Photography, Graves Disease, Insulin pumps and a lot of other things

Writing about a number of things that have been on my mind.

This post concerns several things that have been on my mind for a while.

Photography

During the 2017 end-of-year holidays, I dropped and damaged the mirror box of my Nikon D5100 baby DSLR. It was not a new camera when I bought it on eBay (circa 2012), but it has worked flawlessly for the years I have owned it. Indeed had I not dropped it, it would have yielded at least another five years of service. I was pretty upset when I discovered it was damaged but excited that the attached lens was in good shape. I was also excited at the prospect of buying a new camera. The D5100 was released in April 2011, and in the intervening years, more recent and more capable cameras were introduced by Nikon, Sony, Fuji, Olympus and Canon. Buying a new camera, however, presented a new challenge. Which camera to choose?

There are many buzzes around mirrorless interchangeable lens cameras (MILC). A new term is needed to describe these types of cameras. The term mirrorless camera is as silly as the term horseless carriage. I suggest the time digital viewfinder camera(DVC) or digital interchangeable lens viewfinder(DILV), or electronic viewfinder(EV). Whatever you call it, though, the new style of interchangeable lens camera seems to be popular with many photographers.

Kingston Mill, Red, Water,
Kingston Mill

Canon EOS 5D Mark III + Canon EF 70-200mm f/2.8L IS II USM @ 70mm ISO 100 1/320s ƒ/4

At one time or another over the last two to three years, I have rented Olympus, Sony, Fuji and Panasonic interchangeable lens cameras. They all have pros and cons, with the newer iterations of each camera improving and reducing the problem areas.

I must look like a wet mangy dog without my camera because my wife's best friend offered to let me use her father's 1 camera and lens, a Canon EOS 5D Mk II with Canon EF 70-200 USM IL f/2.8. The 5D Mk II is a full-frame DSLR with "pro" level features. The EF 70-200 mm lens is worth more than all my existing lenses combined. I've never used Canon cameras and lenses and was trying to figure out what to do with this kit. Last week, after learning from a work colleague that any EF lens will work with the EOS 5D MK II, I started looking for used 35mm and 50mm EF lenses on eBay. Getting a used lens for less than $100 was worth it. I was tired of shooting photos of the birds in the backyard. However, I didn't need to.

Fisherman

I remembered that my Dad had given me his Canon Rebel film camera a few years ago. I knew it was somewhere in the basement. It took a few weeks, but I finally found it. It has a Canon EF 28-80mm f/3.5-5.6 lens. It's compatible with the 5D Mk III. I took the camera and lens on a recent road trip to Michigan and Ohio. I downloaded a few photos and noticed the quality could have been better. The images all seem "hazy". I assumed it was due to poor skill on my part -- shooting images with the light in the background. But I noticed photos taken indoors with front lightning had the same issue. I examined the lens and discovered some semi-transparent "goo" on the inside of the lens.

If I continue to use this lens, I must use the Adobe Lightroom "dehaze" tool for every captured image.

I found some inexpensive Nikon to Canon lens adapters on Amazon. I could use my existing Nikon lenses. The caveat is that the adapters do not allow auto-focus and TTL metering. I promise not to replace my Nikon until after my 2017 taxes are filed. I can't wait. I'll get a deal on a Nikon D500.

I've also struggled with impostor syndrome. I look at the excellent work by an artist like Olaf and. I compare my work to theirs, which is a mistake. Olaf has talent and years of experience. I'm just an amateur who photographs mainly on the weekend. The comparison leaves me feeling inadequate. I put the camera down, and my skills atrophy. Why am I doing this?

Old Route 27

Graves Disease

Over 12 years ago, I was diagnosed with Type 1 diabetes. After diagnosis, I started seeing a specialist, an endocrinologist, about every three months. On these regular visits, we discuss my insulin regimen, diet, exercise and the results of my lab tests. The lab results have lots of exciting and helpful information for an endocrinologist, but I only paid attention to the cholesterol and A1C values. But my endo looks at all of it.

One of the things she was testing was my thyroid function, which until recently was normal. And then it wasn't. She tested my thyroid function because people with other immune system diseases, such as type 1 diabetes, have an increased risk of hyperthyroidism. And the onset happened just as rapidly as it did for my Type 1 diabetes. After a battery of tests over a few weeks, my endocrinologist confirmed a diagnosis of Grave's Disease, which the American Thyroid Association describes this way:

Graves' disease, named after Irish physician Robert Graves, is a common cause of hyperthyroidism in the United States. This autoimmune condition leads to the overactivity of the thyroid gland, primarily affecting women (7-8 times more than men).

The disease is triggered by the body's immune system, typically responsible for defending against foreign invaders like bacteria and viruses. However, in Graves' disease, the immune system can produce antibodies that mistakenly target proteins within our own cells. Instead of destroying these cells, these antibodies, known as thyrotropin receptor antibodies (TRAb) or thyroid-stimulating immunoglobulins (TSI), stimulate thyroid cells excessively.

These antibodies bind to receptors on the surface of thyroid cells, prompting them to overproduce and release thyroid hormones. Consequently, this leads to hyperthyroidism, where the thyroid becomes overactive, producing excessive thyroid hormone.

Kingston Mill

Looking back over the last few months, I know I felt the symptoms of the disease, even though I did know how to interpret them.

I was anxious, irritable, and quite emotional. Anger. And sadness. My hands are shaking slightly, and using a computer -- either a keyboard or touchscreen is more complicated. I am sensitive to heat, and I feel like sweating into my socks. I feel tired while simultaneously feeling energetic (heart palpitations), and falling asleep was challenging. I lost seven pounds.

So now you know. I now have two autoimmune diseases. My endo gave me options for treatment -- pills, surgery, radiation therapy. I opted for the drugs. I am hoping the pills work.

I'll also find out from her what the other results of my lab test mean. Am I at risk for another autoimmune disease?

Work

Work has been stressful since a management change last year. As a consultant, I had worked harmoniously with the previous two managers, but over the last year, I had felt the relationship with the new manager was straining. It was also causing me considerable stress. On Monday, I had a panic attack while at the office. I came home early.

My wife reassured me that she was on board with me leaving. The toxic environment created by this person affected my mental and physical health.

Lake Carnegie
Lake Carnegie

I had started looking for new opportunities elsewhere, but my work for the client ended abruptly this week. I was told that my services were no longer needed. I didn't say a word. I didn't ask why. I said, "OK", packed my day bag, handed in my laptop and pass, and left.

Now, I have time to find my next gig or job. I've spoken to a few recruiters and contacted a few colleagues and friends. Next week, I plan to be busy with interviews and have a few offers by the end of April.

Writing

XKCD

As a blogger, it's easy to fall into the trap of thinking everything I write about is already known by everyone or that my audience on Island on the Net has seen everything I've ever published. It's good to remember that every day, someone might be part of the few to learn something new to them, even if I've written about it previously.

I have a backlog of about 116 articles in draft mode. Most of these are technical articles about photography, web development, and the IndieWeb. I want to set aside time to work on these. Perhaps some will be long-form, but I suspect most will be short.

Diabetes

My diabetes management is reasonably good. I usually keep my A1C within the recommended range. However, managing diabetes is not without challenges. Because I often get hypoglycemic when hiking, I don't exercise as much as I may need for optimal health. The fear of hypoglycemia keeps me sitting at the computer. But that may soon change. A new type of insulin pump is on the market, and I have one of the first models, the Medtronic 670G. It's a closed-loop system. Readings from a CGMS are relayed back to the insulin pump, which can adjust insulin delivery to suit the need. On Tuesday, I was trained to set up and use the CGMS and 670G. There is a learning curve. I had my ACCU-Chek insulin pump and Dexcom CGMS for over four years. I had mastered the technology. I'll have to learn anew.

Duck
Ducks
Duck
Duck
Duck

Insulin pumps may not be the best thing for me

I am beginning to feel that an insulin pump isn't right for me. It's been almost two weeks since I started using my insulin pump and I still have no clue if my basal and bolus rates are correct.

I have worked with a certified diabetes educator (CDE) from Roche to get my basal rate set. The first few days were challenging. I got a lot of hypos, requiring lots of treatment with smarties. The CDE considered the data unreliable since treating hypoglycemia doesn't allow us to see how low I would have gone with the rate and how much we should scale back. Of course I can't allow my BG go too low since the complications are immediate. I started using the pump in the middle of the week1 and I had a family event on the weekend2 so doing the "skip-a-meal" test wasn't something I thought I could do.

We tried for the next week but the results were mixed. It was also a very busy week3 at work. I had a number of back to back meetings all week but I tried to eat pretty much the same thing every day. I still had a lot of hypoglycemia but we thought we had made progress on the midday basal rate. We just needed to work out the basal rate for breakfast and dinner.

We modified a number of things including insulin/carb ratios and basal rates for different times of the day and I had fewer hypos that week. But I now had more hyperglycemia.

The CDE recommended I add some fibre to my fruit/vegetable blends. She thought the blends had too much sugar and not enough fibre. She also recommended drinking milk to add a fat to help slow digestion. I don't drink milk. I don't like it and I don't feel well afterwards. I was also advised to have my morning coffee later in the day instead of at breakfast. Somehow coffee might be raising my blood sugar in the morning.

On Roche's site one of the benefits of using a pump is stated as thus:

Plan your life, not your insulin scheduleAccu-Chek

The more I modified my diet and lifestyle to make the numbers works the more I became disenchanted with the pump. My normal breakfast is a blend of spinach, flax or chia seed, and berries or other fruits in a Vitamix. Total number of carbohydrates is about 17-20g. The flax, spinach and chia seed add healthy amounts of fibre. I don't eat eggs, toast and bacon for breakfast. I'd probably throw up if I did.

My lunch is usually a sandwich; a few slices of deli meat, low-fat cheese, lettuce, some may or mustard, between two slices of multi-grain bread. About 40g or carbohydrates. My wife insists on cooking dinner but I will occasionally eat a Trader Joe's packaged meal. A cooked meal may include one serving of brown rice or quinoa, vegetables, and organic fish or organic chicken. The only other meat we eat is grass-fed organic meat but we do that occasionally. We rarely eat out.

Does that sound like the a diet that needs to be modified? Do I really need to chuck my Vitamix and starting eating shit for breakfast? Do I really need to skip a meal and pop and aspirin for the resulting headache while listening to my stomach growl?

Does it make sense that went to bed with a BG of 101 on Saturday night and woke up with a BG of 140? Does it make sense that I went to bed Sunday night (last night) with a BG of 140 and woke up with a BG of 65 on Monday? Does it make sense that I ate the same things for breakfast on Sunday and Monday (this morning) and yet my 2HR post-prandial BG on Sunday was 140 and now (Monday) my BG is headed below 80?

Accurate carb counting is critical for getting the most from your pump.Excerpt From: John Walsh, PA & Ruth Roberts, MA. “Pumping Insulin.

The only way I know of to get accurate carb counts is to eat prepackaged processed foods. Surely this can't be a good thing! I am beginning to think the entire diabetes medical industry is full of shit. Am I supposed to stop eating home made meals unless I weigh and measure every ingredient and then compute nutritional information? Can I now only eat home cooked meals that come from a recipe book that includes nutritional information? Do I only eat at fast food and chain restaurants that have nutritional information available? Are all the local restaurants verboten? Explain to me how a pump fits in with my existing lifestyle or do I need a new one?

I feel the way I felt when I was just diagnosed. I feel like I don't know my body. I don't feel like I have control of my diabetes. I spend more time thinking about my diabetes with the pump then I did when I was on multiple daily injections. I find myself constantly checking the CGMS to see if I am headed for a hypo so that I can set a temporary basal. I find myself testing more often because I started to doubt the CGMS. I feel like I spend more time planning my insulin schedule than my life.

We have been unable to get anything sorted out in the almost two weeks since I started using this pump. Nothing makes sense to me anymore. I have lost control and that is pissing me off. I am disappointed. I am back where I was eight years ago when I was first diagnosed.

But, not wanting to be accused of not given pumping a chance I have decided to give it one more week before I call it quits on the insulin pump. I have set the range on my CGMS to between 80 and 200 so that I won't get "buzzed' by my CGMS in the middle of meetings and the middle of the night. Today and tomorrow, I will eat the same EXACT thing for ALL my meals. On Wednesday, I will skip breakfast. On Thursday I will skip lunch. And on Friday I will skip dinner. Hopefully I won't throw up from eating the same thing for every meal. Hopefully the hunger headaches won't affect my work. Hopefully I can get some restful sleep.

If we don't have a reliable set of observations to work with and we can't get my life back, then I am done with pumping. I will send this unit back to Roche. I will not change my diet and lifestyle to suit this device. It seems to me that is the antithesis of the supposed benefits.

I've read that a lot of people do well on the pump but I think and insulin pump may not be the best thing for me.


  1. My endo wanted to be present during the procedure and was booked for weekends. 
  2. A pizza party for my nephew but I expected his Dad and I would also want beer. 
  3. I am consulting on project with a very tight spring deadline.