Day: 08/11/2016

This Millennial Might Be the New Einstein.

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One of the things the brilliant minds at MIT do — besides ponder the nature of the universe and build sci-fi gizmos, of course — is notarize aircraft airworthiness for the federal government. So when Sabrina Pasterski walked into the campus offices one cold January morning seeking the OK for a single-engine plane she had built, it might have been business as usual. Except that the shaggy-haired, wide-eyed plane builder before them was just 14 and had already flown solo. “I couldn’t believe it,” recalls Peggy Udden, an executive secretary at MIT, “not only because she was so young, but a girl.”

OK, it’s 2016, and gifted females are not exactly rare at MIT; nearly half the undergrads are women. But something about Pasterski led Udden not just to help get her plane approved, but to get the attention of the university’s top professors. Now, eight years later, the lanky, 22-year-old Pasterski is already an MIT graduate and Harvard Ph.D. candidate who has the world of physics abuzz. She’s exploring some of the most challenging and complex issues in physics, much as Stephen Hawking and Albert Einstein (whose theory of relativity just turned 100 years old) did early in their careers. Her research delves into black holes, the nature of gravity and spacetime. A particular focus is trying to better understand “quantum gravity,” which seeks to explain the phenomenon of gravity within the context of quantum mechanics. Discoveries in that area could dramatically change our understanding of the workings of the universe.

Among the many skills she lists on her no-frills website: “spotting elegance within the chaos.”

She’s also caught the attention of some of America’s brightest working at NASA. Also? Jeff Bezos, founder of Amazon.com and aerospace developer and manufacturer Blue Origin, who’s promised her a job whenever she’s ready. Asked by e-mail recently whether his offer still stands, Bezos told OZY: “God, yes!”

But unless you’re the kind of rabid physics fan who’s seen her papers on semiclassical Virasoro symmetry of the quantum gravity S-matrix and Low’s subleading soft theorem as a symmetry of QED (both on approaches to understanding the shape of space and gravity and the first two papers she ever authored), you may not have heard of Pasterski. A first-generation Cuban-American born and bred in the suburbs of Chicago, she’s not on Facebook, LinkedIn or Instagram and doesn’t own a smartphone. She does, however, regularly update a no-frills website called PhysicsGirl, which features a long catalog of achievements and proficiencies. Among them: “spotting elegance within the chaos.”

Pasterski stands out among a growing number of newly minted physics grads in the U.S. There were 7,329 in 2013, double the four-decade low of 3,178 in 1999, according to the American Institute of Physics. Nima Arkani-Hamed, a Princeton professor and winner of the inaugural $3 million Fundamental Physics Prize, told OZY he’s heard “terrific things” about Pasterski from her adviser, Harvard professor Andrew Strominger, who is about to publish a paper with physics rock star Hawking. She’s also received hundreds of thousands of dollars in grants from the Hertz Foundation, the Smith Foundation and the National Science Foundation.

Pasterski, who speaks in frenetic bursts, says she has always been drawn to challenging what’s possible. “Years of pushing the bounds of what I could achieve led me to physics,” she says from her dorm room at Harvard. Yet she doesn’t make it sound like work at all: She calls physics “elegant” but also full of “utility.”

 Despite her impressive résumé, MIT wait-listed Pasterski when she first applied. Professors Allen Haggerty and Earll Murman were aghast. Thanks to Udden, the pair had seen a video of Pasterski building her airplane. “Our mouths were hanging open after we looked at it,” Haggerty said. “Her potential is off the charts.” The two went to bat for her, and she was ultimately accepted, later graduating with a grade average of 5.00, the school’s highest score possible.

An only child, Pasterski speaks with some awkwardness and punctuates her e-mails with smiley faces and exclamation marks. She says she has a handful of close friends but has never had a boyfriend, an alcoholic drink or a cigarette. Pasterski says: “I’d rather stay alert, and hopefully I’m known for what I do and not what I don’t do.”

While mentors offer predictions of physics fame, Pasterski appears well grounded. “A theorist saying he will figure out something in particular over a long time frame almost guarantees that he will not do it,” she says. And Bezos’s pledge notwithstanding, the big picture for science grads in the U.S. is challenging: The U.S. Census Bureau’s most recent American Community Survey shows that only about 26 percent of science grads in the U.S. had jobs in their chosen fields, while nearly 30 percent of physics and chemistry post-docs are unemployed. Pasterski seems unperturbed. “Physics itself is exciting enough,” she says. ”It’s not like a 9-to-5 thing. When you’re tired you sleep, and when you’re not, you do physics.”

400-year-old Greenland shark is the oldest vertebrate animal.

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Shark, which would have reached sexual maturity at around 150 years, sets new record for longevity as biologists finally develop method to determine age

She was born during the reign of James I, was a youngster when René Descartes set out his rules of thought and the great fire of London raged, saw out her adolescent years as George II ascended the throne, reached adulthood around the time that the American revolution kicked off, and lived through two world wars. Living to an estimated age of nearly 400 years, a female Greenland shark has set a new record for longevity, scientists have revealed.

“It kicks off the bowhead whale as the oldest vertebrate animal,” said Julius Nielsen, lead author of the research from the University of Copenhagen, pointing out that bowhead whales have been known to live for 211 years.

But the Greenland shark doesn’t scoop all the gongs – the title of the world’s longest-lived animal is held by Ming, an Icelandic clam known as an ocean quahog, that made it to 507 years before scientists bumped it off.

Grey, plump and growing to lengths of around five metres, the Greenland shark is one of the world’s largest carnivores. With a reported growth rate of less than one centimetre a year, they were already thought to be long-lived creatures, but just how long they lived for was something of a mystery.

“Fish biologists have tried to determine the age and longevity of Greenland sharks for decades, but without success.” said Steven Campana, a shark expert from the University of Iceland. “Given that this shark is the apex predator (king of the food chain) in Arctic waters, it is almost unbelievable that we didn’t know whether the shark lives for 20 years, or for 1000 years.”

The new research, he says, is the first hard evidence of just how long these creatures can live.

“It definitely tells us that this creature is extraordinary and it should be considered among the absolute oldest animals in the world,” said Nielsen.

Writing in the journal Science, Nielsen and an international team of researchers describe how they set about determining the age of 28 female Greenland sharks, collected as by-catch during scientific surveys between 2010 and 2013.

While the ages of many fish can be determined by counting the growth layers of calcium carbonate “stones” found in their ears – in a manner somewhat similar to counting tree rings – sharks do not have such earstones. What’s more, the Greenland shark lacks other calcium-rich tissues suitable for this type of analysis.

Instead the team had to rely on a different approach: scrutiny of the lenses in their eyes.

In order to determine when the proteins were laid down, the scientists turned to radiocarbon dating – a method that relies on determining within a material the levels of a type of carbon, known as carbon-14, that undergoes radioactive decay over time.

A Greenland shark near the surface after its release from the research vessel Sanna in northern Greenland.

By applying this technique to the proteins at the centre of each lens, the scientists deduced a broad range of ages for each shark.

The scientists then made use of a side-effect of atomic bomb tests which took place in the 1950s: when the bombs were detonated, they increased the levels of carbon-14 in the atmosphere. The spike, or pulse, in carbon-14 entered the marine food web across the North Atlantic no later than the early 1960s.

That provides a useful time-stamp, says Nielsen. “I want to know when I see the bomb-pulse in my sharks, what time does that mean,” he said. “Does it mean they are 50 years old, or 10 years old?”

Nielsen and the team found that the eye lens proteins of the two smallest of their 28 Greenland sharks had the highest levels of carbon-14, suggesting that they were born after the early 1960s. The third smallest shark, however, had carbon-14 levels only slightly above those of the 25 larger sharks, hinting that it was actually born in the early 1960s, just as bomb-related carbon-14 began to be incorporated in marine food webs.

A Greenland shark returning to the deep and cold waters of the Uummannaq Fjord in northwestern Greenland. The sharks were part of a tag-and- release program in Norway and Greenland.
A Greenland shark returning to the deep and cold waters of the Uummannaq Fjord in northwestern Greenland. The sharks were part of a tag-and- release program in Norway and Greenland. 

“That indicates that most of our analysed sharks were actually older than the time mark, meaning that they were older than 50 years,” said Nielsen.

The scientists then combined the carbon dating results with estimations of how Greenland sharks grow, to create a model that allowed them to probe the age of the 25 sharks born before the 1960s.

Their findings revealed that the largest shark of the group, a female measuring just over five metres in length, was most likely around 392 years old, although, as Nielsen points out, the range of possible ages stretches from 272 to 512 years.

“The Greenland shark is now the best candidate for the longest living vertebrate animal,” he said.

What’s more, with adult female Greenland sharks known hit sexual maturity only once they reach more than four metres in length, the scientists found that females have to clock up an age of around 150 years before they can produce young.

Trueman agrees that it is possible to get a record of the early life of a vertebrate from eye lens proteins. However, the fact that the proteins in the centre of the eye lenses, and hence the carbon-14 within them, came from nutrients taken in by the shark’s mother adds a number of uncertainties to the calculations, he says.

Campana says while the approach taken by the researchers is sound, he remains unconvinced that Greenland sharks live for almost 400 years. But, he adds, “future research should be able to nail the age down with greater certainty.”

Nielsen is also looking forward to further research, saying that he hopes the Greenland shark’s new found fame will boost awareness of the animal, as well as conservation efforts and attempts to unravel other aspects of its physiology. “There are other aspects of their biology which are super-interesting to know more about and to shed light upon,” he said.

How gravitational waves went from a whisper to a shout

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On 11 February 2016, the Laser Interferometer Gravitational-Wave Observatory (LIGO) and its sister collaboration, Virgo, announced their earthshaking observation of Albert Einstein’s ripples in spacetime. LIGO had seen the death dance of a pair of massive black holes. As the behemoths circled each other faster and faster, the frequency and amplitude of the spacetime waves they produced grew into a crescendo as the black holes became one. Then the new doubly massive black hole began to ring softer and softer like a quieting bell. The escalating chirp and ringdown is also a metaphor for public information flow about the discovery. It could have unfolded differently.

When scientists make a discovery, they must choose how to disseminate it. A big decision they must make is whether to reveal the results before or after peer review. Reveal before peer review—sometimes even before the paper is written—and the community can use the results right away, but there is an increased risk that problems will be found in a very public way. Reveal after peer review, and the chance of such problems decreases, but there is more time for a competitor to announce first or for rumors to leak. At (), where I am an editor, we allow authors to choose when they want to reveal their results. The LIGO collaborators chose to wait.

Just before LIGO’s experimental run began in September 2015, the team held a vote on which journal they would pick if they made a discovery. They picked . Five days after the vote, LIGO’s detectors seemed to hear the universe sing out for the first time.

Had LIGO just confirmed a 100-year-old prediction made by Einstein? Had they discovered the first black hole binary? Had they opened a new era of astrophysics? With the stakes so high, the collaborators wanted to keep their results secret while they determined if the results were real. It was unfortunate that some onlookers chose to publicize vague rumors when the internal vetting had just begun.

 

By early December the collaboration was convinced that the results were real, and LIGO spokesperson Gabriela “Gaby” González let me know that we would be receiving a paper from the group in mid- to late January. When she told me that they had convincingly observed gravitational waves, that it was not a test, and that the source was the merger of two huge black holes, my jaw dropped.

Gaby stressed LIGO’s desire for strict confidentiality, so for a month I told only one other person in the world: my fellow editor Abhishek Agarwal. By mid-January we had to bring others into the loop to prepare for the paper’s arrival, to review it, and eventually to publish it. To avoid information slipping out from a casual conversation or a glance at a screen, we used the code name “Big Paper.” (The code name for the second LIGO, announced in June, discovery was “Big Two.”) To the best of my knowledge no information leaked from us. Inside the LIGO team, for similar reasons, the discovery was referred to as “The Event.”

Big Paper on The Event arrived at on the evening of 21 January 2016, and we immediately sent it out to experts for anonymous peer review. The referees, like everyone involved, were sworn to secrecy. Informed, unbiased advice is central to picking which papers are published and to improving those that are. In this case it was clear that the paper was important and interesting enough for . As expected, the reviews were very favorable and conveyed the message that the paper would be an inspiration to physicists and astronomers alike.

As the time for the announcement drew closer, the rumors increased. In one case, a preprint was spotted on a printer, then a physicist emailed his whole department about the results, one tweet quoted the email, and a science reporter based an entire story on that tweet. The information was incomplete, though correct—except for the journal where the paper would be published. That reporter learned at the press conference that would publish the paper and sheepishly congratulated me.

Meanwhile, we continued to protect the information from leaking. My son, who is a budding science reporter, texted me a few days before the announcement, asking if I’d seen the rumors. That led to an awkward phone call—I still couldn’t tell him about the discovery. When we ordered a celebratory cake for the editorial office, we avoided any mention of the result on the frosting, lest it lead to an information leak. It turned out that we were not being overly cautious: A tweet containing a picture of a cake at NASA’s Goddard Space Flight Center on the morning of the announcement leak news of the discovery!1 Confidentiality requires vigilance.

Everyone at LIGO’s press conference was given access to the paper hours beforehand, on condition that they not publish their stories until after the announcement was made and the news embargo lifted. Actually, it might have been better in some ways had the press had access to the paper a little earlier, but that also would have increased the risk of the paper leaking prior to the announcement.

We had an agreement with the LIGO team to publish the paper online on 11 February at 10:45am Eastern Time, 15 minutes after the press conference was to begin. But I learned that morning from the reporters around me that the embargo was being lifted at 10:30am, and they planned to publish their stories then, which would create 15 minutes of pent-up demand for the paper. So I found the spokesperson minutes before she went to the microphones and asked her if we could publish at 10:30. Gaby smiled and simply said yes.

After a few frantic emails, all the plans were changed, and at 10:30 we published the LIGO paper.2 It didn’t help: The demand for the paper was still so great that our site crashed under a load of 10 000 hits per minute.3 After we added a slew of servers, our site came back up, and the paper was downloaded an unprecedented quarter of a million times on the first day.

The LIGO researchers had chosen to maintain confidentiality because they wanted their results carefully vetted before they went public. They also wanted the information to come from them, not from rumors. Although some of the information leaked before the announcement, they still did get the glory of presenting the full results to the world. And the ringdown phase has been impressive, as news of the result continues to spread far and wide.

Authors may have good reasons to announce their results prior to the completion of peer review—reasons that include competition from other groups, hope for informal community feedback, and desire to control the announcement and avoid weeks of rumors. But if authors choose that path, they should consider the possibility that peer review will turn up problems they did not think of, and they should tailor their announcement accordingly. Authors may instead choose to wait for the completion of peer review, especially when they have no concerns about competition. In such cases it is an even greater pity when rumors leak, because the leakers provide disincentive for such patience.

For LIGO, although much of the information leaked before the press conference, the researchers still had much to announce, probably in part because they had emphasized confidentiality. Announcing early makes sense in some cases, but the LIGO group made the right choice to wait.

Italian parents raising their kids on vegan diet may soon face up to 6 years in jail.

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An Italian official is calling for new laws that would punish parents who put their children on vegan diets, or force “reckless and dangerous eating behavour” on them with a sentence of up to six years in prison, Italian newspaper La Repubblica reported.
© Stephen Lovekin / Getty Images for NYCWFF / AFP

The legislation would “stigmatize the reckless and dangerous eating behaviours imposed by parents… to the detriment of minors,” the outlet quoted Elvira Savino, a deputy of the center-right Forza Italia party, as saying.

Although the law would primarily target vegan diets in situations when parents force children under the age of 16 to forgo meat, eggs, dairy, and animal products, any diet “lacking in essential elements for growth” would also be subject to it.

In the introduction to the bill, Savino warned that the view of a vegan diet “resulting in significant health benefits” was becoming more widely accepted in Italy.

The suggested base penalty for parents is one year, but it could be longer if the child is under three years old. In addition, if a child becomes ill due to the diet, the sentence could be lengthened to 2.5 – 4 years, and if the diet results in a child’s death, parents could be put behind bars for up to six years.

Savino emphasized that “inadequate” diets can leave children with deficits of iron, zinc, B12, omega-3, and other vitamins.

“There is no objection if the person making this choice is an informed adult. A problem arises when children are involved,” she said, La Repubblica reported.

However, the president of the Italian Society of Food Science responded to Savino, telling La Repubblica that a diet containing excessive sugar and fat could do much more harm than vegan diets.

Calls for the anti-Vegan law came after several high-profile cases of children suffering from severe malnutrition as a result of veganism emerged in Italy.

Last month, a one-year-old boy weighing 5 kilograms with blood calcium levels barely sufficient to survive was removed from his parents in Milan.

In June, a two-year-old toddler was hospitalized in Genoa and had to be treated for vitamin deficiency as the result of a vegan diet.

Watch: incredibly rare moment a baby is born inside the amniotic sac

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This is the incredibly rare moment a child is born while still inside its amniotic sac.

A doctor holds the baby on a table

The phenomenon is estimated to occur in one in every 80,000 births and luckily the moment was caught on camera.

The video shows the baby lying on a hospital table inside the fully-intact clear sac which covers the whole body.

Normally, the sac is broken during childbirth or a doctor pierces it with a scalpel during a caesarean.

The doctors and nurses crowded around the newborn to watch the once-in-a-lifetime experience.

The video has been viewed more than 6.8 million times in less than one day.

 Earlier this year another baby was recorded on video being born inside its amniotic sac.During that footage the doctor can be seen using a pair of surgical scissors to cut the baby out of the sack to take its first breaths.

http://www.telegraph.co.uk/news/2016/08/11/watch-incredibly-rare-moment-a-baby-is-born-inside-the-amniotic/?WTmcid=tmgoff_soc_spf_fb&WT.mc_id=sf33078837

10 Tips for Your Insulin Pump

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PumpsHandheldMen_190Whether you’re new to insulin pumps, or have been pumping for most of your life, there’s always something new to learn! Here are our top 10 tips for your MiniMed insulin pump.

  1. The Bolus Wizard on your insulin pump lets you set up to 8 sensitivity settings throughout the day. Your insulin sensitivity is the amount that your blood glucose level is reduced by one unit of insulin and might vary throughout the day.
  2. If you have different schedules on different days (like work days and weekends) which leads to different insulin needs, you can program up to 2 additional basal rate patterns. This allows you to switch from a basal rate on a normal day to different basal rates an instant.
  3. If you ever need just a little more insulin for a bolus (ok, let’s say a whole lot more), but reached the maximum delivery on your pump, here’s how to change the “Max bolus” setting.
  4. A Dual Wave bolus gives you an immediate bolus with the remaining insulin delivered over a set amount of time. This feature is useful for meals with both rapid and slowly absorbed carbohydrates (i.e. a lunch buffet or pizza night).
  5. Each of the bars on your battery icon on your pump screen represents approximately 25% of your battery life. Here are more 5 things to learn about the icons on your pump screen.
  6. When your battery is in a normal mode, if you hold the “B” button and press the down arrow at the same time during any active alert your pump light will turn on. Good to know when you’re in the dark and your pump starts alarming.
  7. Open and close your battery cap with a thick coin, like a nickel or quarter. Tighten until the slot is horizontal to prevent it from overtightening.
  8. There’s a taping technique that can be used with your infusion set known as an “open face sandwich” that helps your sets stick better. We promise you there’s no turkey and bread involved.
  9. If you ever need to clean your pump, use a damp cloth with water mixed with mild detergent to wipe the outside of your pump. Don’t place it under running water.
  10. Sometimes life happens and things can go wrong, so having a backup plan in place can bring you some piece of mind. Make sure you have extra diabetes and pump supplies on hand in case you need them and talk to your doctor about having a diabetes management backup plan in place.

Important Safety Information

Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems.

Pump therapy is not recommended for people who are unwilling or unable to perform a minimum of four blood glucose tests per day. Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately. NOTE: Do NOT use the Bolus Wizard to calculate a bolus for a period of time after giving a manual injection by syringe or pen. The Bolus Wizard does not account for manual injections, and could prompt you to deliver more insulin than needed. Too much insulin may cause hypoglycemia.

A Complication of Diabetes That Should Never Be Ignored

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There is complication of diabetes (well, diagnosis of any disease, really) that is as real as low blood sugar and that complication is depression. As Dr. William Polonsky once said, “I would be concerned if someone does not show some signs of depression after diagnosis.”

depression and diabetes

I have written about this before but it’s always worth repeating and today I want to add something to what I have discussed in the past. It is crucial to realize that just as your body needs a treatment to be physically healthy so, too, does your mind. Just as the body needs tending to when disease hits so, too, does the mind. Do not make the mistake that it I something it’s not. It’s there. It’s real. It needs to be tended to.

And it’s okay to say it.

I know many people do not talk about it and surely they have the choice to keep it to themselves but do not make the mistake of suffering without help. If you want to seek help without anyone knowing, do so; but do not leave it alone. My friend Gary Scheiner, and AADE Educator of the year for 2014, informs me that Integrated Diabetes Services has someone on staff who does teleconferencing in this field, so no matter where you are, you can get help.

Gary is the founder of this medical outreach and as in all cases, do your own homework, but I can tell you that Gary is incredibly respected in the world of diabetes and a powerhouse of knowledge and resources. My point is not just how great Gary is (which he is), my point is that if they have some sort of tele-means to help someone with the psyche side of diabetes, you should know that there is another means/tool out there to help you.

And here is the addition I want to make today. Keep an eye on yourself. Once your child is diagnosed, do not just think it is s/he that may need to talk to someone. Keep an eye out for you. A diagnosis hits the entire family. It hits it hard. If you need you speak to someone, find someone.

With the help that is available out there, no one should be alone in the middle of an ocean. If you find yourself not being able to be part of the mainstream as you were before diagnosis, please find someone to speak to about it. If you are truly struggling, it does no help to your child if you are not yourself.

You would not be the first person to seek help due to a diagnosis, and you will not be the last. But do not be the one who will think ‘it will just go away’. It might not. Be sure. My dear late Richard Rubin made very clear to me how important the psyche side of diabetes is and how much it is a complication. You would never think twice about the complications of a low blood sugar. Don’t think twice about the mental health complication of diabetes either.

Diabetes treatment is important for all complications. Depression is but another one that needs to be dealt with full energy.

Do it today.

A Glimpse Into Your Next Retinopathy Exam

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A man with Type 2 diabetes walks readers through the process, with a few drops of humor.

Type_2_Nation_Glimpse_Retinopathy_Exam_shutterstock_45071833_945px

“And, oh, yes, there is one more thing,” my doctor said after he told me I had Type 2 diabetes. “You’ll need to get your eyes checked once a year.”

When I was a kid, my Aunt Anna’s dwindling eyesight, and her eventual blindness, were attributed to what the civilians in the family referred to as “sugar diabetes.” It was something that ran in the family – a couple of the elders were the kind of diabetics who took lots of shots and a couple others just took pills but eventually needed shots. Everyone loved bread, but Anna never ate it, and had to go easy on the orange juice. That pretty much sums up my understanding of diabetes up to the time my doctor diagnosed me.

“You have all this junk floating around in your system”, my doctor said. Because of that, he continued, the blood vessels in my eyes were going to be vulnerable to damage. If it got bad enough, my vision could be affected. “So, I’ve referred you to an ophthalmologist,” he said. “He’s going to sprinkle some stuff in your eyes to dilate the pupils and then take some pictures. No big deal.”

People often put this eye visit off, and I am a world-class procrastinator. Fortunately for me, I was covered at the time by an insurance company that was an early adopter of the Encourage Proper Self-Management Theory. The insurance company was already going to force me to go to an eye doctor as a condition of a zero deductible policy and a pretty good deal on metformin, so I figured I might as well get it out of the way.

Diabetes and Your Eyes – The Risks

It doesn’t matter, really, what your exact diabetes diagnosis is – if your blood sugar level is elevated and high levels are sustained, you risk the kind of blood vessel and nervous tissue damage that could render you blind. This is nothing to fiddle around with.

Deterioration of eyesight is insidious, just like the onset of Type 2 diabetes. Diabetic retinopathy, although common, is not inevitable. It can be prevented, and slowed if it appears, by following reasonable overall preventive health advice and exercising good glycemic control.

Without that level of attention to self-care, excess blood glucose can cause blockage of the tiny blood vessels that serve the retina. When the blood supply is restricted, the eye tries to grow new blood vessels as a workaround; if the new vessels don’t develop well and become prone to leaking or bursting, the condition will likely worsen.

Here are the two ways the condition progresses:

  1. With early, or non-proliferative, retinopathy, new blood vessels aren’t developing to work around the blocked vessels. At the same time, the working vessels weaken as they become blocked, and tiny bulges called micro-aneurysms develop. If these bulges get large enough, and if nerve fibers in the retina begin to swell at the same time, then the macular tissue (the central part of the retina which captures images to transmit to the optic nerve) becomes damaged.
  2. With proliferative retinopathy, the workaround blood vessels grow abnormally and can leak blood into the vitreous, which is the clear jelly-like fluid encapsulated in the eyeball. Then, if this persists, the pressure inside the eye can become a cause (although not the only cause) of glaucoma, which can permanently damage eyesight.

There are injections and surgical interventions available if the condition worsens, but since diabetes has a way of slowing the healing process and lowering the body’s defenses to post-surgical complications, vigilance on the part of the patient to keep ahead on eye health is the best defense.

For your eye exam, what you can expect is a session lasting an hour to an hour and a half, starting with visual testing just as if all you’re in for is a routine eye checkup. Your doctor or the technician or nurse will ask how your blood sugar levels are doing, and probably ask for a list of your medications.

Then you will sit back for application of the pupil-dilating eye drops, followed by a few minutes of waiting while the drops work. Once the drops have kicked in, you will rest your chin in a frame to hold your head still while a brightly lit magnifier is used to examine the interiors of your eyes for signs of blood vessel damage, abnormalities, or other things that shouldn’t be there.

A glaucoma test will most likely be a part of the exam, and for this you can expect another chin-rest – this time facing a sensor that will (not painfully) record the level of pressure on the eyeball.

Here are four tips for those who may be new to the dilated pupil diabetic retinopathy ophthalmic examination process:

  1. It will take several hours for the dilating solution to wear off. Walking out into the parking lot on a sunny day will be about 30 times the shock of turning on the bathroom light at 3:00 AM. Don’t be so vain as to refuse the huge free wraparound flexible shades that will make you look like a 98-year-old Florida driver. Or, if your must, equip yourself with a nice pair of Ray-Bans or Maui Jims for the trip home.
  2. Have someone come with you to drive you home, or take a cab. Hopping on and off a bus or rail car is not recommended. Not only will the light outside be oppressively bright, but your vision will be blurry from the drops, and your irises won’t be able to shut down. Think of your pre-autofocus camera — your depth of field is going to be off. If you have a kid or a grandkid who has a driver’s license, you can position yourself in the back seat and get some payback for the years of earlier trips with that kid – be sure to kick under the driver’s seat and keep asking if you’re there yet.
  3. Take the work day off or schedule your visit for late afternoon if you’re able, especially if your work requires you to operate machinery, or to read a lot and sit at a keyboard, like my job does. I scheduled an early morning appointment once, and I wound up pretty much useless at work right up to quitting time.
  4. Finally, diet is important, of course, for all people who need to manage caloric and carbohydrate intake, but there are unique and special food choice risks which accompany the dilated eye exam process. Have someone you trust accompany you if you’re stopping for a bite after the exam. This year I grabbed a container of what I thought was creamy potato salad in the hospital cafeteria line – it turned out to be onion dip, which was delicious smeared on my roast beef sandwich, but unexpected.

The annual exam is entirely painless, and can give great peace of mind.

Diabetes Complications: Do You See Them Coming?

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There’s a strange phenomena that comes with living with diabetes. Perhaps the same as living with any illness or condition that slowly, gradually, over time, progresses. So slowly we don’t see it progressing; I certainly don’t feel it progressing.

glasses and eye health

Some complications progress whether we take care of diabetes or not. In the background, slowly during the ordinary days when I get up, work at my computer, meet friends for lunch, walk through the city, laugh through dinner out with my husband.

If I look back I know exactly when my ophthalmologist told me she saw the first sign of an eye problem –- a slow growing cataract when I was 52. The first sign, after 34 years of being so relieved I had no eye problems, now I did. Now I have another ― I have two slow growing cataracts.

I remember exactly when I got my first, of my two, frozen shoulders. It was the day I got off the plane after living and working in Tokyo for six years. Day after day my shoulder became more limited in its movement and more painful.

For a year I went from my endocrinologist to my family doctor to an occupational therapist, even a chiropractor recommended to me while I was visiting friends in San Francisco. But it wasn’t until my mother told me to go to her chiropractor that my shoulder was properly diagnosed and treated.

My second frozen shoulder 15 years later needed an in-hospital operation. The procedure successful. I asked if this could recur. My ace surgeon said, “Maybe, in about fifteen years.”

I consider myself lucky that after 44 years of living with type 1 diabetes I have relatively little to show for it. Yet when I sat in the ear doctor’s office eight years ago and heard him say I had a significant hearing loss I could only cry and think diabetes. I cried all week.

When I notice my calves cramping more than usual, as I have the past few weeks, I can only think neuropathy. And noticing for the first time an odd pulsing in my forearm, like a string being pulled on my nerves, and then it subsides but never really goes away, I think, diabetes?

Now you see me, now you don’t, diabetes. You are there and not there. I can forget you, but never as long as for a day.

And while I know I’m better off working to keep my diabetes well managed to have my best chance to keep complications at bay ― and I am very positive most of the time, even seeing gifts I’ve gained from having diabetes ― I also know I cannot control anything.

Least of all whether complications will creep in in the mist of day, while I’m trying so hard, or during the dark of night while I’m trying only to wake up in the morning.

Keeping Your Insulin Cool with Medactiv Travel Cases

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One hurdle many people face is how to keep their insulin cool while out doing what they do, whether it be hiking up a mountain, relaxing on the beach, or any other time you may not be keeping your insulin on your kitchen counter. For those on multiple daily injections (MDI), keeping your insulin pens with you is essential, but how do you keep them from getting too warm — especially in the summer?

IMG_5472Medactiv has a solution. Their travel bags have a special cooling pack on the inside that, when soaked in water, swells and keeps your insulin cool (not too cold like ice packs would).

The packs work by holding on to the cool water and through the process of evaporation, cool the inside of the pouch. After soaking the special blue pack in cold water for 2 minutes, simply wipe excess water off (I did squeeze mine a bit to get a lot of the water out as well, but it still maintained it’s swollen appearance and cooling abilities), and place it in your travel bag along with your insulin pens.

I received my sample bags (the Classic and the Single) just before my annual trip to the beach. I really wanted to put the packs to the test. So, as we were packing, I soaked my cool pack inserts and packed them away in my suitcase. IMG_5474For most of the trip, I used the small, single-pen pack to keep my fast-acting insulin with me on the beach. I did not keep my pack in the sunlight, but rather packed in amongst other beach essentials in my beach bag (towels, wipes, etc) which stays under a shaded tent. I just knew in the 90-degree heat that it wouldn’t last, but surprisingly, it worked very well for the 2 hours we would spend on the beach. For 2 days, I was able to keep my insulin pen cool in the pack.

The larger pack can hold 3 insulin pens, but is also large enough to accommodate an insulin pump as well if you are one to take it off while on the beach or for whatever other event you may be at.

There’s only one drawback to these cases, which seemed to be sort of a pain by the end of the trip. While the larger one may more easily accommodate possibly a travel bag (snack-bag) with insulin pen needles, the small, single case did not have a spot for them. So one either just be free-floating in the case or you would have to keep the case in with another case that would have your other essentials (pen needles, alcohol wipes, etc).

The cases do their job of keeping your medication at room temperature at least, but they aren’t diabetes supply cases, so keep that in mind if you choose to order one.