“So, that’s my diagnosis story, and those are the tools I use to manage my diabetes.” A few weeks ago I found myself babbling about diabetes to a class of high school juniors enrolled in a special medical interventions honors course. “Any questions?”

Slowly, hands started to go in the air. 

“How does having diabetes impact your work out routine?”

“What does it feel like when your blood sugar is high or low?”

“How do you move that thing [infusion site] around?”

“Can you wear that insulin pump while playing sports?”

“Is there anything you can’t eat?”

“Have you had any close calls when it comes to your blood sugar levels?”

These kids were smart. Their questions were well-informed and sincere. I soon realized that I had underestimated them, not really thinking about what type of kids would be enrolling in a medical interventions course.

We talked about the Pizza Effect, we talked about waking up in a hospital in Japan, we talked about how a CGM measures interstitial fluids and not actual blood glucose, we talked about wedding catering and carbohydrate counts, we talked about the term “bolus-worthy,” we talked about teflon cannulas and wire sensors and all the places you can hide an insulin pump. And when we talked about my symptoms of hypoglycemia, the teacher chimed in and told a story about how defiant I get when my blood glucose is low. She had every right – she’s experienced it several times. Why? Because she’s my mom. And she’s teaching a damn smart class.

“So, do you have any idea why this happened to you?” asked one boy toward the end of the class. “I mean, did you do something earlier that might have caused this, or did you just wake up and…”

“Yeah, I had no clue, no relatives with diabetes. I was diagnosed and… that was that. My life changed pretty quickly.”

“Whoa,” he said, “That’s like… like a wrecking ball in your life!”

I couldn’t argue with him.

We had talked for more than an hour and by the end of it, my faith in humanity was strengthened and my belief that there will someday be a cure was reaffirmed. Why? Because these kids are smart, they are doing their best to “get it,” and they are literally the future. That’s something to look forward to. Thanks to the students for the conversation and to my mom for making it happen.

I like to think that reality TV is finally on a downswing and will soon fade out of our culture. But I’m not sure that’s true and I’m not interested enough to keep up with its trends. From time to time, however, I may spend a few minutes being amused by the over-done non-acting and “you won’t believe what happened next” marketing to keep viewers with what are, apparently, 10-second attention spans. What if there was a diabetes reality TV show? I’m just riffing here, but what would this look like?

So here are a few ideas, although I will fully admit that they are based on my limited exposure to these types of shows.

Top ‘Betes: 10 contestants with diabetes all wearing CGMs and design and eat meals with the goal of achieving the most near-perfect blood sugar levels. The back-stabbing starts when they try to switch in regular soda for diet soda. The tagline: “Pumps down, CGMs up!”

Project Diaway: 10 contestants with diabetes, all designing the best new way to deliver insulin or monitor blood glucose or maybe even design clothes to help them wear/carry their diabetes supplies (because, in my opinion, the world does not have enough functional pockets). The snark-talk about each other would probably have something to do with the weight, size and innovation of each device or system. The tagline: “With diabetes, one day you have it, and the next day you have it, too.”

Real Diabetics (a term only slightly more offensive than “housewife”) of the Internet: The would be the ugliest of the DOC multiplied by 100. There would be smack talk (“chocolate isn’t a fast-acting carb, so if you’re that low why would you do that? Ugh!”), the pseudo-friendly comments in response to posts (“I appreciate different perspectives, but…”), and the fast-and-furious social hour of #dsma (if only we could get someone to overturn a table on Twitter!).

Diabetes-ing with the CDEs: When celebrities with diabetes are paired with top-notch CDEs to try to get level lines on their CGMs. There would be meal prep, exercise, stress reduction, dosage tailoring, and oh-so-much-more. Mostly supportive, a little tough-love training, and sure – there could be some glitzy outfits, too.

Survior[alism]. Basic, day-to-day life with diabetes. No need for an island or challenge. We’ve got enough challenges. But the hype reels for this could be fun. “She was about to sit down to lunch, but when she checked her blood sugar…” (camera pans from the blood glucose meter to the person testing. Slowly she curses while sucking the blood off her finger tip).

Wow. All of these sound horribly boring. But at the same time, the originals are pretty bad, too. Just a thought – this is where my brain goes if I give it the space. Maybe I shouldn’t type it all out, but there you go!

Happy November! It’s Diabetes Month! That means we get to clap our hands and spread the word of life with diabetes. Or diabetes prevention. Or prevention of diabetes complications. Or diabetes statistics. Or blah, blah, blah, diabetes, blah, blah. I have done this in some way, shape or form every year since I was diagnosed. But you’ll have to forgive me – I just can’t do it. Not this year. This year I’m just going to keep doing what I do. Why? Because I don’t need a PR hook to celebrate my life with a chronic illness.

If you’re unfamiliar with the term “PR hook,” here’s the basic concept: It’s whatever makes your news interesting and timely. For example, few people will care about the specifics of Ebola – until there is an epidemic. With health observances, however, it’s a little more manufactured: a designated day, week or month when you get to say the same thing to the media, but can pitch your observance as the “hook” as to why they need to be writing about your observance.

Now, don’t get me wrong – I am glad that November can inspire people to raise their voice, wear whatever color they identify with, raise some much-needed funds, and cause a big fuss about diabetes. Because diabetes deserves a big fuss [*cough* and a cure *cough, cough*]. But I am not color-driven and I am not a fundraiser. I raise my voice when I feel the need – which has never adhered to an annual basis.

Many people don’t realize this, but there are some organizational politics involved in November, too. To “Big Red” it’s American Diabetes Month. To the folks at the NIH, including NIDDK and NDEP, it’s National Diabetes Month. Both of those names are extensions of each organization’s branding. Frankly, I don’t want to put too much thought into whichever term I choose to use.

And speaking of well-branded organizations, there’s another point I’d like to make about Diabetes Month: the audience is so broad – type 1, type 2, friends and family, those at risk, etc. – that it’s nearly impossible to speak to all of them at once. I was reminded of this when I saw a new campaign launched recently about America Gets Cooking to Stop Diabetes… Well, folks, that clearly is not even in the realm of possibility when it comes to my diabetes. Sure, I can share, but that’s a particularly polarizing message and leaves too many of us out of the picture during a month that is supposed to “belong” to us?

Instead I am choosing to celebrate to the best of my abilities: to keep living my little life with my imperfect pancreas, to continue to post about this little life of mine, and to continue to do these two things once November is over.

I will admit that part of this may be due to the fact that I often find myself on the verge of diabetes burnout. And Diabetes Month can exacerbate that burnout. I’d rather keep steady and stay away from burnout.I say this in case anyone else out there feels the same way, and perhaps needs to hear that this is okay (it is!).

Abstaining from Diabetes Month is my own choice – I’m not against it, I just don’t think it’s worth mustering the extra energy right now to give it an extra spotlight. Maybe next year. Maybe not.

And, for what it’s worth, the month of November is also a hook for COPD, Lung Cancer, Alzheimer’s, Healthy Skin, Family Caregivers, Hospice Palliative Care, and Stomach Cancer. Cheers!

My first job out of college was teaching English in rural Japan. I agreed to take the job during my senior year – before I could speak any Japanese and while still within my first full year of having diabetes. After graduation, I enrolled in an intensive language program and three months later, I flew to Japan. And yes, my diabetes came with me. The placement agency that hired me put me in a small town that was only an hour’s drive from the prefecture capital where there would, as they said, be hospitals equipped to handle my diabetes “in case anything went wrong.” To this day, I don’t think they realize what a smart decision that was.

It was about 18 months into my initial two-year contract – January of 2004. My then-boyfriend, Kazu, had come over one Friday night and we made ramen noodles for dinner. We went to sleep and the next thing I remember was having a bizarre dream about looking at a clock and seeing it was after 6 – but I didn’t know if that meant morning or evening – and I was surrounded by strange Japanese men who were talking to me. One of them seemed familiar, but I couldn’t say how I knew him or what his name was.

I decided that the dream I was apparently having was lame and I wanted to go back to sleep, but I couldn’t. Slowly, I started interacting with the familiar man. Yes, I knew who he was – but no, I didn’t know his name. No, I didn’t know where I was. Should I be speaking English or Japanese? I was laying down and felt that was the cause of my disorientation. I had to sit up to help wake from the dream, but I couldn’t. I realized I didn’t have any underwear on, and suddenly I became fixated on that – of all the things that were happening, that seemed like the biggest mystery. Someone kept taking blood glucose readings from my ear lobe. I began to realize it was not a dream and that the familiar man was, in fact, Kazu.

Here is what I learned after the fact:

I had gone severely hypoglycemic in the middle of the night. I didn’t have seizures, but I also didn’t wake up in the morning. Kazu had decided to let me sleep in, although he thought it was strange that I continued to sleep well past noon. By 3pm he called his mother, who was a nurse. She told him to call an ambulance, and he did. I was driven the 30 miles to the capital city, Morioka, in approximately 30 minutes – half the time the drive normally took. When I got to the hospital, my blood glucose was 21 mg/dl.

The doctors wanted to give me glucose through an IV, but couldn’t find a vein because I was dehydrated. Eventually, they had to cut off my underwear and place the IV in my leg near my hip. Once I came to, I demanded that my insulin pump, which had been running the entire time, be disconnected. They kept me there a few hours to ensure my blood glucose levels had stabilized and Kazu stayed with me the whole time. I remember being scared, asking him to talk to me, to tell me a story. I specifically remember requesting Cinderella, not realizing how difficult terms like “glass slipper” and “fairy god mother” would be in a different language, but he did his best. When we were finally released it was quite late at night and his mother came with warm clothes and drove us back to my apartment. It was only the second time I’d ever met her and I was completely mortified.

Once we’d gotten home, I started to vomit. We’d been warned that could happen due to the sudden changes in blood glucose levels. I was worried about putting my insulin pump back on. I was even more worried about sleeping that night, and for many nights after that.

I cannot tell you how horrible it is to have to make the phone calls I needed to make the following day to my family members who were 10,000 miles away to explain what had happened, that I was fine, and that I was planning to stay in Japan. Worse, I cannot tell you how horrible the conversations were a month later when the same thing happened all. over. again. But I did learn a lot about my body’s response to hypoglycemia and what factors could exacerbate it for me. I also learned about the fog that hypoglycemia can create, the sense of altered reality that feels like a dream, a video game, or some other non-critical experience. It was the first of several valuable diabetes lessons that I hope no else else has to experience.

It’s been nearly 10 years since I last spoke to Kazu, but I still appreciate that he did, in fact, save my life.