has been made and cautiouslyoptimistic that there will be more to come.
For example: despite state laws mandatingthat facilities handling these animals, such as private collections,sanctuaries, zoos, and circuses be inspected by the Department of Fish and Gameto ensure the well-being of the animals and the safety of the public, theDepartment was allowing compliance through self-inspection. In other words, a facility’sown veterinarian was signing the forms that all was well! New regulations willmandate that the Department conduct these inspections and not personnel hiredby the compound.
The goal of these new regulations isto make sure that captive wildlife is treated humanely, contained securely, andhandled by qualified entities so as to reduce the danger to the public and theheartbreak of an animal’s untimely killing should he or she escape an insufficientenclosure. We all remember the chaos when loose wild animals were gunned down in Ohio, the fatal attack of a teen after a tiger at the San Francisco Zoo escaped, the group of tigers that escaped in Moorpark or the mauling of two people by a chimp.
Maybe someday we will reach a place where wild animals are not held for sport, exhibition, entertainment or whim.
 |
| courtesy google images |
Stronger state regulations dealingwith the inspection of places that house wild animals have finally beenapproved by the California Department of Fish and Game Commission. As a member of the state-appointed Departmentof Fish and Game Captive Animal Advisory Committee that developed these newregulations I am happy to report that some progress has been made and cautiouslyoptimistic that there will be more to come.
For example: despite state laws mandatingthat facilities handling these animals, such as private collections,sanctuaries, zoos, and circuses be inspected by the Department of Fish and Gameto ensure the well-being of the animals and the safety of the public, theDepartment was allowing compliance through self-inspection. In other words, a facility’sown veterinarian was signing the forms that all was well! New regulations willmandate that the Department conduct these inspections and not personnel hiredby the compound.
The goal of these new regulations isto make sure that captive wildlife is treated humanely, contained securely, andhandled by qualified entities so as to reduce the danger to the public and theheartbreak of an animal’s untimely killing should he or she escape an insufficientenclosure. We all remember the chaos when loose wild animals were gunned down in Ohio, the fatal attack of a teen after a tiger at the San Francisco Zoo escaped, the group of tigers that escaped in Moorpark or the mauling of two people by a chimp.
Maybe someday we will reach a place where wild animals are not held for sport, exhibition, entertainment or whim.
5 Temmuz 2012 Perşembe
Back to Diabetes Basics – Part 1
To contact us Click HERE
What You MayExperience After Diagnosis
Where to start is the question. First,if you have just been handed the diagnosis of type 2 diabetes, eitheryou had an idea because others in you family history have it, or thisis a complete shock as you can recall no history of diabetes in yourfamily. Granted, there could be other reasons that may have inducedtype 2 diabetes, but I will discuss them in another blog. You mustrealize that the symptoms are not what every person feels, but theyare the minority. The feelings may be of a different intensity andlength for each person.
The FirstStage – Shock!
Are you in shock, have anger, ortotally befuddled? I can understand this and even acknowledge thatyou feel this way. This is the first stage in the process you willeventually go through to come to grips with your diabetes diagnosis. My anger was short lived as I had a history of diabetes on mymother's side of the family. My anger was at the time directed at adoctor that kept calling me a liar for not knowing I had diabetes. Yes, he had some reason to be upset at me as I was diagnosed while onthe operating table for angina. Stent insertion plus ballooning ofseveral areas in my arteries was in process and they could not stop. On top of that, they had the problem of stopping the bleeding at thepoint of insertion when finished.
His constant calling me a liar for notknowing I had diabetes resulted in a bedpan being hurled in hisdirection and quite a scene as nurses came running. I said I wantedsome quiet time and the doctor was preventing it. Even my roommatesaid his actions were disturbing and agreed with having him removedfrom the room. He asked to have his doctor come to see him. Shortstory – this doctor was told to stay away from our room as long aseither of us was in the hospital.
Shock, anger, or being in a fog isexpected when you receive the diabetes diagnosis. How you handle thiswill be important, as you need to consider what you do next. It isnot expected that you will retain the information given to you theday of diagnosis. It is important that you be ready for the nextappointment and have your questions ready to ask the doctor.
I hope that your doctor will havetesting equipment available to give you, or give you a prescriptionfor a meter, lancing device, lancets, and test strips. Be aware thatif you are not offered a meter, lancing device, lancets, and teststrips, you need to ask the doctor for a prescription before youleave. If you forgot, go back to the office and insist on aprescription. Some doctors will not as they do not want you to knowwhat your blood glucose levels are or does not want you to becomedepressed by the readings. If you have one of these doctors,seriously consider finding a doctor that will give you aprescription. Your diabetes health can be better for it.
Some doctors will use certifieddiabetes educators (CDEs) that can give you answers to many questionsand should reinforce anything the doctor has time to tell you. Theycan cover many areas of teaching you about diabetes and how to handlemany aspects of the disease. Many doctors do not have CDEs availableor will not use them. Some doctors use registered dietitians (RDs)and some doctors do not. In some of the more rural areas, doctorsare using nutritionists and others with a nutrition degree becauseRDs are not available.
With the rapid increase in people withdiabetes and a snails pace growth in the number of CDEs and RDs,other resources are being explored by some doctors. A minority ofdoctors are using diabetes mentors or peer mentors. A few doctorseven use peer-to-peer groups. The last three are interesting as thisindicates that these doctors are making use of knowledgeable patientsthat can use personal experiences to relate to new patients. This isa measure to help new patients feel like they are not alone in theirstruggle with diabetes, help educate new patients, and be availableto answer some questions when needed. You should avail yourself ofany education you have available. Your doctor is not available 24/7;therefore, you need to educate yourself to manage diabetes.
Okay, I have gotten ahead of myself andcovered a few areas that should come a week to a month afterdiagnosis. Education about diabetes is important, but the first weekwill be very difficult for many people. If shock and anger don'ttake over for a few days, you are definitely in the minority. A fewpeople will take the diagnosis in stride and be ready for the nextstep of being educated. Even if you are in a state of shock, keepthe fog at bay long enough to learn that diabetes “is not yourfault.”
Many people falsely feel that if theyhad done this or done that, they would not have diabetes. Part ofthis may be true, but people that are genetically disposed todiabetes should not feel this is their fault. Yes, their actions mayhave helped make the diagnosis happen earlier, but by having thepredisposition for diabetes; most people have no control inpreventing diabetes, just the timing of the diagnosis. There arepossibly some people that are not genetically predisposed to diabetesthat are diagnosed, but there is little evidence to-date supportingthis happening in large numbers.
There is no advantage in dwelling onthe past. This was a hard lesson for me to learn, but I had a goodfriend tell me that diabetes is the here and now and I needed tolearn how to deal with it. Since this person did not have diabetes,it really stopped me and made me realize that unless I did just that,I might not be capable of managing my diabetes.
The SecondStage – Denial!
After the initial shock, anger, or whatyou want to call it, you may have denial. This is not necessarilythe order, but can happen early on or years later. Denial can wreckhavoc in diabetes management and make it difficult to recover. Denial is thinking you have mastered diabetes and don't have to doanymore to battle diabetes and just stop, or outright refusal torecognize that you have diabetes. Both are damaging to you and maymake future management of your diabetes more difficult. Diabetesburnout is very different and should not be confused with denial.
The ThirdStage – Acceptance!
The next stage is acceptance ofdiabetes and the desire to manage it to the best of your abilities. And yes, denial can happen after what may seem like acceptance, butgenerally does not. Acceptance means that you recognize diabetes iswhat you have and have decided to manage it as only you can do. Yes,you will rely on your doctor for guidance and assistance, but youhave accepted it as your diabetes and intend to do battle with it.
A PossibleFourth Stage – Depression!
Now that I have covered the main stagesthat most people encounter, I need to add a possible fourth stage. This stage does not generally happen to about one-third of peoplediagnosed with diabetes, but may happen to the other two-thirds. This is generally a minor depression and may happen at anytime fromdiagnosis to years later. Only about 19 percent of people developsevere depression. The risk is there and needs to be considered anddealt with when it happens.
I have had diabetes for eight plusyears and have had what I believe was depression only twice, the lastabout a month age. I was in a down mood or funk and had to forcemyself to continue to work on blogs and do my research, but therewere days I did not want to do anything. I don't know what happensto everyone, but unless you really are seriously depressed, take itin stride and work to overcome it. Seek professional help if youfeel the need. Some do have serious depression and need to seekprofessional help. This is normally the best route to follow and getthe help necessary.
The last item for this blog is astatement by William Polonsky, PhD, CDE, and director of TheBehavioral Diabetes Institute in San Diego, CA. He states that“diabetes does not cause anything.” That is right;diabetes causes nothing, no complications or related problems. Thismay surprise a few people, but the cause of the complications andsome other problems is the poor or lack of diabetes management. Youmay think that this is what diabetes does, but no, if you maintainblood glucose levels at or near normal, the complications areunlikely to happen. Old age may happen before diabetes complicationsand you will likely die from old age before diabetes or itscomplication take over if you accomplish excellent blood glucosemanagement.
This also puts to rest the first myth. Many believe that diabetes is progressive and continues to get worse. If diabetes is managed properly, progression will not happen andpeople may live a long, normal healthy life. The factor that addsreality and keeps this myth in front of people is that few peopleactually do what they are supposed to do to manage diabetes. Forthem diabetes is progressive and their quality of life is often injeopardy.
Series 1 of 12.
What You MayExperience After Diagnosis
Where to start is the question. First,if you have just been handed the diagnosis of type 2 diabetes, eitheryou had an idea because others in you family history have it, or thisis a complete shock as you can recall no history of diabetes in yourfamily. Granted, there could be other reasons that may have inducedtype 2 diabetes, but I will discuss them in another blog. You mustrealize that the symptoms are not what every person feels, but theyare the minority. The feelings may be of a different intensity andlength for each person.
The FirstStage – Shock!
Are you in shock, have anger, ortotally befuddled? I can understand this and even acknowledge thatyou feel this way. This is the first stage in the process you willeventually go through to come to grips with your diabetes diagnosis. My anger was short lived as I had a history of diabetes on mymother's side of the family. My anger was at the time directed at adoctor that kept calling me a liar for not knowing I had diabetes. Yes, he had some reason to be upset at me as I was diagnosed while onthe operating table for angina. Stent insertion plus ballooning ofseveral areas in my arteries was in process and they could not stop. On top of that, they had the problem of stopping the bleeding at thepoint of insertion when finished.
His constant calling me a liar for notknowing I had diabetes resulted in a bedpan being hurled in hisdirection and quite a scene as nurses came running. I said I wantedsome quiet time and the doctor was preventing it. Even my roommatesaid his actions were disturbing and agreed with having him removedfrom the room. He asked to have his doctor come to see him. Shortstory – this doctor was told to stay away from our room as long aseither of us was in the hospital.
Shock, anger, or being in a fog isexpected when you receive the diabetes diagnosis. How you handle thiswill be important, as you need to consider what you do next. It isnot expected that you will retain the information given to you theday of diagnosis. It is important that you be ready for the nextappointment and have your questions ready to ask the doctor.
I hope that your doctor will havetesting equipment available to give you, or give you a prescriptionfor a meter, lancing device, lancets, and test strips. Be aware thatif you are not offered a meter, lancing device, lancets, and teststrips, you need to ask the doctor for a prescription before youleave. If you forgot, go back to the office and insist on aprescription. Some doctors will not as they do not want you to knowwhat your blood glucose levels are or does not want you to becomedepressed by the readings. If you have one of these doctors,seriously consider finding a doctor that will give you aprescription. Your diabetes health can be better for it.
Some doctors will use certifieddiabetes educators (CDEs) that can give you answers to many questionsand should reinforce anything the doctor has time to tell you. Theycan cover many areas of teaching you about diabetes and how to handlemany aspects of the disease. Many doctors do not have CDEs availableor will not use them. Some doctors use registered dietitians (RDs)and some doctors do not. In some of the more rural areas, doctorsare using nutritionists and others with a nutrition degree becauseRDs are not available.
With the rapid increase in people withdiabetes and a snails pace growth in the number of CDEs and RDs,other resources are being explored by some doctors. A minority ofdoctors are using diabetes mentors or peer mentors. A few doctorseven use peer-to-peer groups. The last three are interesting as thisindicates that these doctors are making use of knowledgeable patientsthat can use personal experiences to relate to new patients. This isa measure to help new patients feel like they are not alone in theirstruggle with diabetes, help educate new patients, and be availableto answer some questions when needed. You should avail yourself ofany education you have available. Your doctor is not available 24/7;therefore, you need to educate yourself to manage diabetes.
Okay, I have gotten ahead of myself andcovered a few areas that should come a week to a month afterdiagnosis. Education about diabetes is important, but the first weekwill be very difficult for many people. If shock and anger don'ttake over for a few days, you are definitely in the minority. A fewpeople will take the diagnosis in stride and be ready for the nextstep of being educated. Even if you are in a state of shock, keepthe fog at bay long enough to learn that diabetes “is not yourfault.”
Many people falsely feel that if theyhad done this or done that, they would not have diabetes. Part ofthis may be true, but people that are genetically disposed todiabetes should not feel this is their fault. Yes, their actions mayhave helped make the diagnosis happen earlier, but by having thepredisposition for diabetes; most people have no control inpreventing diabetes, just the timing of the diagnosis. There arepossibly some people that are not genetically predisposed to diabetesthat are diagnosed, but there is little evidence to-date supportingthis happening in large numbers.
There is no advantage in dwelling onthe past. This was a hard lesson for me to learn, but I had a goodfriend tell me that diabetes is the here and now and I needed tolearn how to deal with it. Since this person did not have diabetes,it really stopped me and made me realize that unless I did just that,I might not be capable of managing my diabetes.
The SecondStage – Denial!
After the initial shock, anger, or whatyou want to call it, you may have denial. This is not necessarilythe order, but can happen early on or years later. Denial can wreckhavoc in diabetes management and make it difficult to recover. Denial is thinking you have mastered diabetes and don't have to doanymore to battle diabetes and just stop, or outright refusal torecognize that you have diabetes. Both are damaging to you and maymake future management of your diabetes more difficult. Diabetesburnout is very different and should not be confused with denial.
The ThirdStage – Acceptance!
The next stage is acceptance ofdiabetes and the desire to manage it to the best of your abilities. And yes, denial can happen after what may seem like acceptance, butgenerally does not. Acceptance means that you recognize diabetes iswhat you have and have decided to manage it as only you can do. Yes,you will rely on your doctor for guidance and assistance, but youhave accepted it as your diabetes and intend to do battle with it.
A PossibleFourth Stage – Depression!
Now that I have covered the main stagesthat most people encounter, I need to add a possible fourth stage. This stage does not generally happen to about one-third of peoplediagnosed with diabetes, but may happen to the other two-thirds. This is generally a minor depression and may happen at anytime fromdiagnosis to years later. Only about 19 percent of people developsevere depression. The risk is there and needs to be considered anddealt with when it happens.
I have had diabetes for eight plusyears and have had what I believe was depression only twice, the lastabout a month age. I was in a down mood or funk and had to forcemyself to continue to work on blogs and do my research, but therewere days I did not want to do anything. I don't know what happensto everyone, but unless you really are seriously depressed, take itin stride and work to overcome it. Seek professional help if youfeel the need. Some do have serious depression and need to seekprofessional help. This is normally the best route to follow and getthe help necessary.
The last item for this blog is astatement by William Polonsky, PhD, CDE, and director of TheBehavioral Diabetes Institute in San Diego, CA. He states that“diabetes does not cause anything.” That is right;diabetes causes nothing, no complications or related problems. Thismay surprise a few people, but the cause of the complications andsome other problems is the poor or lack of diabetes management. Youmay think that this is what diabetes does, but no, if you maintainblood glucose levels at or near normal, the complications areunlikely to happen. Old age may happen before diabetes complicationsand you will likely die from old age before diabetes or itscomplication take over if you accomplish excellent blood glucosemanagement.
This also puts to rest the first myth. Many believe that diabetes is progressive and continues to get worse. If diabetes is managed properly, progression will not happen andpeople may live a long, normal healthy life. The factor that addsreality and keeps this myth in front of people is that few peopleactually do what they are supposed to do to manage diabetes. Forthem diabetes is progressive and their quality of life is often injeopardy.
Series 1 of 12.
Back to Diabetes Basics – Part 2
To contact us Click HERE
Why KeepDiabetes A Secret?
Having a diagnosis of type 2 diabetesis probably not something you would shout from the rooftop, butshould you keep it a secret? Many people do just this and will nottalk about it even to family members unless it is necessary. Extremesecrecy can be difficult. There was a situation a few years ago nearhere that made me laugh. Husband did not tell wife or anyone abouthis diabetes diagnosis. Two weeks later, his wife answered thetelephone, and it was husband's doctor office calling to remind himof his diabetes education class the next day.
When husband learned this had happened,he hired a lawyer to sue the doctor's office for failure to keep hismedical records private. Judge had a sense of humor and askedhusband if he loved his wife and he answered yes. The judge said ifthis were true, why had he attempted to keep his disease a secretfrom his wife? The judge said he could understand the secrecy desirefor the husband's affair uncovered by the sheriff. He handed downthe following judgment. One-dollar fine to the doctor office – toremind them to be more careful and court costs on the husband for thelawsuit and wasting the court's time. He gave instructions to thewife that should she ever decide to divorce her husband, all shewould need to do is file the paperwork and it would be granted. Inaddition, he wanted the court proceeding widely published.
PresentlyThere Is No Cure
A topic that often surfaces shortlyafter diagnosis is “the cure.” I am somewhat hesitant to discussthis here, but if I can prevent anyone from avoiding this approach,it will be worth it. There are charlatans out there just waiting toseparate you from your hard-earned money. They exist in small townAmerica, in the large cities, and on the internet. They have theskill and arguments to make it sound very convincing and may bedoctors or just cunning salespeople. They have one thought, and itis getting you to hand over your hard-earned money for their falseclaims. Read my blog here for more.
There are also researchers and medicalpeople that have plans to (as they claim) put diabetes is remission. They promote extreme low calorie regimens and certain supplementplans which may make it seem like diabetes is stopped and are safe touse. Just be careful as these are for the short term and researchhas not proven they will succeed for the long term. The stress onyour body using these extreme low calories diets has not beenresearched beyond a few months. They have proven that they work forthe short-term and that is their promotion to obtain your money. Then in a few months when your blood glucose levels start back towardthe stratosphere, they will try to sell you another round of the sameregimen. Your long-term health is being put in jeopardy. Do notattempt these plans without your doctor's knowledge.
Acronyms andTheir Use
As you start reading and looking forinformation on the Internet, you will come across many acronyms usedby people to avoid typing long or even short strings of words. Thiscan be discouraging for the new person with diabetes. What do theymean in the context of the sentence? One that you need to be verycareful with is this one – ADA. It still means American DiabetesAssociation and Americans with Disabilities Act. Many still use itfor the American Dietetic Association, but as of January 2012 it wasofficially changed to AND (Academy of Nutrition and Dietetics).
Changes in names can be a good thing,but the change above was solely to camouflage a takeover of competingoccupations and eliminate competition by criminalizing people notbecoming certified under their organization. This is not a veryprofessional objective.
How you see acronyms will vary witheach writer. Many will give the program or profession name in oneparagraph and then start using the acronym in the next or laterparagraphs. Others will use the full explanation followedimmediately by the acronym and then use the acronym for the rest ofthe article. Some writers assume that their readers know the meaningof the acronym and never give the full name. These are the writersthat make it difficult for all types of readers. Time after time.when there is the possibility of confusion, I have seen commentsasking for the full definition of an acronym. Some people areespecially sarcastic about this and provide a definition they know iswrong and abrasive, but the writer seldom clarifies. Some writers dothen provide the correct meaning for the acronym. A few writers docorrect their habits, and the rest just disappear.
I do use acronyms, and if you catch menot giving the full meaning, please let me know. I use the fulldefinition and then the acronym in parenthesis or the acronym withthe full definition in parenthesis. I have used the full definitionin the first paragraph or two and then start using the acronym;however, I am trying to break that habit.
Some of theTesting Basics
Hopefully, you are now comfortable withtesting and are doing it regularly. You need to understand what theblood glucose (BG) readings mean and what actions are available toyou. Whether you are endeavoring to manage your diabetes withexercise and diet without medications, or are using an oralmedication, you need education about both and when to test. Mosteveryone tests upon rising from sleep and this is termed fastingblood glucose (FBG) and your goal should be between 80 mg/dl(milligrams per deciliter) (4.4 mmol/L) and 100 mg/dl (5.6 mmol/L,(millimole per liter). Or, as many write, keep fasting blood glucose(FBG) under 100 mg/dl.
Then we come to the next meal. Hopefully, you will be under 100 mg/dl for the pre-meal blood glucosereading (preprandial). If you are not, then consider what you atethat would keep you higher. I like the goal of one hour post mealreading being 140 mg/dl (7.8 mmol/L) or lower (postprandial). At thetwo hour postprandial blood glucose reading should be 120 mg/dl (6.7mmol/L) or lower. However, if these become your goals, be careful aseating the American Diabetes Association's recommended mealconsumption of carbohydrates will make these goals unachievable formany patients.
Testing is the only way you have indetermining how different foods and food quantities affect your bloodglucose levels. A term you will see in blood glucose management isself-monitoring of blood glucose (SMBG – is the acronym). You willalso need to test more frequently in the beginning to learn how longbefore you reach the high level of your BG. Many suggest one hourafter first bite and for some people this can be too early. If youare a speedy eater (gobble down your food) this may work; however,studies have shown that you should eat slower for greater bloodglucose management. Some writers do use the word control instead ofmanage for the same meaning. Some will suggest testing more oftenuntil you are comfortable with when your high level of BG happens. Isuggest starting at the one-hour mark and testing every half hour thefirst few times until you see the readings start decline. Somepeople will test every 15 minutes. Somewhere between the highestreading and the lower next reading, the high may have occurred.
Occasionally the high mark can happenbefore the one-hour mark or beyond the three-hour mark. Thisindicates that the food you ate enters the blood stream quickly andwas easily digestible and probably contained little fiber, if any. If it is after three hours, this indicates a higher than normalamount of fat, example – pizza. If you are saying this isconfusing and too much to learn, you may as well know up front thatthere are not firm guides or rules to follow. It is important toknow that what works for me, may not work for you. It is importantto know that you need to become your own lab rat to determine how thedifferent foods affect your system and what works for you. Manypeople keep a detailed journal during this time of the readings, whatwas consumed, and other observations that they feel is important. Read my blog here for further discussion of postprandial testing.
How often you test will depend on yourdesire to bring diabetes under excellent management and your budget. You will also need to find out how willing your doctor is to go tobat for you with the insurance company for additional testingsupplies. Some companies will allow some extra test strips in thefirst few months, but then want to restrict you thereafter. Otherinsurance companies will only allow a set number of test strips perday. I recommend that you talk with your insurance company to findout what they are willing to allow. You may need to bargain withthem and attempt to convince them of the need for allowing more teststrips for the first three to five months. Don't be surprised if youare denied, but it is still worth the effort. If your budget willallow for the test strips, the knowledge you gain will be worth thecost. Medicare will not allow extra test strips.
As you are testing you are also lookingfor trends. If you are bouncing up and down at the two-hourpostprandial, looking at your food log may provide clues as to why. If your FBG is on an upward trend for a couple of weeks then beconcerned and be more careful of your last meal of the day. Also donot let a lot of time pass after rising in the morning as this allowsyour liver to dump more glucose into the system and can distort thetrend. Many people can also have what is termed the dawn phenomena(DP) which is the livers function to dump glucose into your system togive you energy for waking up and starting the day. Upward trendsshould always be of concern and if they continue or start to trendupward more rapidly, always consider talking with your doctor. Hemay request an office visit and may increase the dosage of yourmedication or start you on a new medication.
Never be concerned with some bouncingup or down of BG readings, as this can happen if you are coming downwith an illness or can vary with the food you ate at the previousmeal. Trends up or down for longer that a month should be talkedabout with your doctor. He/she may need to adjust you medication. Trends under 80 mg/dl should always be talked about with your doctor. More about this in the next blog.
Series 2 of 12
Why KeepDiabetes A Secret?
Having a diagnosis of type 2 diabetesis probably not something you would shout from the rooftop, butshould you keep it a secret? Many people do just this and will nottalk about it even to family members unless it is necessary. Extremesecrecy can be difficult. There was a situation a few years ago nearhere that made me laugh. Husband did not tell wife or anyone abouthis diabetes diagnosis. Two weeks later, his wife answered thetelephone, and it was husband's doctor office calling to remind himof his diabetes education class the next day.
When husband learned this had happened,he hired a lawyer to sue the doctor's office for failure to keep hismedical records private. Judge had a sense of humor and askedhusband if he loved his wife and he answered yes. The judge said ifthis were true, why had he attempted to keep his disease a secretfrom his wife? The judge said he could understand the secrecy desirefor the husband's affair uncovered by the sheriff. He handed downthe following judgment. One-dollar fine to the doctor office – toremind them to be more careful and court costs on the husband for thelawsuit and wasting the court's time. He gave instructions to thewife that should she ever decide to divorce her husband, all shewould need to do is file the paperwork and it would be granted. Inaddition, he wanted the court proceeding widely published.
PresentlyThere Is No Cure
A topic that often surfaces shortlyafter diagnosis is “the cure.” I am somewhat hesitant to discussthis here, but if I can prevent anyone from avoiding this approach,it will be worth it. There are charlatans out there just waiting toseparate you from your hard-earned money. They exist in small townAmerica, in the large cities, and on the internet. They have theskill and arguments to make it sound very convincing and may bedoctors or just cunning salespeople. They have one thought, and itis getting you to hand over your hard-earned money for their falseclaims. Read my blog here for more.
There are also researchers and medicalpeople that have plans to (as they claim) put diabetes is remission. They promote extreme low calorie regimens and certain supplementplans which may make it seem like diabetes is stopped and are safe touse. Just be careful as these are for the short term and researchhas not proven they will succeed for the long term. The stress onyour body using these extreme low calories diets has not beenresearched beyond a few months. They have proven that they work forthe short-term and that is their promotion to obtain your money. Then in a few months when your blood glucose levels start back towardthe stratosphere, they will try to sell you another round of the sameregimen. Your long-term health is being put in jeopardy. Do notattempt these plans without your doctor's knowledge.
Acronyms andTheir Use
As you start reading and looking forinformation on the Internet, you will come across many acronyms usedby people to avoid typing long or even short strings of words. Thiscan be discouraging for the new person with diabetes. What do theymean in the context of the sentence? One that you need to be verycareful with is this one – ADA. It still means American DiabetesAssociation and Americans with Disabilities Act. Many still use itfor the American Dietetic Association, but as of January 2012 it wasofficially changed to AND (Academy of Nutrition and Dietetics).
Changes in names can be a good thing,but the change above was solely to camouflage a takeover of competingoccupations and eliminate competition by criminalizing people notbecoming certified under their organization. This is not a veryprofessional objective.
How you see acronyms will vary witheach writer. Many will give the program or profession name in oneparagraph and then start using the acronym in the next or laterparagraphs. Others will use the full explanation followedimmediately by the acronym and then use the acronym for the rest ofthe article. Some writers assume that their readers know the meaningof the acronym and never give the full name. These are the writersthat make it difficult for all types of readers. Time after time.when there is the possibility of confusion, I have seen commentsasking for the full definition of an acronym. Some people areespecially sarcastic about this and provide a definition they know iswrong and abrasive, but the writer seldom clarifies. Some writers dothen provide the correct meaning for the acronym. A few writers docorrect their habits, and the rest just disappear.
I do use acronyms, and if you catch menot giving the full meaning, please let me know. I use the fulldefinition and then the acronym in parenthesis or the acronym withthe full definition in parenthesis. I have used the full definitionin the first paragraph or two and then start using the acronym;however, I am trying to break that habit.
Some of theTesting Basics
Hopefully, you are now comfortable withtesting and are doing it regularly. You need to understand what theblood glucose (BG) readings mean and what actions are available toyou. Whether you are endeavoring to manage your diabetes withexercise and diet without medications, or are using an oralmedication, you need education about both and when to test. Mosteveryone tests upon rising from sleep and this is termed fastingblood glucose (FBG) and your goal should be between 80 mg/dl(milligrams per deciliter) (4.4 mmol/L) and 100 mg/dl (5.6 mmol/L,(millimole per liter). Or, as many write, keep fasting blood glucose(FBG) under 100 mg/dl.
Then we come to the next meal. Hopefully, you will be under 100 mg/dl for the pre-meal blood glucosereading (preprandial). If you are not, then consider what you atethat would keep you higher. I like the goal of one hour post mealreading being 140 mg/dl (7.8 mmol/L) or lower (postprandial). At thetwo hour postprandial blood glucose reading should be 120 mg/dl (6.7mmol/L) or lower. However, if these become your goals, be careful aseating the American Diabetes Association's recommended mealconsumption of carbohydrates will make these goals unachievable formany patients.
Testing is the only way you have indetermining how different foods and food quantities affect your bloodglucose levels. A term you will see in blood glucose management isself-monitoring of blood glucose (SMBG – is the acronym). You willalso need to test more frequently in the beginning to learn how longbefore you reach the high level of your BG. Many suggest one hourafter first bite and for some people this can be too early. If youare a speedy eater (gobble down your food) this may work; however,studies have shown that you should eat slower for greater bloodglucose management. Some writers do use the word control instead ofmanage for the same meaning. Some will suggest testing more oftenuntil you are comfortable with when your high level of BG happens. Isuggest starting at the one-hour mark and testing every half hour thefirst few times until you see the readings start decline. Somepeople will test every 15 minutes. Somewhere between the highestreading and the lower next reading, the high may have occurred.
Occasionally the high mark can happenbefore the one-hour mark or beyond the three-hour mark. Thisindicates that the food you ate enters the blood stream quickly andwas easily digestible and probably contained little fiber, if any. If it is after three hours, this indicates a higher than normalamount of fat, example – pizza. If you are saying this isconfusing and too much to learn, you may as well know up front thatthere are not firm guides or rules to follow. It is important toknow that what works for me, may not work for you. It is importantto know that you need to become your own lab rat to determine how thedifferent foods affect your system and what works for you. Manypeople keep a detailed journal during this time of the readings, whatwas consumed, and other observations that they feel is important. Read my blog here for further discussion of postprandial testing.
How often you test will depend on yourdesire to bring diabetes under excellent management and your budget. You will also need to find out how willing your doctor is to go tobat for you with the insurance company for additional testingsupplies. Some companies will allow some extra test strips in thefirst few months, but then want to restrict you thereafter. Otherinsurance companies will only allow a set number of test strips perday. I recommend that you talk with your insurance company to findout what they are willing to allow. You may need to bargain withthem and attempt to convince them of the need for allowing more teststrips for the first three to five months. Don't be surprised if youare denied, but it is still worth the effort. If your budget willallow for the test strips, the knowledge you gain will be worth thecost. Medicare will not allow extra test strips.
As you are testing you are also lookingfor trends. If you are bouncing up and down at the two-hourpostprandial, looking at your food log may provide clues as to why. If your FBG is on an upward trend for a couple of weeks then beconcerned and be more careful of your last meal of the day. Also donot let a lot of time pass after rising in the morning as this allowsyour liver to dump more glucose into the system and can distort thetrend. Many people can also have what is termed the dawn phenomena(DP) which is the livers function to dump glucose into your system togive you energy for waking up and starting the day. Upward trendsshould always be of concern and if they continue or start to trendupward more rapidly, always consider talking with your doctor. Hemay request an office visit and may increase the dosage of yourmedication or start you on a new medication.
Never be concerned with some bouncingup or down of BG readings, as this can happen if you are coming downwith an illness or can vary with the food you ate at the previousmeal. Trends up or down for longer that a month should be talkedabout with your doctor. He/she may need to adjust you medication. Trends under 80 mg/dl should always be talked about with your doctor. More about this in the next blog.
Series 2 of 12
APS (Accessible Pedestrian Signals)
To contact us Click HERE
Yesterday on my way home from school I drove by this gigantic and gorgeous patch of pink tulips. With it being so nice outside I immediately decided I would hurry home and I was going to go for a walk from my apartment to this patch of tulips and take a picture. It ended up being quite a lengthy walk and the whole time all I was focused on was it felt good being outside with such nice weather, FINALLY, and how I needed to figure out something to blog about.
So on my walk to these fantastic tulips, I kept racking my brain about what I would hopefully see something that would spark a blog.
The entire walk nothing came about. All I could manage to think was that I was enjoying the exercise and how beautiful the weather was. As I got to the patch of tulips I pushed the button to cross the crosswalk and I realized that when you pushed the button it didn't even "push in" it just made a beep sound. And this caused me to think about in class when we were asked if we had ever heard of the "bird chirping" when it was safe to cross a crosswalk.
I remember the first time I ever heard the bird chirping sound. I was taking a student tour of the University of Oregon with my Honor's Society group and we were at a crosswalk and we heard that noise and I immediately thought what the heck is that and why is it doing it? Later on I discovered that this sound was to signal to the visually impaired pedestrians that it was safe to cross the crosswalk. I was so thrilled because I thought it was so awesome for those who couldn't seem themselves that it was safe to cross and only were able to rely on their hearing.
So, I decided to do a little bit of research and look up the details on the details of the APS (accessible pedestrian signal).
This is what I found: They only recently began to install APS systems because cars got quieter so it was much harder to hear cars moving. Also, another thing that was brought up about a year ago is that the bird chirping sound that signals its safe to cross sounds very familiar to a pretty popular bird up around Canada called the northern cardinal. They also said that the bird sound also seemed to imitate the sounds of cars backing up or the turn signal of some motorcycles so it became confusing.
But, now that I think about it, the last time I used a crosswalk the sound I heard was more of a two tones beeping sound.
It just seems so crazy to me how difficult it'd be to actually get around especially if you knew what the northern cardinal bird sounded like you'd be a bit confused and that would be extremely frustrating.
It's also amazing to just open up all of your senses and realize what's going on around you and notice that I, myself, have heard two different APS noises and never actually realized it until now.
Yesterday on my way home from school I drove by this gigantic and gorgeous patch of pink tulips. With it being so nice outside I immediately decided I would hurry home and I was going to go for a walk from my apartment to this patch of tulips and take a picture. It ended up being quite a lengthy walk and the whole time all I was focused on was it felt good being outside with such nice weather, FINALLY, and how I needed to figure out something to blog about.So on my walk to these fantastic tulips, I kept racking my brain about what I would hopefully see something that would spark a blog.
The entire walk nothing came about. All I could manage to think was that I was enjoying the exercise and how beautiful the weather was. As I got to the patch of tulips I pushed the button to cross the crosswalk and I realized that when you pushed the button it didn't even "push in" it just made a beep sound. And this caused me to think about in class when we were asked if we had ever heard of the "bird chirping" when it was safe to cross a crosswalk.
I remember the first time I ever heard the bird chirping sound. I was taking a student tour of the University of Oregon with my Honor's Society group and we were at a crosswalk and we heard that noise and I immediately thought what the heck is that and why is it doing it? Later on I discovered that this sound was to signal to the visually impaired pedestrians that it was safe to cross the crosswalk. I was so thrilled because I thought it was so awesome for those who couldn't seem themselves that it was safe to cross and only were able to rely on their hearing.
So, I decided to do a little bit of research and look up the details on the details of the APS (accessible pedestrian signal).
This is what I found: They only recently began to install APS systems because cars got quieter so it was much harder to hear cars moving. Also, another thing that was brought up about a year ago is that the bird chirping sound that signals its safe to cross sounds very familiar to a pretty popular bird up around Canada called the northern cardinal. They also said that the bird sound also seemed to imitate the sounds of cars backing up or the turn signal of some motorcycles so it became confusing.
But, now that I think about it, the last time I used a crosswalk the sound I heard was more of a two tones beeping sound.
It just seems so crazy to me how difficult it'd be to actually get around especially if you knew what the northern cardinal bird sounded like you'd be a bit confused and that would be extremely frustrating.
It's also amazing to just open up all of your senses and realize what's going on around you and notice that I, myself, have heard two different APS noises and never actually realized it until now.
Let's Focus on the Up Side...
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For this blog I wanted to write about the up side of things we are getting RIGHT in the world of human factors. I didn't want to find anything negative or something could improve on, because, let's face it....the world is always changing and adapting. Slowly, but surely. I've recently been apartment hunting a little for when I get married in August. During my search I have almost always come across a little wheel chair sign at the bottom of the website I was looking at townhouses on. For a while I couldn't figure out what it meant. Then I took a drive to one of the town homes I had looked at online and I realized that most apartment complexes or even town home community make special areas for the handicap to live. For instance these particular town homes I was looking at were all multi level and when I drove around I saw some one level homes.
It dawned on me later that that particular row was for the handicap, because they were all one level, they had special parking so that those residents didn't have to go so far to get into their home.
It impressed me, and maybe it's only something small. However, I love that they do this because they are able to have all kinds of residents and don't have to turn away residents who wouldn't be able to live in a multi level home.
It dawned on me later that that particular row was for the handicap, because they were all one level, they had special parking so that those residents didn't have to go so far to get into their home.
It impressed me, and maybe it's only something small. However, I love that they do this because they are able to have all kinds of residents and don't have to turn away residents who wouldn't be able to live in a multi level home.
Designing Isn't Just for Adults..
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I think that our field kind of has some negative views sometimes. People don't really know what we do or understand what we do. They think that we simply "fluff pillows and pick paint chips."
However, we know that this isn't the case. We know that we do much more than this. People don't understand that we are going to school to make their lives better and more comfortable. We know stuff that could make a difference in the way that they live.
It never ceases to amaze me the amount of knowledge I learn everyday about our field of choice. When I gave my presentation last week it amazed me the certain things we could do to even improve a newborns room by putting in sound systems. Or even when Marcene did the presentation on health care environments and she talked about how they were painting their machines bright colors or making them look like something cool and not a big scary MRI machine. It's amazing how even just those small touches can improve the way a child might behave and not be scared to go to the doctor.
There is all sorts of knowledge out there for us to learn how to design and it's not just for adults and elderly. It's very useful for children too.
However, we know that this isn't the case. We know that we do much more than this. People don't understand that we are going to school to make their lives better and more comfortable. We know stuff that could make a difference in the way that they live.
It never ceases to amaze me the amount of knowledge I learn everyday about our field of choice. When I gave my presentation last week it amazed me the certain things we could do to even improve a newborns room by putting in sound systems. Or even when Marcene did the presentation on health care environments and she talked about how they were painting their machines bright colors or making them look like something cool and not a big scary MRI machine. It's amazing how even just those small touches can improve the way a child might behave and not be scared to go to the doctor.
There is all sorts of knowledge out there for us to learn how to design and it's not just for adults and elderly. It's very useful for children too.
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