Exciting times

#DBlogCheck day has inspired me to take a few moments out of my day to remind myself (and others) how excited I am by all that is going on in the diabetes community and in my own diabetic life right now!

The past few weeks and months have been an incredible crescendo of activity, and one which continues to rise. Friends For Life International Children With Diabetes Conference Orlando 2014 was, as previous years have been, an unbelievable and critical part of my life and of so many others'. I am privileged and grateful to have had an expanded role as faculty of this amazing conference, and to have seen the conference schedule continue to evolve. Much of the rest of this list is a direct result of what CWD has brought to my life. Previous contacts and friendships have evolved, new ones have been made, and all add so very much to my personal life, my professional life, and my diabetes life, and the intersections of all three. In no particular order, and I'm sure in no sense of comprehensiveness, here is what I'll want to remember later from this past year (and apologies for anything/anyone I unintentionally fail to mention):

• Laura, Jeff, Brenda, Marissa, Adam, Connor, Natalie, Jim, and many more of the CWD crew!
• Kerri at SixUntilMe, who published her first book, Balancing Diabetes--so awesome to see in print the names of so many from our community (including me, proudly).
• Scott at ScottsDiabetes and mySugr.
• Chris and Philip from GlucoLift.
• Christel at theperfectd.
• Kelly at Diabetesaliciousness.
• Briley at inDpendence.
• Bennet at YDMV.
• Manny at Diabetes Hands Foudation.
• Bill and Anna at glu.
• Ed Damiano, PhD, of Boston University's Bionic Pancreas project, who sorely needs help raising funds--and SOON so please, PLEASE give here--to help fund the next crucial step of device development for the system that so many people, myself included, fully believe will be a total game changer in how hard we have to work and how well we do in managing diabetes.
• Howard Look and the amazing things happening (all started within the past year!) at tidepool.org. Keep your eyes open for when their products come out publicly. They could use your help with funding too.
• Diana and Korey (and the work that Tamara and I are doing with Korey on a medical school textbook chapter on biopsychosocial aspects of diabetes).
• Heather, Jess, and Pat--their mentorship and support to Tamara and me as we embark on a research journey--and having been awarded our very first research grant, to investigate blog use in type 1 diabetes--more to come on this!
• All of the bloggers who have pledged their support to our research--you know who you are and your help is so greatly appreciated!
• So many families we've met and gotten to know better, both online and in person, and their amazing kids.
• CGM in the Cloud and its explosion in the past few weeks. #WeAreNotWaiting
• The upcoming Diabetes UnConference, Spring 2015. Though I won't be able to attend, I'm looking forward to following whatever posts, tweets, and updates I can, and hopefully to attending its second annual meeting :)
• Diabetes advocacy and, for example, the Strip Safely campaign's actually getting the attention of the FDA.

What a year!  What a great time to be part of this unequaled community! And what a great time (if there is one) to have type 1 diabetes! I cannot wait to see what the coming year has in store.

25 years

Today marks 25 years with type 1 diabetes. 25 years since I was whisked away from all of my friends to jump a hastily booked flight across the Atlantic, back to the States, to fly overnight and alone with a disease I knew little about and which I thought was probably terminal.

I was shocked, devastated, confused, afraid, and lonely.

The shock faded first, and though it tended to return in fits at unexpected times, it quickly retreated each of those times. The devastation slowly receded as I realized bit by bit that I'd still be able to do a lot of things. The confusion still visits quite often, 25 years later, but it's a familiar visitor, and one usually brushed easily aside, because even when blood sugars are wacky despite confident carb counts, ratios, and rates, I now know that sometimes they just don't follow predictable rules, yet I have to move forward with the rules immediately anyway, so the confusion needs to be dismissed. The fear diminished too, over the early months and years, as the daily (hourly?) work of diabetes became routine and commonplace.

Loneliness turned out to be the toughest foe. It was the least expected, and it was the most persistent. However, in just these past 3 years, I've taken the upper hand, with my newly discovered secret weapon: the diabetes online community and a combination of virtual contacts and face to face meetings, the latter only possible because of the power, organization, and commitment of the DOC as an online force that occasionally but necessarily goes beyond online to in-person. I didn't know that I felt lost without it because I didn't know that it was missing or that it existed. Now I know what a crucial part of my diabetes self-management it is and I am grateful for the many new friends and shoulders it has brought.

My great regret is that though those who know it love it, there seems to be little similar recognition among most healthcare providers, and this keeps it from being introduced to most patients and their families, for the healthcare providers are usually the place most people turn for support resources. So during these next 25 years, while I await the cure that I was assured would arrive 15 to 20 years ago, I plan to conduct some of the research that will validate the DOC and bring its existence and its benefits to the consciousness of the healthcare community, and in so doing extend its many opportunities and promises to the vast majority of patients who don't know it's out there or what it can do. My wife is dedicated to partnering with me in these efforts, as are many in the DOC who have pledged their support. You know who you are, and I am grateful. Together we can do this work, and maybe those countless others can have just some of their shock, devastation, confusion, fear, and loneliness diminished more quickly and more substantially than they were for me until now. 

Tribute

This post has little or nothing to do with diabetes. It has to do with me at work, outside my usual wheelhouse. Oh, and I happen to have diabetes.

I gazed at the withering man, taking in the clinical information I needed through my eyes alone. His drawn skin, stretching over hollowing cheeks. His unfocused gaze. His well defined muscles gave away his substantial strength, but his arms themselves, much too long, gave away that those same muscles were far weaker than they had been up until this point in his life. I leaned over the hospital bed and placed my stethoscope gingerly on his chest. I closed my eyes to isolate my hearing, as I often do, listening for the sounds his still-strong heart was producing. I heard the familiar sounds of a cardiac monitor beep-beep-beeping in that muffled way they assume when the earpieces seal well in your ears.

But that cardiac monitor was sorely out of place. I opened my eyes suddenly, to verify that I was, in fact, not in a hospital, but in my patient's home. I hadn't heard the rhythmic sounds before, the sounds made by the rumbling clothes dryer as it clink-clink-clinked a button against the dryer wall, and I caught myself being too clinical when I needed to be less. I had to ease the suffering of a dying man and his reeling family, each in various stages of acceptance, denial, and coping with great change. I quickly wrapped up my exam, checking for swelling and for pressure ulcers, and I shifted my focus.

As I sat by his bedside and he told me stories of his childhood, his sister came over to hear. "I need to get the details of this story straight," she said. "I've always relied on him to tell these stories, but I have to learn them quickly now so I can carry them on."

I looked around as I listened. The hospital bed was set up in the side of the living room, by the large window. A cathedral ceiling rose over his head and drew his gaze most of the time I was there. His sister's cigarettes and lighter lay gently on the armrest of the couch across the room. His wife wrung her hands slowly and discretely as she hovered, lovingly, not knowing how to help or what to do for this man beyond her ability or mine to fix, only to comfort. A young girl--four? five?--giggled from the other hallway, chattered and giggled and giggled some more, before I realized there were two girls making those noises. This brought a thin but definite smile to his lips, each time the sweet sounds of his giggling granddaughters bubbled down the hall.

He was very weak today. His wife told me it was because he had insisted on a walk across the street yesterday, to see the creek. While they were out, struggling to help him walk, a storm came quickly, and they got caught in the rain as they walked him back to the house. He slowed down, lingering outside. He always loved the feeling of the rain coming down on his skin, they told me. He smiled at that too, but with melancholy this time.

His wife and I excused ourselves to the kitchen, where we talked about his medications--which ones he'd no longer need, which ones would make him more comfortable, and when and how much to give. She was very worried about the medications, but I assured her that there was really nothing she could do to hurt him. I explained that our sole focus at this time should be on easing any discomfort to the best of our abilities. We wouldn't be able to prevent all pain or confusion, but we'd minimize them as best we could.

I went back to sit with him once more, to hear another story of his ancestors, and to glean all I could from my rare visit to a patient's home.

The circumstances that led me there, rather than him to my office, were quite unique. It was the first home visit I had made in 10 years. The very first on my own. The others (all four of them) had been in medical school and residency.

The patient was grateful (not why I did it), as was his family (not why I did it). I did it because it was what he needed at that time. But it was transforming for me. More than almost anything else I do, it came with the knowledge that I truly and fundamentally changed the experience of his dying and was able to bring comfort in ways not so accessible in the office or in the hospital. I didn't follow any clinical practice guidelines. I didn't use any checklists. I didn't have an electronic medical record. I just had my stethoscope and a pen, and I didn't really need them, either.

I have to make this happen more often.

On my way in, his sister had shut a laptop that was open on a bedstand near his head. As I walked toward the door on my way out, she opened it again, and gospel music began to play, following me through the door, to my car, and lingering in my ears, slowly fading as I drove away along the creek across the street.

I take comfort in knowing that the gospel music was still playing there when he took his last breath this morning.

What my daughter made for dinner

My non-D-daughter is taking "Family & Consumer Science" right now at school.  I'd say that I'm pretty sure that's 2013 for "Home Economics," but I'm probably not allowed to.  Anyway, tonight was one of her major projects: making dinner for the family, starting with menu planning and grocery shopping.  This is a HUGE undertaking for her.  I love her dearly, in so many ways, but this promised trouble from the start.  She is an extremely picky eater, shows no interest in cooking, and her only expressed interest in grocery shopping is to get a donut when her D-sister isn't there (not that we don't allow her to eat donuts...).  This is amplified by her sister's ever too ready side by side comparison; my other daughter is an adventurous eater, loves to cook, and can easily find her way around the grocery store.

She looked through numerous cookbooks and selected her recipes.  She went through the ingredients we had on hand and then made a grocery list of the items she'd need.  So, with the greatest of attitudes, I took her shopping today.  We collected the items she'd need, went home, and she started to cook.

She did fine with the appetizer she had selected--spiced pecans.  She learned about how to measure butter by the markings on the stick.  She learned about cayenne and cumin, which were new to her.  She learned how important the stove temperature can be.  Her feelings were a little hurt when her sister didn't want to try the nuts, and wasn't very appreciative when I couldn't help pointing out the obvious: "See how someone's feelings can be hurt when you cook something and they won't even try it?"  (I really couldn't help it.)  But she was learning!  So far, so good.  And then she shifted to the main course, and that's where we hit a speed bump.

"Dad, where's the chicken?"

"What chicken, sweetheart?"

"Dad, I'm making chicken teriyaki.  I forgot to put chicken on the list.  Oh no, I guess we're eating nuts for dinner."

"Honey, that's okay.  Mom or I can take you to get chicken.  But making dinner really is harder than it looks, isn't it?"  (I couldn't help it again.)

So my wife took her, with heavier than usual traffic due to the evening rush, and they came back 6 miles and 1 hour later.

She was a little deflated, but I got to make up for my previous utterances and tell her the story of how when I started cooking I was eager and adventurous, but completely incapable of getting dinner on the table before 9 (or 10) pm.  She still needed a lot of cheerleading, because the poor thing was really struggling and feeling the effort and the burden grow.  ("Everyone is getting hungrier and it's getting later and later.  I can't believe I forgot the chicken.  Please eat the nuts.  At least you'll have something.  I'm going to fail this class.")

We sat down to eat, and no sooner did she sit, with apron on--very cute--than she sprang back up to go make dessert.

"Dad, where's the powdered sugar?"
"Where's the vanilla extract?"
"Do we have a 'fine mesh sieve' Dad?"

It took four tries to get the beaters attached to the hand mixer, but she watched with amusement as the cream formed firm peaks, then took the blackberry puree ("Dad, do we have a food processor?") and folded it in ("Where is the rubber spatula?!") along with some whole fresh blackberries.

In the end, everything was delicious, and she learned a ton.  She obviously learned the most from her stumbles.  She lamented that she thought everyone else in class probably did better than she did, and that she really was no good at it.  I reminded her that it all tasted great, and that she just needs more practice and more experience.  She was glad it tasted good, but was tired and it was getting late, and she had other homework to do, which she hadn't had a chance to start.  She struggled through that, and her shower, and lost even more steam as she made her way to bed.  She was visibly relieved when I told her I'd do the dishes--she had done quite enough.  I tucked her in and wished her good night.

And then I went down to clean up and do those dishes.  I eventually cleared away enough debris to find the pile of cookbooks on the counter.  Sitting on top, still open to her recipe, was the one she had used tonight.  I closed it to put it away--and I stopped.  It was only then that I realized she had used a cookbook "for families living with type 1 diabetes."  She had made low-carb selections, and adapted them to be gluten free.  She hadn't had to ask for any help with those parts.  She knows that stuff cold, though she has neither diabetes nor celiac herself.  She was already asleep, but in the morning I'll be sure to tell her that despite what she thinks, I'm pretty certain that no one else in her class can do what she did tonight.

Unexpected Perspective

It was a fairly typical day, with an afternoon schedule full of patients and a meeting at the end of the day, the only significant mystery being how late I'd be to the meeting because of the perpetual time-creep that has me running several minutes behind (at least) by the end of the day.

One particular patient I saw today was not very interesting at all, almost downright forgettable.  He was so absolutely straightforward (both medically and with direct communication) that I finished in 5 minutes fewer than the time he was scheduled for.  He is seen once a year, takes one medication, has no side effects, has exactly the desired response to that medication, and has no other issues.  He is a very nice, professional man who works hard, is good at what he does, and enjoys grown-up leisure activities.  I gave him a new prescription, told him I would see him in a year--sooner if the need or desire arose--and moved on to the next patient.  I didn't dictate a note on our visit, leaving that for later in the evening so that I wouldn't miss [more of] my meeting.  My other patients were all far more medically "interesting" (i.e., complicated, and generally not something someone aspires to) than he was, and I soon forgot about our visit.

Fast forward past my other patients, my meeting, dinner, kids' homework, bedtime battles...I sat down to dictate the afternoon's appointments.  When I got to him, I noticed his birthdate.  He was born on the day I was diagnosed with diabetes, 24 years ago.  Over the years I've gotten used to just counting (though there were several years where I wasn't counting at all, the years just stacking up).  Though I've reflected a little on the number, I haven't reflected at all on the actual time represented by that number.  I  stopped before dictating, transfixed by his birthdate, and it suddenly seemed that I've had diabetes forever. Since I was diagnosed, he was born, learned to crawl, to walk, to talk, went to kindergarten, high school, college, work.  He shaves.  He votes.  He drinks.  He's married.  He has a kid on the way.  Suddenly I saw my diabetes as an adult itself, having grown through all of those stages, in a flash.  How can my diabetes be old enough to do all of those things?

In the end, completely unexpectedly and in a completely new light, he was the most interesting patient I'd seen not only today, but in a very long time.

Firsts

Almost free-association on some firsts in my life. Almost.

Tenley is the first person I ever knew to have diabetes.  She is also the first person I knew at the time of their diagnosis--I knew her as the girl across the street for as long as I could remember.  We were great friends, very close, and she was like a sister to me.  She is a year older than me, and was probably 7 or 8 when she was diagnosed.  I have a vague memory of her mother, Ann, crying.  I remember my mother crying too.  I was little and, I imagine, deliberately insulated from what was going on.  I didn't know much about Tenley's diabetes, except that she was "very sick."  Something to do with sugar, but I didn't understand what.  When she came home after several days, she seemed fine to me.  As a kid, that's what was most important: she seemed okay, so the details didn't really matter.

She is also the first person I thought of when I was diagnosed with diabetes at age 17.  Something to do with sugar, but I still didn't really know what.

Alvin was one of my neighbors back then, I think, though I wasn't quite sure where he lived.  He seemed to be in the neighborhood often, and he walked everywhere, so I figured he must have lived nearby.  He was the first person I knew who was very "different."  That was how I thought of him.  I wasn't sure why he was different, but he was.  He seemed nice, was always cheerful, but by the same token was scary to a little kid like me as well.  I don't remember him clearly enough, but as I look back I now understand that he was mentally retarded and also probably had cerebral palsy. Tenley's older brother Tim had made Alvin a walking wheel, or at least that's how I thought of it--I'm not really sure what to call it.  I think it was a bike wheel on a long metal handle, with a bike grip and an odometer.  Alvin took it everywhere, and he would proudly tell people how far he had walked.  He was especially enthusiastic when he'd see Tim and announce how many miles he had on his odometer.

I always looked up to Tim.  He's a few years older than Tenley (Tracey is in between Tim and Tenley, and Todd is the oldest of the four).  Though a few years older than me, Tim still seemed too young to ride the orange, gas-powered dirt bike that he sometimes brought across the street for me to look at (and attempt to lift).  I was in awe of that bike and of Tim's being able to handle it.  I loved that he would hold it up and let me sit on the seat, twist the throttle, and practice my "vroom vroom vroooooooooom" voice, silently wishing the engine was running when doing so.

Tim was diagnosed with type 1 diabetes years later, the first person I knew who was diagnosed as an adult.  Since I had been diagnosed at 17--almost an adult--he turned to me for advice and information during his post-diagnosis maelstrom, and then later too, when things settled down a bit.  I was still in college--nowhere near medical school yet--and remember that being the first time that someone specifically sought health advice from me.

Paul--father to Todd, Tim, Tracey, and Tenley, and husband to Ann--was my first dentist.  He gave me my first filling and my first Novocain.  He is the first person I knew who chewed tobacco, and their house was the first place I ever saw a spitoon.  He's the first person I knew who hunted, and the first person I knew to pour so much passion into hunting.  He trained retrievers and hunted ducks, and the family dogs--always big--were the first dogs I feared, and the first I grew close to once the fear began to ebb.

Ann is the first second-mom I had.  During those formative years when we lived across the street, from age 2 to 7 for me, she seemed more like another mom than a neighbor, and I always thought of her that way--another mother-type who happened to live across the street.  (Neighbors, to me, were only people who lived next to you, not across from you.)  After we moved a couple of miles away, our families remained very close.  When my wife and I began dating, Ann was the first to tell me "She's a keeper!" She was also the first to really mean it, and to make sure that I knew that.

That was 18 years ago.  Life has led me away from that area--not extremely far, but far enough that I grew apart from their family.  My parents and sister have stayed close, and they would give me updates from time to time.  Ann is the first real smoker I ever knew, so I wasn't especially surprised when I learned that she had been diagnosed with lung cancer.  I think I was still in medical school at the time, but already knew lots of statistics about it--how low the survival rates, how poor the prognosis.  Ann did great from all I heard, but I expected the worst.  Lung cancer treatment often seems good at first, but it tends to return, usually relatively soon in the scheme of things, which is why the five year survival is so low.  I kept expecting to hear about a recurrence, only I never did.  I kept hearing updates about Ann and Paul, their kids and grandkids, and they were all about life--not about cancer.  Eventually I got used to this--this anticipation of bad news never delivered--and without realizing it, that feeling became so familiar, and the lack of bad news so consistent, that I began to feel like it would never come.  Even though I believed that Ann's cancer would come back, it truly felt like it never would, and that Ann would just keep on going forever.

At the same time, my medical career was progressing, and I was gaining ever more experience with numerous conditions, from birth to death and everything in between.  I have cared for many patients at the end of their lives, and I hope and believe that I have helped many to have greater peace when they have ultimately died.  I have known many patients who have transitioned to hospice to complete their journey through life.  I have become comfortable--or at least at peace--with end-of-life and hospice.  Though sad and final, it seems to be more natural when appropriate, especially in contrast to the endless and sometimes torturous things people may otherwise endure in our life-prolonging and cure-oriented health system.  First do no harm.

Ann has been in the hospital all week.  She has been there before.  But today she transferred to hospice.

I am not as accepting as I am for the patients with whom I have traveled this path. While friendly, they have been patients, not friends--at least, not my friends.  Ann is the first friend I know who has entered hospice. I have believed for a long time that this would eventually happen, but I have grown accustomed to this expectation being unmet. So I was surprised.  I was unprepared.  I am sad.  As the evening and then night have gone on, I am beginning to be accepting.  I am remembering--sometimes smiling, sometimes aching.

I am reflecting, on so many firsts.

Another Hiatus, Ended Better Yet

Spoiler alert: this is a sequel.  It is a welcome follow-up to a previous post from five months earlier, which actually was my last substantive post until now.  You see, there's this pattern that is emerging, wherein I feel moved to write a blog post immediately after Children With Diabetes conferences.  Or maybe it's after crossing paths with Ed Damiano, but I'm getting ahead of myself.

I've just returned from CWD's Friends For Life 2013 conference in Orlando, Florida.  Last year was my first time attending FFL, and I resolved right then and there to do everything possible to make it so that I never miss another.  The biggest mistake we made last year was staying a couple of days after the conference to go to theme parks.  We hadn't anticipated how empty the hotel's conference center would be, nor how quickly the next convention would move in and start setting up (it felt like they were desecrating our home while we still lived there), nor how thoroughly depressing that would be.

So this year, we added a couple of days at the beginning, before the conference began.  It was on one of those mornings that I was standing in line with my family, waiting to be seated for breakfast at Pepper's Market, at Disney's Coronado Springs Resort.  Up walked one of my favorite PWDs, Natalie, whom I hadn't seen since CWD's Focus on Technology in February in Crystal City, Virginia.  Hugs all around, and we began talking, and didn't really stop talking.  Before long, we got to the topic of Ed Damiano and the Bionic Pancreas, how she'd like to participate in the research study, and how I felt that seeing that one lecture changed my life. We were both talking at the same time, ever so enthusiastic and ever so passionate (which is Natalie all the time as far as I can tell, and me not nearly as often). I was standing next to a pillar at the restaurant's entrance and she was facing me, as people were lining up behind us and we weren't moving forward with the line as we should, nor taking the table offered to us.  So I didn't see who was approaching when she turned to the side and said to the approaching group "No way! We were just talking about you!" and then Ed Damiano rounded the corner and stood right in front of me.

"Ed, have you met my friend Sean?  He's a family physician with type 1 diabetes," said Natalie, as I struggled to maintain a shred of composure.

I shook his hand and told him "I just wanted to say thank you for all that you're doing and all that you've done.  I saw your lecture at CWD's Focus on Technology in DC in February, and it blew me away.  I've been to a lot of lectures since medical school, and I'm really not the 'best thing ever!' type, but I have to tell you, with complete sincerity, that your talk was the best lecture I've ever seen.  After last year's FFL I started to blog, thought I would blog a lot, but only wrote two posts and then stopped.  Seeing your lecture, months later, finally inspired me to write another post."

"You wrote a blog post about that?  What was it called?" he asked me.

I struggled to recall the name, which eventually came to me: "Long hiatus, ended well," I replied.

"You wrote that?!" he asked, stepping back as his eyebrows registered surprise, "I've been dying to meet you!"

Then it was my eyebrows' turn to rocket to the ceiling.  As they did, also to my surprise, his daughter stepped toward me, opened her arms, reached up, and gave me a tight hug.

As I regained my waning composure, I managed to say something like: "You've been dying to meet me? That's ridiculous. I've been dying to meet you!"

As we talked some more, he invited my family and me to dinner with his team and their families the evening before his lecture.  Reservations for a group of 35.  I was shocked and flattered to be included.  We exchanged phone numbers so he'd be able to reach me with dinner details.

We finally managed to eat breakfast, and then it was off for a day at Epcot.

*          *          *

Fast forward to Wednesday, after the grand opening of the exhibit hall.  Ed texted me to meet at his Bionic Pancreas booth, so everyone could walk over together for dinner.  Some of the families didn't stay since the reservation was so late, but it was still a large group, at multiple tables.  Thankful for Ed's gracious invitation, I took an empty seat at one of the tables, just glad to be there, and expecting a pleasant dinner with some of his team members.  I was shocked all over again when Ed sat down directly across from me.  And then, to heighten the already unparalleled surreality, he matter-of-factly laid down all of the pieces of his experimental bionic pancreas device right on the table between us, where it sat the whole evening, except for when he picked it up to take it apart and show me its insides.

We talked and shared over a two and a half hour dinner and sparkling water. I learned more about his research, his family, his team, his plan, and his charm. And, like just about any other parent at CWD, he made me feel very much at ease in talking with him and sharing ideas.  At one point he mentioned a new feature they were considering, and I felt compelled to offer my [differing] opinion.  While I was talking, I was conscious of a part of my brain saying "Don't tell him his business!"  But I felt strongly, he listened closely, and in the end he said "That's a great point. I hadn't thought of it that way. We'll really need to look at that."

I spoke with other team members sitting next to and across from me as well, from a pump designer, to a pediatric endocrine research fellow, to Firas El-Khatib, the genius behind the controller algorithm and computer code that run the magic system.

It was, without a doubt, one of the most incredible, amazing, and unexpected experiences I have ever had.

Around midnight, I eventually made it back to my hotel room.  The kids were fast asleep, and my wife roused enough to make sure it was me who was entering the room.  I couldn't contain my excitement, and in a semi-coherent flurry of mostly complete sentences, I tried to recount some of the highlights to her, but I kept interrupting myself as I went on and on.

I eventually went to bed, still not believing the day I had just had, and looking forward to what the next day would bring, including Ed's formal presentation to the conference attendees.  The talk I had attended five months earlier had included results from his 2-day experiments, before the newest study had started.  Ed had just told me at dinner that I was in for quite a surprise at tomorrow's talk, when I'd get to see the 5-day data from the newest study.  He was pretty sure I'd be pleased.  (Of course, he was absolutely right.)  As I finally fell asleep, I was vaguely aware of the enormous smile that wouldn't leave my face.

*          *          *

Back to that day at breakfast where I first met Ed.  I could hardly eat.  I had so many thoughts and feelings ricocheting around I didn't know what to do with myself.  I could have gone home right then and there and the conference would already have been an enormous success.

CWD FFL is just that way.  The amazing happens.  The unexpected happens.  Lives are changed.  Energy is found, and then it is focused.  Hope is reignited, fanned, fueled.

And the conference hadn't even started yet.

Which is another sequel, all to itself.