The Healthcare Experience – #DBlogWeek Day 4

Our topic today is The Healthcare Experience.  Most people who live with a chronic illness end up with a lot of experience when it comes to dealing with healthcare. How would you improve or change your healthcare experience? What would you like to see happening during medical visits with your healthcare team? How about when dealing with your health insurance companies? What’s your Healthcare Wish List or Biggest Frustration? Today is the day to share it all!

Before I say anything here I would like to draw your attention to the fact that all of my diabetes care is government funded in New Zealand and because of this there are a great deal of factors that are beyond the control of HCP’s and as a result are not their fault. 

I’ll start with what frustrates me about the healthcare system at present with it’s treatment of T1D because I want to finish on a high 😉

There are only two things that I can really pick on with T1D management and in the grand scheme of things, when compared to some other countries these are not worth complaining about.

The first is that resources for T1D management are limited and controlled by the government. As i’m sure we have all seen on other blogs, Facebook pages and websites there is a plethora of resources available to assist with T1D management but in New Zealand only ones that the Government approves of are allowed to be sold within the country and only one brand of blood glucose meter and test strips are funded, there is a constant battle between people having to use these resources daily and the Government as often these resources are not appropriate or of good enough quality/reliability. When living with a chronic illness I believe it is really important to acknowledge that every individual is just that, an individual, the way that they choose to live their lives is different, what they face each day is different and because of this different management techniques suit different people. There is not, has not been and never will be a one size fits all management strategy for people with T1D and I really would like to see the Government acknowledge this and make moves to allow and fund more management resources within the country.

The second is a mixture of the training provided to staff members and access to trained staff members. I think that as someone with a chronic illness you become an expert on it, lets face it you live with it 24/7, you deal with the highs and lows and manage every aspect, often unassisted so you have a great deal more time to gain experience and knowledge because of this I feel the need to point out that HCP’s do not (on the whole) get this experience and therefore I don’t feel I can judge them too harshly. BUT I have noticed that there is this feeling of ‘I’ve been trained about this so I know, now do what I say’ that appears to come from some medical staff (to be fair these staff members are the ones working generically not specifically in T1D) but it can be really affronting to be told that you basically don’t know anything and should just do what you are told. Often what is suggested is very old hat or basic and if you are like me you are quite a bit more advanced and do actually have an understanding on a more biological level. I would really like to see more compassion and acknowledgement that I, as a patient may actually have some knowledge on the topic and my illness can be discussed WITH me instead of just IN FRONT of me and a slightly less ‘high and mighty’ approach from HCP’s (I must stress here that most of the people I have experienced this kind of attitude with have been younger new grads and I do wonder if it is just a younger person thing?) I am someone who does not reach out for medical help with their T1D until they really have to, if I have scrapped the bottom of the barrel and there is no where left to go then I will look for help but all too often I cannot get the help and feel left hanging 😦 it’s a horrible feeling and situation to be in and makes me feel really vulnerable. Unfortunately it is all down to funding, there is not enough staff to  have an expert available 24/7, the staff do try but things have to be prioritized and if the list is long things can get lost.

Overall, for me personally, I don’t see my endocrinologist any more than once a year as her understanding of pumps is not enough to assist in my management. I see one nurse every 3months who I have an amazing relationship with and cannot speak highly enough of! I have had her since I was 10 and admittedly have not always had the best relationship with her but as I have grown up this has improved. My only complaint is that she is so busy that I cannot get hold of her easily when I need to but this is not her fault, it is due to staffing and funding.

Last of all, what am I doing about all of this. I feel that it is all very well to sit and tell you what I don’t like and how hard I have it but I don’t really feel I have the right to unless I am actively trying to change it. So I became a ‘Friend of the Medical School’ I go in whenever I am called and attend lectures or small classes on one of the various things that is wrong with me and the students quiz, poke, prod and examine me. We talk about how my conditions effect my life, my health, my lifestyle. The resources I use, how they help and what would be more helpful if it were available. It provides an opportunity for the students to view T1D and other conditions through a different lens and hopefully allows them to come away with a rounder view on the condition, rather than just viewing it through a purely medical lens. I get asked questions that I had never thought of and I get to share information that I feel is important for these young Doctors to know before they begin their practice. They hopefully come away with more knowledge and I come away with a feeling that i have done some good in enabling them to have more understanding about various conditions and making them think more before jumping to conclusions. It allows me to feel like my conditions are being used for good and it is not all just bad my having them.

All in all I am extremely lucky with the medical treatment and resources available to me, yes there could be vast improvements but I am alive and have a very reasonable quality of life because of these treatments and resources, which I am very grateful for.

 

Hope

Language and Diabetes-#DBlog Week Day 3

Our topic today is Language and Diabetes.  There is an old saying that states “Sticks and stones may break my bones, but words will never hurt me”. I’m willing to bet we’ve all disagreed with this at some point, and especially when it comes to diabetes. Many advocate for the importance of using non-stigmatizing, inclusive and non-judgmental language when speaking about or to people with diabetes. For some, they don’t care, others care passionately. Where do you stand when it comes to “person with diabetes” versus “diabetic”, or “checking” blood sugar versus “testing”, or any of the tons of other examples? Let’s explore the power of words, but please remember to keep things respectful.

Hmmm, I feel like this topic is one that is locked, loaded and ready to explode so I am approaching it very warily. Please note that what I say within this blog (as with most of them) is my own personal experience and feelings/thoughts, everyone is different, you do not have to share in my opinions but if you do that’s great.

There are many quotes available on how important our words are, the impact they have and how they can cut deeper than any sword and do more damage than a beating. I’m sure that we have all experienced the full impact of cruelly directed words at one point or another, I know that I have been in tears over words said about my diabetes or management online or in person, I have felt made to feel bad about the way in which I choose to manage my diabetes or made to feel that because I don’t follow diets or regimes my bad blood sugars are my fault and to be blunt, it sucks. We can all say that things people say don’t affect us but deep down words all do something.

I try to be very careful with how I phrase things and put my opinions when I blog, make videos and am commenting on others things online but I’m sure that even when keeping this in mind I have said some things that have been misinterpreted or understood.

It can be very hard to share opinions online, I think that as humans when someone doesn’t share our opinion and states a different one we feel attacked and ganged up on, even if this is not the case. I have noted though that there does seem to be a ‘my way or the highway’ mentality in many DOC’s and it is dividing the communities. As we all know there are many different management techniques for T1D and everyone seems to opt for a different method or multiple methods that they feel work best for their body, lifestyle and results they want. Personally I try to eat a balanced diet (I carb count to the gram), I walk a lot, I bolus 15-20mins before meals and test 12 times a day and once in a blue moon I eat junk food and watch movies all evening, this combination works for me but i totally understand that it’s not for everyone and if people want to do it another way I am supportive of that but if they want to know how I do it I’m happy to share. I understand that not everyone’s bodies, metabolisms, lifestyles, beliefs and capabilities are the same as me and because of that they do what they believe works best for them and I will not tear that down because I am not in their shoes.

There is only one terminology or name that I struggle with in the diabetes world and that is when people refer to me as a diabetic. I know that absolutely nothing bad is meant by it but I struggle with it because I feel labelled. Once someone refers to me or introduces me as a diabetic I feel like everyone makes assumptions and decisions based on what they know about diabetes. I feel that they don’t want to get to know ‘me’ after knowing that because I become ‘Hope the diabetic’ not Hope who spins and knits and walks and bikes and paints, none of that matters because I’m diabetic and that’s all there is to me. I know there is never this intention by people but this is what I have experienced and I will always prefer to be Hope who is creative, loves the outdoors, music and taking photos and just happens to live with diabetes.

Whenever talking diabetes, be it online, in person, wherever just remember when commenting on others thoughts and when receiving comments yourself that no one is an exact replica of you and what you hold close others may not and vice versa.

Hope

The Other Half of Diabetes

“Our topic today is The Other Half of Diabetes.  We think a lot about the physical component of diabetes, but the mental component is just as significant. How does diabetes affect you or your loved one mentally or emotionally? How have you learned to deal with the mental aspect of the condition? Any tips, positive phrases, mantras, or ideas to share on getting out of a diabetes funk? (If you are a caregiver to a person with diabetes, write about yourself or your loved one or both!)” Karen Grafeo (Bitter-Sweet Diabetes).

I’m so far behind in Dblog week, my apologies, this year it happened to fall amongst my assessment week and they have had to take priority. I will write all the blogs planned they will just be really late 😛

Emotion, thefreedictionary.com defines emotion to be:

1. A mental state that arises spontaneously rather than through conscious effort and is often accompanied by physiological changes; a feeling: the emotions of joy, sorrow, and anger.
2. Such mental states or the qualities that are associated with them, especially in contrast to reason: a decision based on emotion rather than logic.

So how does that tie with diabetes? How does your body not producing insulin link with you being angry, sad or happy? Honestly, at a chemical or biological level, I don’t know but it does have a huge affect! More than I to care to acknowledge, looking into some stats for this blog I discovered that people with T1D have two to four times the chance of developing depression. Whilst I cannot explain why there is is link o what that link is, I can describe/explain what happens to me and my methods of trying to deal with it.

Last month I was asked if I would mind contributing a blog to Diabetes Daily Grind it could be on anything I liked, there was only an approximate word count that I had to comply with. I spent a few days trying to come up with a subject to write about and then I had a really bad high and ended up blowing up at someone (I have a feeling it may have been my Mum but I can’t rightly remember 😦 ) Mum and I had a big talk about what happens when I am high and how much I have changed emotionally since going on a pump and gaining some form of control over my bloods. I realized that I cannot be the only one who experiences intense emotions with blood level changes and I felt like it needed discussed. So that was my blog Putting a Face to the Name (the High Blood Sugar Demon)  I have linked it in so that you can go and have a look at it rather than post the whole thing. Keep in mind in that post I am only discussing high blood sugars.

I also want to talk about low blood sugars and what I experience with them because whilst my coping methods are similar to high blood sugars what I actually experience is totally different. I want to link in a blog post written  by someone else here because I believe the author has hit the nail on the head and I am not able to describe any more accurately. The post is called ‘Everything was in slow motion. Even my brain was going slow. (A hypoglycemic event explained)’ written by Neel Jadeja on the blog ‘LifeLoveandInsulin.’

Having to deal with such an emotional roller-coaster everyday is exhausting, especially when there is the opinion that if you worked harder and controlled your bloods better then you would not be experiencing the emotions caused by highs and lows. It never stops, you don’t get a holiday, you don’t get paid and there is very little reward for the effort required in comparison to the flack you will get when you are deemed not to have done enough. It’s normal to feel confused, irritated, sad or frustrated about it all and on the whole those feelings come and go as your management changes but sometimes ruts form and those feelings don’t go away, they get worse and start effecting how you manage your T1D, or in some cases don’t manage it. If this happens one of the best things you can do is talk to your DN or endo, let someone know you are struggling, it sucks to admit it and have to talk about it (trust me I know) but if you don’t no one can help. Generally hospitals will have a psychiatrist on the team who specializes in chronic illnesses and you can be referred to talk to them. Being referred to them doesn’t mean you are sick, it just means that you need some support and you may only need this a few times or you may need it over a longer period but if its what you need in order to manage your T1D most effectively then it just has to be part of your management system. If you can find out if there is someone available who specializes in chronic illnesses (or even better T1D) but if not then a general councilor or just talking to your DN or endo is a fantastic place to start.

Most importantly, know that you are never alone in how T1D makes you feel and there is always someone who can talk it over with you and take some of the strain.

 

Putting a Face to the Name (the High Blood Sugar Demon)

I was recently asked if  would like to submit a blog post to Diabetes Daily Grind to be published on their site. I was over the moon!!! But rather stumped as to what to write about. Then I had a really bad high and I knew what to write about. What it is like to experience a high blood sugar.

Here is the blog post.

arguments

Please let me know what you think, do you experience highs differently? How do you handle the emotions that come with it?

Make sure you check out Diabetes Daily Grinds site too and some of the other fantastic blog entries 😀

Hope

 

Foods On Friday – #DBlogWeek Day 5

Today is all about food…this is a bit of an iffy subject for me, in my world food is for fuel, I often don’t enjoy what I am eating and only eat it to regulate my BS (blood sugar). In saying that there are a few foods that I really do enjoy when given the chance and good BS 😉 so we will see how this goes, I will try and explain why I have chosen what I have to eat throughout the day and I’ll tell you what I have to do in order to be able to eat it and have a reasonable BS afterward.

I thought a good way of connecting my diabetes into this post would be to show you a standard day for me on Diasend, so I have screenshoted Saturdays record and I will walk you through it all 🙂 I wont explain all the information on the graphs etc because I feel it is pretty self explanatory but if you do have any questions please feel free to ask them (I do understand that looking at this from a non T1D point of view it may seem rather confusing).

Oh and I have used Saturdays information instead of Fridays as Friday got away on me and I attended a friends garden party in the evening which is not my norm and which also entailed a beautiful potluck and alcohol (neither of which is great for a PWD trying to carb count hehe but it tasted so good!) so I figured that giving you a standard day would possibly be of more use 😉

Lets get into it then 🙂 carbs that I consumed are in the lower table just above but I will tease them out and give explanations of what I ate and why etc etc.

08:46 – Breakfast – 24g = porridge. I try to always have porridge for breakfast, I find it is a good slow release and doesn’t contain any added sugars or sweeteners. I also have the problem of feeling sick in the mornings and not wanting to eat anything at all but having diabetes doesn’t let me act on that feeling, when I do have breakfast I often have very distorted taste and I figure porridge is bland so it’s not as upsetting to my taste buds hehe. This feeling is always exasperated when I wake up with a high BS (I don’t know if any other PWD have this or if it is just one of my irritating qwirks?)

12:53 – Lunch – 30g = cheese toastie. Now I realize that not everyone reading this will be from New Zealand and we have very different terminology from the USA so I shall expand on what a cheese toastie is. You take two pieces of bread and butter them on both sides (this will make sense in a sec), next you place cheese and pineapple inside like a sandwich. Finally you place all of this in a toastie maker (I think this is also called a sandwich press?) What you end up with is toasted bread with melted cheese in the middle that is about 90 Degrees Celsius and burns you as you bite into but you are caught in a trap because as you pull away you realize the cheese has stuck to your mouth and is now stringy and looping everywhere. It is hilarious to watch people eat and tastes really good!

16:40 – Afternoon Tea – 21g = Cheese roll. Another New Zealand phenomenon hehe, this time you do the same thing but instead of pineapple you put chives and spring onion and you roll the bread into a roll before toasting (so good!)

17:36 – I was hungry – 27g = lammington (sponge with icing and coconut). Basically I hid two of these in my room so my younger brother wouldn’t eat the whole packet and I would actually get one, anyway, it was staring at me and I was hungry so it made sense.

18:09 – Curiosity – 16g = sour jelly beans. I found these fancy jelly beans I was given for Christmas and felt the need to try them then and there without having to wait for a hypo 😛

19:46 – Dinner – 30g = grilled chicken and steamed veges. It’s fair to say I was not overly hungry at this point but needs must 😛

20:03 – Lack of Self Control – the jelly beans were calling…

22:19 – Too Much IOB (insulin on board) – 10g = jelly beans. I tested and was perfect but I had over 1unit on board which was enough to send me into a hypo, it was logical to eat enough to cancel that out.

22:28 – Where is my brain?! – 21g = another lammington! At this point I must confess something, I was skyping my boyfriend and so was completely preoccupied when I was eating the jelly beans 10mins ago, I bolused for them, when the entire point of eating them was to cancel out my IOB! (Men! They just mess with your sugars!) So as a second cancellation of IOB I had my last lammington.

Whenever I had any of these things too eat I have to calculate the carbs that I am consuming I do this one of three ways: I weigh my food and enter it into Calorie King, here is the link if you want to have a look (I think it’s fantastic); or if it is something I eat regularly such as an apple I know the carbs and can just enter them from memory; or for things that come in servings I will weigh out a serving portion and use the information provided on the packet 🙂 after I find out the carbs I enter the total into my pump and a calculation is run based on my I:C ratio (insulin carb ratio, how many units of insulin I need per gram of carb) and that insulin is given to me.

When I am at college I will make myself a packed lunch and when I was learning to carb count (and if I have anything new in my lunch box) I will write the carb total onto the gladwrap of the food item. It looks a bit daft but I find it very helpful when I am on the go or trying to concentrate on other things and busy.


The main thing i would like you to take away from this post is that PWD can eat anything that they want, we aren’t allergic to sugar and we wont die if we eat it as long as we have the appropriate insulin to cover it. I don’t normally eat so many sweets but every now and again it doesn’t hurt 😛  Some people do this via carb counting others have other methods. For me I HAVE to have three main meals a day and if I do not have a small snack mid morning and afternoon I will go low (as I did at lunch today because I didn’t have morning tea). Everyone has certain things that they have to do every day to keep themselves healthy, mentally and physically, everyone’s list is different and mine includes having to eat at certain times and calculate what I have eaten. It feels really overwhelming at first but as you do it, it becomes second nature and a lot easier.

If you have any questions about carb counting or how I do things or need clarification on anything please feel free to ask. I’m not a Dr so cannot give you any advice or direction that regard but I have learnt some tips along the way that make things easier 🙂

PancreaticallyChallenged – YouTube

And so I started a YouTube channel…

I’ve been doing a great deal of YouTubing recently and I have realized that there are no (none that I could find) YouTube channels about type 1 diabetes (T1D) in New Zealand or for New Zealanders (kiwi’s).

In New Zealand we have quite a different system when it comes to health care and in particular diabetes care. It is fantastic to see all the American and English ones! I really do appreciate them but at the end of the day what is available there and what is available here are quite different. So I started PancreaticallyChallenged.

My plan for this channel is to be a place where people can ask questions about T1D and get a really honest answer. I’ve found that often people are either too scared to ask or don’t know where to ask. So this gives people reasonable anonymity to ask and a place to do so.

I have only managed one video so far, it has been the holidays (dreadful time to start YouTubing!) but hopefully it will continue from there. I will also blog here all the extra details for the videos.

If you would like to check out my first video you can do so bellow and if you have any questions or ideas or videos please comment with them bellow, I would love to hear them!

https://www.youtube.com/watch?v=Vtrd2TDxMnw

Enjoy guys!

An Article in the Local Paper

During November (Diabetes awareness month) I was interviewed by a lovely journalist from the Otago Daily Times (ODT) our local news paper here. I was interviewed all about my type 1 diabetes (T1D).

I was so nervous! I wasn’t sure what she was going to ask and then there was the uncertainty of what she would actually write and how she would portray me…and others with T1D. I felt like I was being placed with such responsibility to make sure that the correct things were being heard and understood about T1D but at the same time I felt I had no control over any of it!

The journalist and I spoke for about an hour, about everything! From hospital appointments to how T1D affects friendships.

This is the article that was published as a result.

http://www.odt.co.nz/lifestyle/magazine/328536/fear-blindness-wake-call-diabetic

Hopefully if I have done this correctly you can just click the link above  and it will open in a new tab!

I thought I would put it up here to give you all: a) a chance to read it and b) a place to ask me further questions should you have any. I really hope that you enjoy reading this and please feel free to ask any questions about anything, if I can help in anyway I’m more than happy to 🙂

Just a shot…I think not

So as all of you probably know by now those of us with T1D have to give ourselves insulin manually, this is done either through an injection or an infusion via pump. Today I’m going to explain the process that you have to go through to have an injection of insulin, that right there is more to it than drawl up an amount, stab and push in insulin.

This is the pen that I use to deliver the majority of my shots (I have another one with a different insulin but I only use it once a day).

Insulin pen

Before I tell you exactly how the pen works lets start at the beginning of the whole equation (trust me the whole thing turns into a giant equation!)

Blood test, that’s right, it all starts here. Depending on what your bloods are you may need to factor in a corrective dose to your insulin shot. How do you work this out? Well every T1D is different on this point so I will just explain what I do. I have what they call a correction factor, so for every 2 mmol/L of blood sugar that I want my bloods to come down I need to have 1unit of insulin. So right now lets say that I want my bloods to come down by 5mmol/L, I would need 2.5units of insulin.

Part one:check.

Next are you going to eat anything? For arguments sake we are 😉 for this part you have another calculation to run. It starts with how many carbohydrates have you eaten? (as a diabetic you are taught to carb count but I wont give you a lecture on that right now or your head might explode, the easy way is look up on your phone how many carbs are in your meal) So lets say we’ve eaten dinner and all up dinner contained 60g of carbs. Now we have to divide those carbs by what is called a carb ratio (every T1D’s ratio is different!) my ratio is 10:1 so for every 10g of carbs that I eat i need 1unit of insulin. 60g of carbs means I need 6units of insulin.

Part two:check.

Now it’s time to have your insulin, right? Wrong, now you have to factor in how much activity you are going to do after dinner. If you don’t do this you will either need to eat again to keep from going low or your will go low. If I’m going to do exercise I will generally have 10% less insulin. So lets say that I am going to do some exercise and we’ll factor that in in the next bit.

So we have 2.5units for a correction and 6units for our carbs, together that’s 8.5, but now we have to minus 10% for exercise that we are going to do (I generally round the numbers to the nearest .5 because my pen has increases of .5) so that brings us to a grand total of 7.5units of insulin.

Now for the easy part, having the shot. Simply dial up the required amount, choose the place you want to have it, put the needle in and press the insulin in. I then keep the needle in for a count of 10seconds because it can take the insulin a little bit longer to come out of the needle and start to be absorbed. If you don’t wait insulin will come out of your injection site and then you’ll go high because you haven’t had your full dose.

As you can see having a shot just isn’t that simple. Every time that I test my bloods or eat food I have to go through this process. At first it was really difficult and I needed lto write it down and use a calculator but now I can manage it all in my head. But if my bloods are too high this makes thinking harder so doing all of the above takes me a little while longer. Hopefully now you see that we T1D’s have to do a bit more than just have shots to keep alive, I just felt the need to let y’all know 😉 any questions about any of this y’all know where to put them 🙂

What’s Wrong With Me?

So many people think that Diabetes is Diabetes, that everyone who has Diabetes has the same kind and it is caused by the same thing and can be treated in the same way…well today I’m going to tell you that is wrong. I’m going to explain what Type 1 Diabetes is in the most understandable way that I can, a little bit of a story for you. So lets give it a go, I’ve no idea which order to tell things in so if I say them in an order that to you doesn’t make sense I apologize.

Lets start with what a non-diabetics body does.

When you eat food with glucose in it (that’s sugar that comes in many different forms but the form that I count it in is called carbohydrate) the glucose is absorbed into your bloodstream. Now here comes the fancy part. In order for your body to use the glucose for energy it needs to get into your cells (where is is transformed into a form of energy that your body can use). Glucose cannot just float in and out of your cells it needs the equivalent of a hall pass, something which can accompany it through the walls of the cell and inside. This thing in your body is insulin and is produced in your pancreas by your beta cells.

So to wrap that one up, when you eat glucose it gets absorbed into your blood stream, then your pancreas produces insulin which accompanies the glucose into your cells. The glucose is then transformed into energy that your body can use for daily functioning, things like running around, thinking, walking, getting out of bed, pretty much everything that you do needs energy and you get this from the process above.

In a type 1 diabetics body this doesn’t happen. Our beta cells don’t produce insulin and therefore the glucose in our blood cannot get into our cells and be transformed into energy. Instead it builds up in our cells and turns into something called ketones, if the ketones aren’t dealt with or build up too much they become toxic to our bodies and we can die.

Here is why my body now doesn’t produce insulin.

One day there was a civil war inside my body, my immune system decided that my beta cells in my pancreas were bad and so they attacked them. No one knows what caused my immune system to think that my beta cells were bad, it’s just something that happened and it can happen to anyone at any time, although it is most common in your younger or adult years.

Over a period of time my immune system kept attacking my beta cells, now my body does not produce any insulin on its own. So the glucose that I eat cannot get into my cells and cannot be transformed into energy for me to use. There is only one thing that can be done to get insulin into my body and that is to inject it. The insulin that I inject is made in a laboratory (years and years ago it was made from pig beta cells!) but it has the same molecularity as the insulin that a non-diabetic produces and does the same job only in gets there in a different way.

It’s a pretty short explanation I know but it’s how I explain it to people and generally they seem to understand. I’ll post later on what exactly I have to do to use insulin (it’s not as straight forward as just injecting it) but I think maybe this will be enough to try wrap your head around in one reading 😉 If you have any questions about any of this or want more information I’m more than happy to try and help just comment below 🙂

Hopefully now you understand what type 1 diabetes is, it is not caused by eating too much, eating the wrong foods, not doing enough exercise, being over-weight, how you were raised, or where you live, it is just a freak event that happens inside you one day for no reason, it happens to some people and not to others, it is unfair, there is no explanation or cure, but it is not contagious and we can live reasonably normally lives (well most of the time anyway 😉 ).

Last but not least, this is what I look like as a type 1 diabetic, I have an identity, style and life that is unique to me just like all of you whether you are type 1 or not. Really when it comes down to it, I’m just another person 🙂 only I have a faulty organ in there somewhere haha.

Leading a Heifer in an A&P show grand parade

Leading a Heifer in an A&P show grand parade