What I Learned: Reliving the Holocaust

My trip to Washington, DC brought some unforgettable surprises with my Diabetes. Here are several important things that I learned from it:

1. Intense heat can play havoc on your sugar levels.

2. Eat small snacks in between a long delay of meals to keep you BG levels in check.

3. Wear a medic alert bracelet or necklace, it saved my life.

4. When not feeling 100 percent, tell someone.

5. Check your blood sugar with a glucose monitor frequently.

6. Don't walk across four lanes of traffic!

7. Now being older, I actually like Vermont quite a bit. It's a very peaceful place with great people and scenery. The skiing also rocks!

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Walking Small: Reliving the Holocaust

Spring in DC felt like summer in Africa. Temperatures were soaring and the soles of my shoes were getting up close and personal with the concrete in a sticky way. The couple of days away from the normal grind of classes were welcomed, no matter how hot it was.

Once a year, sophomores at the Green Mountain Valley School are treated with a trip to either New York City or Washington, DC. Since I had been to The City so many times before, I decided to go against the grain and check out our nation's capital instead. The trip from Vermont to DC was long, but I didn’t mind. I was escaping from Vermont, for young people a not so exciting state, unless if you are really into cows and Ben and Jerry’s. Our first stop on the trip was a gloomy one, the Holocaust Museum.

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"The Holocaust is the state-sponsored systematic persecution and annihilation of European Jewry by Nazi Germany and its collaborators between 1933 and 1945. Jews were the primary victims -- six million were murdered; Roma and Sinti (Gypsies), people with mental and physical disabilities, and Poles were also targeted for destruction or decimation for racial, ethnic, or national reasons. Millions more, including homosexuals, Jehovah's Witnesses, Soviet prisoners of war, and political dissidents, also suffered grievous oppression and death under Nazi Germany."
(Source: USHMM FAQ)

The building looked like a concrete fortress on the outside surrounded by a moat of flowing street traffic. With the hot sun beating down upon our bodies, our school group rushed inside to the museum’s wonderfully accurate, cooled enclosure. The day was young and we were full of energy. Each of the three floors of the museum would provide our eager minds and bodies with the entertainment we would need for the next several hours.

I took it all in, and as quickly as possible. My attention span seemed minimal at best as I shot from one exhibit to the next. In what seemed to be approximately 5 minutes, I and a few friends had navigated through the three floors; it had all gone by in a blur. Considering that the rest of our group was only half-way through the tour, one more go-around seemed appropriate, so we started our sprint again.

Were we running? It felt like it as the exhibits passed by with blazing speed. The air is getting hotter in the building, maybe they had turned down the air conditioning to save money. My legs were tired from all this exercise. I had finished my walk through again before the rest of my group had even finished their first. I sat down on a marble bench near the entrance. The dome that enclosed the entrance was ever so slightly expanding before my eyes...

Had I fallen asleep? I think I'm dreaming. Feeling as light as a feather I levitate to my feet. My steps seem to slow in my dreamlike state. I'm not controlling my body anymore as some supernatural power floats me from one point to another. I can see people walking by me as I open the doors to another world. Everything is bright, hazy and feels soft to the touch. Am I dead? This place doesn't look like heaven...

And heaven it was not. The quick pulsating sounds of the ambulance brought me back to reality. Awkwardness stared back at me in the form of a paramedic. His eyes darted away as he checked my vitals. Not again I thought to myself. My mind had cleared, I know what had probably happened, I just couldn't remember how or why.

"I’m going to ask you a few questions, answer them to the best of your knowledge.", "Ok.", "What’s your name?", "Marc Epstein", "When where you born?", "February 25th, 1984", "What year is it?", "2000". There was one question that baffled me, an important one, "Where are you right now?", "An ambulance", "I meant, what city?", "Um...I don't know". How could I not know where I am? I thought long and hard, but the answer never came to me. The ride seemed short but stressful to the hospital.

I lay in confusion on the hospital bed for what seemed like hours. Would my group ever find me, would I be in trouble? Had I done anything absurd? I gave the nurses all the information I had about the school I went to, what my teacher's names were. They took the information from my medical alert necklace to call my parents and inform them of the situation.

Somehow, without my knowledge, the connections were made and my group was notified of my location, which I still was unsure of. When I was finally picked up by my caretakers, I was given the story of what supposedly happened.

More than likely, all the running around had put some strain on my blood sugar levels. I hadn't eaten anything since breakfast and by the time I had finished my second viewing of the Holocaust Museum it was already around 12:30pm. Combining this with the extreme temperatures outside threw me into a Diabetic reaction. One that made me lose all touch with reality.

I had wandered around the main entrance hall of the museum for a few minutes, and then decided to venture outside, never a good thing when you're in a drunken like state. After taking in the view, I decided to go for a stroll across 4 lanes of traffic. Fortunately a police officer noticed me before I was struck by a moving vehicle. He grabbed me, called for an ambulance, and then I was whisked away. The rest, is history.

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BG Levels: The Weekly Roundup

Even though my blood sugar testing started out very sporadic, I'm glad to report that Sunday was a lot smoother. I feel that my morning levels are high due to my craving of food right before bed time. This is something that I will have to gradually reduce as time passes.

Last night I had a bowl of Lucky Charms before falling asleep. My sugar suffered a bit in the morning, but it felt so worth it! Maybe I can cut down to half a bowl :). Well, without further adieu, here is the weekly roundup of my sugars including today:

2/5/09:
9:45pm - 129
2/6/09:
7:32am - 239
12:50pm - 67
7:40pm - 278
9:53pm - 50
2/7/09:
9:00am - 200
12:30pm - 194
5:30pm - 65
2/8/09:
7:45am - 209
1:24pm - 130
7:17pm - 110

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BG Levels: Update 2/7/09

So my second full day of testing has shown some sporadic results. I feel that this may be because I am overreacting to a result and counteracting with either too much insulin or too much food. In the long run I would like to eventually show a more stabilized pattern in my BG testing. Currently I would be comfortable with a range from 100 to 125.

Personally when I get to around 80, I feel a little nervous. Last night right before dinner I had a high sugar and decided to take 5 units of Apidra to lower it. Unfortunately I decided to skip out on all the carbohydrates in my meal and eat just the chicken and salad (no bread). When I checked myself later that night, my sugar had dropped a little quicker than I expected. I drank a glass of OJ to fix the problem.

I also had a snack bar before bed, but probably didn't need it as you can see from my morning result:

2/6/09:
7:40pm - 278
9:53pm - 50
2/7/09:
9:00am - 200
12:30 - 194

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BG Levels: I'm Checking In

Ok, I'm going to tell you a little secret. I haven't been checking my blood sugar levels consistently for quite some time now. Every once and a while I go through a phase where I start checking my BG (blood glucose), and I try to stick with it, but then something clicks off in my brain and I stop testing.

So from last night at about 9:45 I will start checking my levels again, hopefully for good. I will update you daily with a single posting of my blood sugars for that day and then a weekly roundup at the end of the week. If I don't post my BG levels for a certain day that could mean one of two things: either I forgot to post or I have stopped monitoring.

If I stop monitoring, feel free to send me a nasty email or comment via the posts (not too nasty please :) ). My goal is at least 3 checks per day (breakfast, lunch, dinner) Below are my BG readouts from last night until lunch today:

2/5/09:
9:45pm - 129
2/6/09:
7:32am - 239 (Little high, I had a bite to eat right before sleeping)
12:50pm - 67 (Eating a little later than usual - work related)

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Diabetes 101 - By Naomi Cook

Naomi Cook earned her bachelors in Animal Science from Cornell University and received her masters from NYU in Science Education. Currently Naomi teaches AP Biology in Wetchester, NY. She includes concepts from both Type 1 + 2 Diabetes in her core curriculum.

Diabetes is literally a disorder that results in increased urination. This can be directly caused by a higher than normal blood glucose (sugar) level, as the kidneys work harder to rid the body of the excess glucose. The hormone insulin is produced by the pancreas and acts like a chemical messenger that instructs cells to allow glucose in. Once in the cell, glucose can be oxidized to release energy for life functions or it can be stored in the cells of the liver as a molecule called glycogen. When insulin is produced and cells are responding to it properly, blood glucose levels are stable. When a person’s cells become either unable to respond to insulin or unable to produce insulin, blood glucose levels increase and Diabetes results. There are two types of Diabetes, Type I and Type II.

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Type I Diabetes occurs when the body stops producing insulin, usually during childhood. The Type I Diabetic injects insulin in order to regulate his or her own blood glucose level. There is currently no cure for Type I Diabetes. Type II Diabetes occurs when the body continues to produce insulin, but cells become unresponsive to the insulin. Therefore, Type II Diabetics do not take insulin. Instead, they regulate their blood glucose levels through diet and exercise. Unlike Type I, Type II Diabetes usually develops in adulthood.

In Type I Diabetes, the insulin producing cells of the pancreas called the Islets of Langerhans, are attacked by the person’s own immune system. We do not know why this happens yet, but it usually occurs in childhood and scientists think that it may be linked to genetics or viral infections. As a result, that person stops producing insulin, and blood glucose levels increase. This is called hyperglycemia and occurs when a Type I Diabetic eats a large meal. The person will experience increased urination, thirst, fatigue, blurry vision and nausea. In order to prevent this, he or she injects insulin, which will lower blood glucose.

If too much insulin is taken, hypoglycemia (low blood sugar) can occur. This is process is exaggerated with either not enough food intake or when the person engages in physical activity. The symptoms of hypoglycemia are sweating, shakiness, hunger and dizziness. If not treated, hypoglycemia can result in slurred speech, drowsiness, confusion and in its worst case, diabetic coma as the organs of the body shut down because they are starved for glucose. The most effective treatment is ingesting anything with high levels of sugar such as juice or candy.

A condition called ketoacidosis may also result because cells are not getting the glucose they need. This can happen if the Diabetic is not taking his or her insulin and glucose is not able to enter into the cell. Cells will begin to excessively utilize fats and proteins for energy. Unfortunately, the byproducts of this reaction are ketones, which are toxic to the body.

The Type I Diabetic is responsible for lowering blood glucose after a meal by injecting insulin, but not letting it get so low that hypoglycemia begins to happen. It’s a difficult task. Because insulin is a peptide (a small protein) it can not be taken as a pill. Proteins are digested into their amino acid building blocks in the stomach, before the Diabetic can absorb the insulin into the blood stream. Therefore, it must be injected, making treatment even more complicated, but extremely important.

If not controlled, the short term effects of hypoglycemia can be dramatic and dangerous. The long term effects of hyperglycemia can seriously affect quality of life. Damage to the tissue of the heart can lead to heart attack, stroke and high blood pressure. Damage to blood vessels serving the retina can lead to blindness. Nerve damage in the leg may lead to tingling, numbness and an inability for wounds to heal. Nerve damage to the kidneys can result in kidney failure.

In Type II Diabetes, the person’s cells become unresponsive to insulin, even though the pancreas continues to produce it. Similar to Type I Diabetes, blood glucose levels will increase. Because cells are unresponsive to insulin, Type II Diabetics do not control their sugar by taking insulin. They must do so through diet and exercise. As Type II Diabetes progress, the pancreas continues producing insulin even though cells remain unresponsive, and can eventually become overwhelmed. At this point, the Islets of Langerhans stop producing insulin and the Diabetic may need to start insulin treatment. Type II Diabetics can suffer from hyperglycemia and will also suffer from hypoglycemia if they are on glucose lowering medications. If blood glucose is not regulated, the long term effects of hyperglycemia will damage tissue just as it does with the Type I Diabetic.

Although the exact mechanism for developing Type II Diabetes is unknown, certain factors seem to increase the likelihood that a person’s cells will become unresponsive to insulin. Excess fatty tissue and inactivity is linked to Type II Diabetes. Unlike Type I Diabetes, a person’s risk increases with age. There also appears to be a genetic link to Type II Diabetes. A person’s risk increases if a sibling or parent has the disease, and certain races such as Asians Americans, Native Americans, Hispanics and Blacks have higher incidences of Type II Diabetes.

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Walking Tall: Biking for Charity

This past summer I started biking(road cycling) to help with my cardio. For me running puts a lot of stress on my back and feet so I wanted to find an exercise that was fun, exciting, and kept me in shape. Biking is all that rolled up into one.

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While riding during the summer I noticed a charity bike event for the Kelly Brush Foundation called the Kelly Brush Century Ride. I decided to sign up for 1 loop which is half of a century (50 miles).

Starting out was tough, as is with almost any sport, but once I started to get into better shape, I noticed my mileage increasing each ride. 50 miles seemed like an unreachable distance at first, but a friend of mine let me tag along with him while he rode which kept me motivated. We pushed each other to the next level every mile we rode.

The training cut off extra fat from my body, I felt better than I ever did, and my metabolism shot up decreasing the amount of insulin needed for my Diabetes. Riding outside on the warm summer days was joyful and helped me forget about any problems I was having with normal day life (at least temporarily). Relieving stress is an important part of Diabetes control for me.

Well the day came for my charity bike adventure and I felt both nervous and prepared. The weather was a little cloudy and cool, perfect for biking. I decided to bring with me two power bars, a bottle of water and a bottle of Gatorade/water mix. Its always important to be prepared for any type of exercise with food and water, Diabetic or not. My bg tested normal and I was ready.

The ride started out strong with me keeping pace with the top guys in the event. I know it wasn't a race, but I have such a competitive nature! After about 12 miles I decided to drop off of the front peloton to conserve energy because I knew that I wouldn't be able to keep up that pace for 50 miles. Around mile 20 I decided to eat half of my power bar to keep my carbohydrate levels up. I felt strong all the way until about mile 40 and then the long hills came into play.

Never been a great hill climber (in my minimal experience), but I kept pushing, even at a slower than average pace. I wasn't with the elite, but I was doing better than the average cyclist in the event. I was tired for the last 3 miles of the ride but when I saw the finish I realized that I had accomplished my goal.

I finished the ride in 2 hours and 37 minutes, around a 19 mph pace. I felt great. My blood sugar was in check throughout the whole ride, I had fun, and I did better than I expected. I guess you can say that I was Walking Tall that day, or would that be riding?

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