"Do No Harm" Does Harm

Tonight on NBC there is the series premiere of a new show called “Do No Harm.” I’ve known this show was coming for quite some time. In fact, I knew about it when they were filming the pilot, mostly due to the fact that one of my favorite Broadway actors is in the show. Turns out SEVERAL Broadway actors I like are in the show, and it was directed by a Broadway director that I also like.

Because of that, I had been waiting on this show to air. Waiting for news about it. Getting little snippets of what was going on. A week or so ago, NBC made the premiere episode available online. I watched it last week. Of course, I watched it on the chance to see some actors I know from the stage, like Lin Manuel Miranda, Michael Esper, and the star of the show Steven Pasquale.

I won’t spoil the whole show for you. I won’t give away all the details, but the basic premise of the show is that Dr. Jason Cole is a brilliant neurosurgeon with a problem. He has Dissociative Identity Disorder… also known as a split personality. His alter ego, Ian Price, is not a nice person. He’s aggressive, a playboy, and an all-around NOT good guy. Ian shows up at 8:25 every night and goes away at 8:25 every morning. So basically, for 12 hours a day, Dr. Jason Cole can’t be around anyone he knows or cares about, as Ian will hurt them.

There is an outstanding cast of actors in the show. It has an interesting plot line. It COULD be the kind of show I would like to watch. BUT (there’s always a but) there was some terribly incorrect information regarding diabetes throughout the entire show. And the saddest part of the entire thing is that some of the information regarding diabetes will probably continue to be a part of the show for as long as it lasts.

“Why?” you ask? Most medical shows will touch on diabetes for an episode or two here and there, but it never lingers very long. In “Do No Harm” Dr. Cole says he has diabetes. As he is a brilliant neurosurgeon, he has to test his blood sugar levels before he performs surgery. The machine they use is interesting. It’s not an actually BLOOD sugar machine. It’s some sort of device that he places his finger in and it uses infrared light to test his glucose levels.

Honestly, it looked like a pretty awesome machine, except that it was HUGE (think a rolling blood pressure machine from a hospital). And I’m pretty sure it doesn’t exist. I did some research on the internet after I saw this. From everything I can find, this technology doesn’t exist yet. There areseveral companies working on the technology that would allow us to check ourglucose levels with infrared technology, but so far nothing has been approved, and from what I can find, it doesn’t even really exist more than what scientists seem to be TRYING to develop. Basically, nothing headed our way anytime soon.

So, what I wanna know is how to get one… cause if it’s on TV, it must exist, right? You see where I’m going with this? Um, I don’t want people telling me I don’t have to poke my fingers all the time cause I can get this cool machine that tests my glucose with infrared technology. I don’t want to have to take the time to explain that it’s Hollywood making something else up.

That was alarm bell number one in my head. But, you know, it’s not THAT big of a deal….but then Dr. Jason Cole has a conversation with the director of his hospital, Dr. Vanessa Young (a lovely and talented Phylicia Rashad).  

Dr. Young offers Dr. Cole tickets to a Phillies game because it’s his birthday. He tries to turn them down and she says “Just because your diabetes keeps you from working at night doesn’t mean it keeps you from going to a game.” And there’s alarm bell number two in my head. What do you MEAN that diabetes keeps you from working at night?!? I know several people who live with diabetes (T1 & T2) who work the night shift. And why wouldn’t a DOCTOR (and probably a pretty extensively trained doctor, if she’s running a major hospital like in the show) call bullsh** on that? A doctor that knows anything would know that isn’t true.

And that led into alarm bell number three….how does someone who is unable to work for at least 12 hours a day able to make it through medical school? I know people who have gone through med school. There are many, many long shifts. Many times they end up sleeping at the hospital and definitely working night shifts during their residency and/or fellowship. So how did Dr. Cole make it through medical school to become this stellar neurosurgeon??  

Obviously, he is using diabetes as a reason to be able to be home and away from everyone when his alter ego takes over, but what diabetes? It’s kind of a flimsy excuse, especially if you are in the medical profession. And this makes it obvious that the character doesn’t actually HAVE diabetes.

The show continues on and there is an incident in which Dr. Cole can’t remove himself far enough away from people to keep his alter ego from taking over. Dr. Cole reschedules a brain surgery for nighttime. At first I couldn’t figure out WHY. Alter ego Ian Price has no medical training. And Ian pretends to be Dr. Cole… so this untrained person is going to operate on a human? Turns out there is a reason that Dr. Cole did this. And this is where alarm bells four, five, six, etcetera went off in my head.

Ian Price, pretending to be Dr. Jason Cole, enters the surgery room and they demand that he checks his glucose levels (on that awesome, non-existent machine) before he operates on the patient. When the results come they are 315. Here is the basic of what happens in the operating room at that point:

Ian Price asks what’s going on. A nurse says, “You’re hypoglycemic (the closed captioning read “hyperglycemic”, but if you listen to it several times like I did, it SAYS hypoglycemic). You’re going into diabetic shock!” Another nurse/doctor says “Give him 20 units of regular insulin.”

I’m going to stop right there and point out the things wrong with JUST that part. First off, a blood sugar level of 315 isn’t going to send someone into diabetic shock. Possible ketones maybe. Thirst, headache, at worst, blurry vision. But I’ve never known anyone to enter into diabetic shock (I’m assuming they mean full diabetic ketoacidosis with unconsciousness) from a 315.

Secondly, 20 units of regular insulin for almost anyone with diabetes could be lethal. It’s way, way, way too much insulin for a 315. I assume there are cases of super insulin resistance that would call from something like that, but in general, 20 units of regular insulin is crazy. Also, regular insulin is kind of outdated. I know some people who use it still, but in general, it is so slow working that insulin like Levimir, Humalog, and Novolog are used. They work faster.  

Onto the rest of the scene (which was only about 30 seconds to a minute long). The doctors and nurses in the operating room restrain Mr. Ian Price (who fights them the whole time) and the jab him with some epi pen looking thing while he thrashes around. He immediately goes into convulsions. A nurse says, “He’s tachycardiac-Adverse reaction from the insulin.” Some else yells “Call anesthesia stat! And get me a stretcher.” Mr. Ian Price passes out.

Okay, all the things wrong with that part…. Oh my. Well, first off, the epi-pen looking thing. I suppose it might have been an insulin pen of some sort. Perhaps. But really it just look like they jabbed him with this thing in the arm. Insulin doesn’t need to be administered like that at all. And a true diabetic would have administered the insulin themselves.

Then there is the immediate onset of convulsions. Insulin does NOT work that quickly. There is NO insulin out there that works that quickly. It doesn’t exist. In fact, when you look at active insulin times, the quickest I could find was Aphidra, which according to WebMD has an active insulin time of 1 ½ to 2 hours. This means that while it might start working right away, there’s nothing that would drop the blood glucose levels so quickly as to put someone into immediate convulsions, even if their blood sugar was completely normal and they were given 20 units of insulin. Also a note: Regular insulin has an active insulin time of 5 to 8 hours. http://diabetes.webmd.com/guide/diabetes-types-insulin

Then there is the next part. About the tachycardia. I actually did not know what that word meant. I had to look it up. The American Heart Association says that tachycardia is a heart rate of more than 100 beats per minute in an adult. I didn’t know that insulin (or a low blood sugar) could cause a rapid heart rate. But apparently it can. I googled that one too, just to be sure. Again, I just can’t imagine blood sugar dropping so rapidly that it would cause immediate convulsions and rapid heart rates. I suppose that this could be considered an “adverse reaction to the insulin” but I just call it a low blood sugar.

And what was that about calling anesthesia?  Why? Were they going to knock out the man already passed out on the floor? I mean really? What was the point of that? Why did no one suggest glucagon (or the more medically potent D50, also known as dextrose). This would have brought around a person having a low in just a few minutes.

At this point, I’m laughing hysterically at the computer screen as I watch the show. I wanted to tell them how crazy they were being. But it just got worse and worse.

Dr. Jason Cole wakes up the next day in a hospital room and Dr. Marcado, a friend who is helping him try to keep Ian from coming out every night, is in the room with him asking him what went happened. Dr. Cole states that he moved up the surgery on purpose because he knew that Ian would fail the glucose test.

When Dr. Marcado asks how he knew he’d fail he says “Come on, Ruben, personality affects body chemistry. Aggression triggers adrenaline” and Dr. Marcado follows up with “Which looks like high blood sugar.” Dr. Cole finishes up with “He’d be given insulin, which he didn’t need.” And Dr. Marcado chimes in, “It would knock him out.”

Okay, I’m not a medical professional. I could be wrong. But again, I googled it. Everything I found in regards to adrenaline and high blood glucose levels was directly related to people who already have diabetes. I KNOW adrenaline causes my liver to kick out sugars, raising my blood sugar levels. But someone without diabetes (which we know Dr. Jason Cole to be) should be covered by their own, working pancreas, right?

And what was that about personality affecting body chemistry? Huh? How would it affect his body chemistry? It’s just so completely out there that I was appalled. By the end of the show I was laughing, but I was also saddened.

taken from the Do No Harm facebook page

What happens when a show is SO full of misleading information about diabetes? Especially when it’s a medical drama? I mean, people listen to the stuff on these shows. They believe the stuff on these shows. And I get to spend all of my free time and energy trying to correct what Hollywood destroyed.

I’ve been told that any medical show is supposed to have a medical technical advisor. I googled. I checked IMDB. I googled again. I couldn’t find anywhere that there was a medical technical advisor listed. It confused me. Maybe because it was a pilot episode they didn’t have one? I wanted to know who told them this information was correct.

The only thing I could find was the name of the writer of the episode and the producers of the show. It was written by David Schulner, directed by Michael Mayer (a Broadway person that I LOVE), and produced by Rachel Kaplan, Michael Mayer, David Schulner, and Peter Traugott.

I really do want to like this show, but they can’t ditch the diabetes storyline at this point. It’s too engrained in who Dr. Jason Cole/Ian Price is as a character. But it’s also a lousy cover for his Dissasociative Identity Disorder and perpetuates the myths about diabetes.

You can find “Do No Harm” on facebook, twitter, and about a million other social networking sites. Do something. Watch the first episode. Then SAY something. Blog about it. Post on facebook about it. Tweet them about it.  I tried to find twitter accounts on the producers and writer but was unable to.

Personally, I just hope this blog post gets out there. Because “Do No Harm” could actually cause a lot of harm by misleading and perpetuating untruths about diabetes. I plan on asking them on twitter & facebook who their medical advisor was. I hope I get an answer. If they don't have one, they should hire me. At least for the diabetes related stuff. I'd tell them to scrap the entire storyline involving diabetes. But then they'd probably try to write about a medical cure.

"Non-Preferred"

So several months ago MiniMed made the announcement that they had teamed with Bayer to produce their new Link meter. Prior to that, they were teamed with Life Scan/One Touch. I’ve only been insulin pumping for six years, but during that time I’ve always had a link meter. Prior to the Life Scan/One Touch partnership, there was a BD link meter.

My One Touch Ultra Link

I like the convenience of a Link meter for my pump. It may not save me much time, but it does save me some time. It remotely sends my blood sugars to my insulin pump, saving me from having to punch the number in myself. Another great thing is that when I download my pump data, the blood sugars are downloaded as well, meaning I don’t need to worry about downloading a meter as well.

This week, MiniMed sent me my Bayer Contour Next Link. I’ve been reluctant about it just because I LIKE my One Touch. In fact, I used a One Touch for years before I starting pumping and was really glad when MiniMed switched from BD to One Touch. The thought of changing meters again made me kind of twitchy.

But, as with any new meter, curiosity got to me. I opened it up and decided I’d at least try it. I linked it to my pump (you can have more than one meter linked to your pump, which I didn’t know). And I used it. And I liked it. A lot. It surprised me how much. I like a lot of different meters, but having this one made me want to keep using it. I thought about switching after my next refill of test strips, so I stopped by my pharmacy and had them run my insurance to see if I could get the strips. Turns out Bayer strips are “non-preferred” and that makes them not covered. Accu-Chek and One Touch are (which I already knew).

My Bayer Contour Next Link

Honestly, I don’t mind staying with One Touch, but what about people who didn’t have that option. They are just getting their insulin pumps and are automatically given the Bayer meter. They would have to give up that convenience option because of stupid insurance.

There is supposedly a program that Bayer has that offers a discount on strips if you have insurance (not Medicaid or Medicare). You only pay $15 per month for strips. I thought about doing this as well. I could use the new meter and it would actually be cheaper than my current co-pays because they are more (way more) than the $15 per month. BUT then I read the small print. The program is only through December 2013 (and there is the even smaller print that says Bayer can cancel the program at any time).

Would I get used to a new meter? Learn to love it? Be happy about it and then be forced to go back to One Touch because the Bayer strips still aren’t covered by my insurance?? Or is this some type of bridge program til they can get more insurance companies to cover it? I don’t know.

I know I have one friend that was forced to change to the Bayer strips cause insurance quit covering they One Touch. I know another than had no problems with her insurance ever covering the Bayer strips. I have good insurance. Really good insurance. So I don’t particularly want to rock the boat. I just wish that they looked at glucose strips as glucose strips. They all pretty much cost the same, so why do they care?!

Has anyone else had trouble getting these Bayer Contour strips covered? Does anyone know what the deal is with the strip program? Is it going to continue? What’s the purpose of it? I mean, if more insurance companies aren’t picking them up at the end of the year, they will lose customers. We don’t have money to pay for strips out of pocket if we don’t have to.

Anyway, another choice in the life of a person with diabetes. Which meter? Sigh. This is life. Sadly, I can’t go with the “fun” meter just because it’s fun. I’ve got to go with what the insurance will pay for.

Fourth Times a Charm?

I swear, sometimes diabetes just likes to raise a fuss. It does it in whatever way it can and causes as much trouble as possible in as short a span of time as possible. A couple of days ago my blood sugars starting running on the high side. I wasn't sure why. It happens sometimes. But I dealt with it. I thought.

I was at work and I ended up bolusing ALL DAY LONG. It felt crazy. I figured I was 3 days into my infusion set, so my site was probably going bad. I didn't change it at work cause I only had and hour left. I decided to wait until I got home.

When I got home I grabbed my dinner and heated it up. As it was heating, I did a site change. New insulin, new site, ready to go. I bolused and started to eat. Not 30 seconds in, I get a "No Delivery" alarm. GAHH!

Okay, I hate "No Delivery" alarms. They are annoying. I don't know why I get them and nine times out of ten, my cannula isn't bent. But it still ends up requiring me to replace a set. I took out my new set and cleaned with alcohol and popped in a new set.

Problem? Um.... I didn't wait for the alcohol to dry. Guess what... sticky doesn't stick when it's still wet from alcohol. And you know what that means? Another infusion site.

At this point it was infusion set number THREE for me.

I finally bolused and ate dinner.

And waited. My blood sugar wasn't coming down. It was going up, up, up! I tried bolusing again. And by the time it was time for me to go to bed, it was obvious that my blood sugar wasn't coming down. I took a chance on the fact that I had ANOTHER bad site and ripped out my third site and put in a fourth.

I bolused again and set my phone alarm to wake me up at 2 a.m. for a middle of the night test.
I was 170 at that point. I bolused again and when I woke up I was in the 140s.

I figured I had taken care of the problem. But I ended up running my insulin pump on 120% basal for most of the morning.

It's almost like my body revolted on me after the initial high. After lunch, everything went back to normal and I've been doing well since then.

What's annoying is that it took FOUR new infusion sites and a day and a half of insane bolusing to get my blood sugars back to where they should be.

So.... maybe fourth times a charm?

JDRF South Region T1D Symposium - 2013

Over the weekend I attended the JDRF South Region Symposium in Nashville. I was so blessed to get to go and I have so many things to share. This was the first Symposium of it's kind that I've been to. And the first that Nashville and the South Region of JDRF has done. I'd personally like to see it become a regular thing. Let me tell you why....

When they announced this Symposium back in September, I knew right away that I had to go. Why? Well, one of the guest speakers was the D-OC's own Kerri Sparling. I wasn't about to let Kerri come to Tennessee and NOT go see her. Plus, I kind of wanted to see her around a bunch of people with Southern accents. ;)

I signed up to go with a dear friend of mine. She's not a blogger...or a tweeter, but she's on facebook and TuDiabetes and she occasionally guest blogs for me. Sherry is one of the kindest souls I know and I knew we would have so much fun.

When the weekend arrived, I was buzzing with excitement. I knew some other people I'd met before were coming. I also knew there were a few people that I'd never met IRL before that were going to be there. AND I knew there were new people to meet.

There were vendors set up when we were registering and getting settled in on Saturday morning. One of the good things about that was that I got to hold and play with the new t:slim insulin pump. I thought it was pretty awesome looking, and fun to play with. It also appeared to be more sturdy than I first imagined...though I guess the true trial would be how long it lasted (I'm tough on pumps).

Before we could even sit down to have lunch, I ran into some old Nashville area diabetes friends that I hadn't seen in a while. And I got to meet some bloggers and tweeters that I hadn't had the chance to meet yet, including Julie, Andrea, Holly of Arnold and Me & Aaron Jaffe (who I didn't know had a blog called Rep the Betes, until this weekend; shame on me!).

Seeing Victoria again was SO much fun. And I got to meet some awesome new friends like Stephanie, Madison, and Jordan (who had two blogs like I do! You can find her d blog HERE).

Honestly, the friend connections are always my favorite part of things like this, but there was also a host of fantastic information. Listening to Tom Brobson, National Director, Research Investment Opportunities for JDRF, shared his experience with the artificial pancrease trial, and shared some of the focus of JDRF.

One of my favorite quotes of the weekend (that Tom Brobson shared) was "Less Until None" in reference to JDRF working toward diabetes having less burden, being less invasive, having less complexity, and having less danger in our lives until there is no diabetes left. I like the sound of that. While I don't know that I expect a cure any time soon, the "less" stuff has a nice ring to it.

I attended both of Kerri's breakout sessions, and was thoroughly glad I did. The first was on Pregnancy & Parenting. While I'm not a parent, not pregnant, and not planning to be, I do think that pregnancy and parenthood are in my future somewhere. I wanted to know what she did and is doing to have a healthy pregnancy, and being healthy for her daughter. Kerri had an endo there also answering questions (turns out it was MY endo!!!), so there was medical advice, as well as Kerri's personal experience.

Kerri's other session was on T1 Diabetes in the "real" world. There was a whole room full of young people, older people, parents of children with d, people who'd been recently diagnosed. It was great to see everyone coming together and sharing stories. And just for reference, Kerri's talks sound exactly how she writes her blog posts. :)

Another session that I attended was on diabetes complications. It was a little depressing, but I liked some of the information I gained. I had mixed feelings about it, honestly. It wasn't what I was expecting, so I was a little disappointed. But at the same time, I found it very informing and I learned a lot, so I can't be TOO disappointed.

 

Overall, I thought the weekend was a rousing success and I really hope that JDRF continues to do things like this. While I understand that they like as much money as possible to go into funding research, there is a huge mental aspect to diabetes and this is one way to help. It goes right along with that "Less burden" part of the JDRF "Less Until More." Because things like this make diabetes less of a burden in my life.

New Year with Diabetes

New Year with Diabetes : Striving for _______ in 2013.

This is the topic for this month's #DSMA Blog Carnival. When I saw the topic I spent some time thinking about what I want to do this year in regards to diabetes. My first thoughts were about specifically health related things. Perhaps trying to lower my A1c? Exercising more (or at all)? Eating healthier? Avoiding things I know make my blood sugar spike? There are so many things I could strive for, but in truth most of these things are things I work toward at some point in every year.

Then I started thinking about the advocacy part of diabetes. Truth be known, my blogging has decreased, my active online presence has drifted from nearly non-existent to semi-active. I want to change these things. So I have a few major goals for 2013. I won't call them "resolutions" because I never seem to keep those. Instead, they'll just stay goals. I'll work toward them steadily and if I reach them in 2013, that will be amazing. If not, I'll keep at it until I get there.

First off, I'd like to get back into active tweeting on my diabetes twitter account. I feel like I've slacked, and I miss my friends.

Secondly, I want to make a goal to blog at least once a week for this blog. That means 52 blog posts in 2013. I want to make this happen.

Next, I want to make it a goal to read (and comment) on more blogs. I have slacked on my reading of blogs, and I want that back. It's how I keep in touch with what's happening in the D-OC and I need to get back to that.

And finally, I want to become more active locally in diabetes advocacy. There is so little that goes on in my area, and I feel a need to get people together. Living in a rural area makes it hard to find people who are willing to get together, but I think it's possible. And I want to make this happen.

So these are my goals for 2013. I hope to reach them soon, and feel more than free to slap me around if I look like I'm not doing them. I give you permission. :)

 

This post is my January entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2013/january-dsma-blog-carnival-2/