9.17.2009

A meme to bring me back to my blog

Taken from Keri, who stole it from George, who lifted it from LeeAnn, who got it from ... SOMEWHERE!

1. I’ve come to realize that my chest-size … is something I never really thought about before (unless I'm buying undergarmets!)

2. I’ve come to realize that my job … is very rewarding yet completely exhausting.

3. I’ve come to realize that when I’m driving … I'm usually on my cell phone.

4. I’ve come to realize that I need … a TON of emotional support.

5. I’ve come to realize that I have lost … a part of my ability to trust others, and that I will always have to work on that.

6. I’ve come to realize that I HATE it when … I feel like people aren't hearing me or listening to me (people being those close to me).

7. I’ve come to realize that if I’m drunk … its usually because something else in my life is wrong.

8. I’ve come to realize that money … isn't everything but does help out with all the little things in life.

9. I’ve come to realize that certain people … may never understand me, and maybe thats okay.

10. I’ve come to realize that I’ll always … need a pet. I can't live with out one!

11. I’ve come to realize that my sibling … is an awesome friend and woman!

12. I’ve come to realize that my mom … has gone through a lot in her life and is someone I can learn a lot from.

13. I’ve come to realize that my cell phone … isn't as important as I think it is.

14. I’ve come to realize that when I woke up this morning … okay, I actually just woke up (working nights will do that to a person) so when I woke up I DID think it was morning but it was evening and THAT'S simply confusing.

15. I’ve come to realize that last night before I went to sleep … I shouldn't have taken that sleep aid.

16. I’ve come to realize that right now I am thinking …about my diabetes and how I NEED to change that infusion set...

17. I’ve come to realize that my dad … isn't well and may not be with us beyond the year 2010.

18. I’ve come to realize that when I get on Facebook … I use it as a distraction from myself.

19. I’ve come to realize that today … was completely lost, but again, that happens when you work nights.

20. I’ve come to realize that tonight … doesn't look any better.

21. I’ve come to realize that tomorrow …is waiting, new and glistening.

22. I’ve come to realize that I really want to … be in a healthy relationship for once.

23. I’ve come to realize that the person who is most likely to repost this is … dependent on the reader.

24. I’ve come to realize that life … isn't like a box of chocolates, or even sugar-free chocolates for that matter. Life is the choices we make based on what cards we are dealt and how we play our hand.

25. I’ve come to realize that this weekItalicend … is full of possibilities and dependent on what I choose.

26. I’ve come to realize that marriage … is sacred and not to be taken lightly.

27. I’ve come to realize that my friends … really do keep me together!

28. I’ve come to realize that this year … was terribly difficult.

29. I’ve come to realize that my ex is … something I am still unclear about.

30. I’ve come to realize that maybe I should … be nicer to myself.

31. I’ve come to realize that I love … animals. They comfort me beyond words.

32. I’ve come to realize that I don’t understand … a lot and am always learning something new.

33. I’ve come to realize my past … will always be there, so I may as well accept it and move on.

34. I’ve come to realize that parties … and me don't mix well.

35. I’ve come to realize that I’m totally terrified … of failure.

9.04.2009

Stevia herb. What is it?

7.01.2009

Reaching my A1C goals

I am trying to get my A1C lower. In April it was 7.5 which is where it was in January, and I want it below 7 (to follow the new guidelines of diabetes control). I have 5 weeks until my next A1C test (had to push it back for our trip to Colorado at the end of July) and I am trying to plan now how to manage the next 5 weeks to at least get my A1C closer to 7. I know I should have been doing this for the past 8 weeks since my last endo visit, but there were other things I had to focus on instead.

So, now that the test is looming nearer, and I am feeling more in control of my emotions, I am wondering what to do. I have had an A1C under 7 during the last 9 months of 2007, but I wouldn't say that I had good control during that time. In fact, in the time where it was under 7 I had some of the worst lows ever as an adult.

I know that its attainable, but for me its just figuring out how to keep my daily glucose numbers stable and in my "target range". For myself I am aiming for a premeal/fasting range of 85-130mg/dL, and a post meal range of 140-180mg/dL. At a blood sugar of 80 I find I tend to go low easily and fast. And anything over 190 tends to give me headaches or other negative symptoms of hyperglycemia (irritability, excessive thirst, sore muscles, so on...)

I think trying to keep stable blood sugars is a better criteria of reaching my goal for a couple of reasons. First, it will hopefully prevent me from having as many lows as I did back in 2007; secondly it will help keep my weight stable and ideally even assist with my weight loss goal. Lastly I am hoping that keeping my glucose in range will help my mood, because I feel that highs and lows have a tremendous effect on my mood. A high blood sugar makes my anger flare up a lot quicker than normal, and a low makes me overly sensitive and teary-eyed, not to mention exhausted after its treated. Does anyone else get that too, that highs and lows play with your mood?

So, for now, here's what I have on my plan:
  • Wear the CGMS. Not once a while but as often as I can, every day if I can tolerate it.
  • Eat more fresh veggies. I LOVE red, yellow, and green peppers so I should try to eat them more. Along with cucumbers. Yum!
  • Add more fiber to my diet. I bought some English muffins today with the right amount of carbs I want (21g) and 5g of fiber. Perfect for breakfast, just add protein and I'm good to go.
There. I put it in writing, on my blog. Now I have to follow through!

6.18.2009

A brief history in my diabetes

Before I start this post I just wanted to say thanks to the fellow people with diabetes I met last weekend at Mall of America. I had a great time!! I think I forgot what it was like to be around people who know what its like to have diabetes. Sunday evening I felt more like a person than a diabetic. You all helped me see that I am NOT alone living with the frustrations of diabetes, so THANKS Allison, Scott, Sandy, Bob, and Heather!! (That's the order of everyone in the pic too with me at the end on the right.) I hope we get together again soon!



Going to the meet up made me realize that there are a lot of things I haven't talked about in my blog that is related to diabetes. Like what it was like having diabetes as a teenager, young adult, in college, and such. Reading Penny's post from last week also touched on a nerve of mine too - the fear of complications.
So I wanted to write about what it was like growing up with diabetes as a kid, what worked, what didn't work, what went wrong, and what went well. This will probably take more than one post...

When I was diagnosed with diabetes I was nine. I went to Children's Hospital in St. Paul and stayed there two weeks learning about how to take care of myself with diabetes. My Mom was there learning too. We left with syringes, NPH and regular insulin, a glucometer from LifeScan OneTouch, and a log book. I was warned about keeping my blood sugars in control in the 120-180 range, keeping my A1c under 8, and eating right in order to stay physically healthy. I was also warned that getting sick has bad effects on blood sugars and to closely monitor my blood sugar when I was sick. I was essentially told that getting the flu was so dangerous that it could kill me and if I ever got the flu that I should be brought to the hospital. Thank GOD I didn't get the flu when I was younger. I don't think I've had the flu once since being diagnosed actually...

And that was it. I had a lot of follow up appointments in the first year after being diagnosed. It was always during the day so I would miss a day of school to go to my appointments. My Mom would make that a special day to help ease the "going to the doctors - again" stigma and would spend the whole day with me. I liked these days with her, I liked going to the doctor and talking about diabetes. That's pretty much how it went for the first year.

Now, I don't remember when things started to fall apart. I know I kept a "good for the time A1c" as a kid/preteen (basically an A1c under 8 when I was a kid was what was "good"). But I also know that sometime in my preteen/teenage years things went really bad. My A1c jumped in the matter of months from 8, to 9, to 10, to 11. I want to say that this was around when I was 13 or 14 years old. By the time I was 15 my A1c was somewhere around 12 or 13 and stayed there until I finished high school. I don't know what the hell I was thinking. Because I had such a bad A1c I went to diabetes counseling where we talked about my feelings on having diabetes. I was young, I was smart, and I was a liar. I said to everyone in my life that I was okay with it because it forced me to lead a healthier lifestyle. I said that it forced me to be aware of nutritional values, and that I was grateful for that knowledge because so many kids my age didn't care how much sugar they consumed, but I did. Lies. All lies.

I don't know if I was just that convincing in my lies or if the counselor could see through them but simply didn't know how to reach me. I know that even today a lot of my friends and family are surprised to hear that I am struggling with depression telling me that I always appear happy. Whatever the reason, I was able to spew these lies despite a terrible A1c. Looking back, a part of me wishes someone had shaken me saying "Your actions are telling us something entirely different Amber! If you really felt that way about diabetes you wouldn't have such a high A1c. You would be testing your blood sugars more, taking your insulin on time, recording what you're doing. But you aren't doing any that. Why aren't you doing that?"

Instead of asking me these things though, I was told terrible diabetes complication stories. About my Mom's coworker who at one time worked with a young woman who had diabetes and appeared fine until she got an infection on her toe and had to have her leg amputated and shortly there after died. Or how another patients sister while pregnant with uncontrolled diabetes because she wasn't testing her blood sugars, went into DKA, lost the baby and died too. Or how someone else went blind from uncontrolled diabetes and couldn't have a normal life anymore since they couldn't draw up the insulin into the syringe , let alone test and give their own shot. I mean, literally, that was what I was given as a warning call. The horror stories of others uncontrolled diabetes and what happened, and always, at the end of the story the phrase, "You don't want that to happen to you, do you?"

The uncontrolled story of my diabetes history is a huge part of it. During high school I hardly tested and rarely took injections on time. I continued to lie about my feelings on living with diabetes. And the summer after my first year in college managed to have an A1c of 17 at which point someone, my nurse practitoner who I saw for my diabetes, did shake me up with the words, "You are trying to kill yourself! Something needs to change! You CAN'T keep on living like this!" I was 19 at the time, working full time and about to start another full time semester at Hamline Univerisity. My idea of change was to cut back my hours to 30 hours/week while taking 15 credits. Needless to say, that didn't work well and a month into the semester I withdrew from school to focus on my diabetes.

But instead I dove head first into work. got my first apartment, worked as much overtime as I could, even getting a second job. I did manage to lower my A1c in all of this work to 13, but it sayted there for a while. I still didn't test as much as I should have, but at least it was an improvement I told myself. But what made it worse was keeping diabetes on a back burner. Letting it simmer with out a close eye watching it to prevent it from boiling over. Letting myself fixate everything else but the management of my diabetes. Hell, I was young, simply trying to stay a float.

It took me a long time to stop lying to myself and others about diabetes, to stop running from it. By the time I was 22 I was just beginning to see that I despised diabetes. I hated that when ever I was upset my family and closest friends would ask me "Whats your blood sugar?" instead of "Whats wrong, Amber?" I hated that everyone always seemed to know what I was doing wrong but not how to help me do something right for a change. I hated seeing that my blood sugar was high because it meant that I failed at trying to help myself, which was why I hated testing my blood sugar. Hated it.

Now, I know I am doing a lot of complaining here. I am very good at complaining I think. But I just wanted to show that lying to yourself, at any age, about diabetes is a bad idea. It took me a long time to realize that in lying to myself, my doctors, and support team I was denying my self the chance to make things better. I was what was holding back better control, and I was the antagonist in my diabetes story. Not the disease, not the glucometer, not the injections, not the doctors who may or may not get it. Me. Which is why I think complaining is sometimes OK. Not ALL THE TIME of course. But some of the time, for me, I just have to acknowledge how I feel, accept it, and move on.

I am nearing on 27 years old now, 18 of them with type one diabetes. I still hate it. I still wish I was free of this disease. I still fear loosing a limb to this disease. I still hate it when my actions are attributed to my disease and not just me. Like when I am upset at something, if anyone asks me to test my bloodsugar I will pretty much start yelling. That my disease doesn't regulate my emotions. It can enhance my emotions, I will admit, but it doesn't give me the emotion simply because my bloodsugar is high or low. Thats all me.

This was a long post, sorry. I think I needed to just get that out there.

6.09.2009

I was all right, for a while

Last month was a difficult month for me. My sister was graduating from the University of MN, I was walking at my graduation for completing my AA degree last December, and there was a few special bills that always come in May that I wasn't looking forward to. Or maybe it was just me being me. I don't know. But it was very difficult. After many a shouting then crying spell with Jason I had to take a step back.

Depression has been with me as long as I can remember. I have never found a satisfactory way to cope with it though. About three years ago I took myself off my antidepressant due to sleep disturbances that I couldn't adjust to. I didn't think that it was a bad decision at the time, or for a long time until I started looking back at the last three years and how I've been feeling while off the antidepressant. And sadly, I came to realize I haven't been feeling good. Sure good things have happened in the last three years. And there were brief moments of happiness when those good things were taking place. But overall, I'd say they've been tough. Even when the good things came there was always a dark thought in my mind that I'd have to struggle to keep at bay to stay focused on the present. It was exhausting! It is exhausting.

At the start of May I felt wonderful, there were a lot of things to celebrate about, and many reasons to be happy. I was energized and motivated to start a new workout program. I was excited to have the summer months start, and things at my new job were beginning to get comfortable.

Slowly it hit me. I had to rearrange my work/sleep schedule in order to participate with my sisters graduation and my own. I had to swap a few shifts to get the time to help with and attend the open house my mom had arranged. I worked a double to help with the loss of a shift to get the one day off that I needed. When the day of the open house came one simple sentence thew me into a heap of despair and depression that I am still struggling with today. "Your mom worked really hard on this open house; I hope you show her you're thankful for her efforts."

There were many other things that were making me sad and a little out of sorts but it was this comment that threw me over the edge from mildly depressed into severely depressed. It felt like a slap in the face. It came out of the blue and I wasn't prepared for it; I didn't know why the comment was directed at me. I didn't know why it was delivered in such a cold tone less than a half an hour before guests were to arrive, it didn't make any sense to me. I finished putting out the cheese trays I was working on and quickly went upstairs to a private bathroom and cried. Cried my heart out for a good five minutes.

The door bell rang and I was pulled back to reality. I couldn't keep crying; there was an open house going on and guests to greet. I splashed my face with cold water, applied more powder to my face and a new coat of mascara and went down stairs to the open house.

That's sort of how its been with me and depression. It catches me and pulls me down so low that I can't do anything but cry, and then life comes at me kicking and screaming and I have to stop crying and deal with the fight going on before my eyes.

After the open house my crying spells got worse and more frequent. I began to think there was something fundamentally wrong with me. I started scheduling more counseling appointments and told my counselor in gasps between crying that something was wrong, that I was a weak person to feel the way I feel when others around me are dealing with the same issues and doing just fine. Through tears she tried to convince me that I wasn't weak, there wasn't anything wrong with me, that depression, a chronic disease, and managing a stressful life while working night shifts would be hard for anyone. Unconvinced I scheduled an appointment with my old psychiatrist to get their perspective on my moods and emotions.

I met with them a week ago and their perspective was exactly the same. Having heard my counselor tell me the same thing every week for three weeks before helped the message to sink in this time. Of course their solution was different than my counselors. While they were impressed with all my attempts to keep sane (counseling, exercise, changing my eating habits, yoga) they still thought an antidepressant would help. I don't like antidepressants. I don't like the side effects that come with them. I don't like that one has nevered worked for me before. So I generally just don't agree with them. But I can't keep on like I have been and all my attempts seem to get knocked out with one unexpected comment. So, hesitantly, I agreed to try another, evil in my mind, antidepressant.

Its been a week on the damn thing. It also messes with my sleep cycle, only making me drowsier unlike the last pill I was on which made it impossible to fall asleep. It gives me a dry mouth and seems to make me oblivious to my lows thanks to the constant thirst. But in the last week I haven't had a night of crying. Its a start I guess.

5.18.2009

Monday Update -

My second vlog. Trying to be quick so I can start my weekly errands! Enjoy!


video

5.07.2009

Hello Again Vlog

I decided to run with the webcam in Jason's new computer. So here is my first Vlog attempt. YaY!

video

4.25.2009

Not so terrifying

Quick update. It wasn't as bad as I thought. 7.5. At least it stayed the same. WHEW! Now I am off to the gym. More trial and error. Today I am reducing my basal rate, only not as much since I am starting out at 172...

Here goes!

Thanks Scott and George for the words of encouragement!!

4.24.2009

Terrified

I have an endo appointment later today and just got done uploading my pump to the CareLink site. I like to use the reports that can be generated there, they do an awesome job of showing trends, especially with the sensor. So, after uploading my devices and reviewing my reports I was very disappointed to see that my average glucose is floating between 170 and 190 for the last 2 to 12 weeks. More than disappointed. Terrified. And pissed. With all the lows I have been having the past 3 months you'd think that I would at least have kept my average the same as it was before - 150ish. But no.

Later today is when I will have the blood drawn for the A1c and I will get the result during my appointment. I am trying not to tell myself it will be terrible, but I have a feeling it will be. According to this online calculator (that I got from Kerri's page, thanks!) my A1c will be between 7.6 and 8.2. Ughh. Not what I wanted. Not what I hoped for.

And I just don't get it. I don't get what I am doing wrong. I know there are things I can do better, but I didn't realize that in not doing those things better I would bump my A1c up so easily in the course of 3 months. Uggg. It makes me feel sick just thinking about it. Or maybe that's the creamer in my coffee kicking in and churning my stomach. I don't know.

A part of me feels like the increased average is due to my harder attempt at working out. Because when I work out I HAVE to raise my blood sugar to at least 180 so I don't drop low during the workout. Sometimes I have raised it too high and finished a workout with my glucose in the 190s. But that only happened a few times, usually I am right at 100 or less post workout. And....

And I just don't GET IT! How am I supposed to work out but keep my blood sugar from dropping? And don't say to suspend the pump because I learned quickly that this only leads to extreme highs 2 hours post work out. Reducing my basal rates before/during exercise does something similar only I don't spike quite as high.

(If you can't tell this is the pissed side coming out)

So, here I am stuck. Not sure how to do this diabetes and workout thing right. And probably with a worse off A1c because of it. Damn.

3.28.2009

I couldn't resist!!

It called to me from the moment I saw it on the shelf.
Even though I have other meters (plus a silver mini that isn't pictured):

But when I went to the pharmacy last night and saw it was on sale for only $15 I had to have it...

A PURPLE Ultra Mini!
Isn't it adorable?!?!

There is something about having these meters in a variety of colors that brings me a strange sense of diabetes bliss that I can't even begin to explain. I would have a Ultra Mini in every color if I could find a way to justify it. For now, I will settle for my silver, pink and new purple and pray that there isn't a new color introduced later on that I also won't be able to resist...
Is anyone else in love with the One Touch Ultra Mini and its color selection?

3.10.2009

Unloading

I am having a really hard time with depression right now. Its sort of eating away at my will to do anything. Also at my relationships. And my diabetes care, naturally. I feel like there is no one I can reach out to. I feel like there is no one who understands. I feel like I can't relate to anyone because I feel so damned isolated with these feelings.

I tried to talk to Jason, my boyfriend, about it the other day. Which didn't get anywhere. He tries to get me to expand on the depressive thoughts, as if they are some sort of rational thought that can be logically explained away. But they aren't.

And even though I can see the logical way that I should be thinking, I don't. Or I can't right now. I can't get those healthy thoughts in and the unhealthy ones out. Which makes me sound a little crazy I realize. But that is what depression is like for me - a constant stream of negative thoughts, about my self and what I do and what I need to do better, that doesn't stop, or let down, or give up. Thoughts that consume every part of my being and make seeing a solution to my problems impossible.

The other day I tried to email my doctor about why I haven't sent him an updated log book, despite the blood sugar issues I have been having. It went something like this:

Hi Dr. B. I know I haven't emailed you a new log book in a while. I tried to create a more detailed one for you, which meant keeping track of everything I ate and the time I ate it and the carbs. Because I don't carry a log book with me I started putting what I ate into my phone as a note. After only 36 hours I had 15 notes saved of what I ate, down to a few M&M's at 3:00am while at work. Which is when I got overwhelmed. Thinking of matching up what I ate with the blood sugars I took on my two meters and the insulin I gave with my pump. Using 4 devices to track my diabetes and then having to compile all the information on each device into time slots of pre/post meals, just defeated my whole attempt at logging before it even started. So, I wanted you to know that right now, doing all of that, just is proving to be more difficult than I can handle.

Then I stopped. Deleted the email. Because the defeated/overwhelmed with diabetes care isn't something I want to unload onto my endo. Though I think they should know about it, I don't feel like its my place to tell them. Another one of those irrational thoughts. Don't tell the people who help with diabetes whats going on and preventing me from having better diabetes care.

A part of me thinks they should definitely know what its like for a patient with diabetes and depression. And another part of me thinks that in telling my endo these things I am crossing a line. That depression is a psychology issue, not an endocrinology issue. So I can't cross the two. Even they are so closely related in my eyes, would they be in the eyes of a doctor?

So, there it is. Though I didn't tell my endo, and am having issues telling Jason and everyone else in my life, at least I am putting it here.

2.20.2009

Two Week Outlook

So I haven't been posting anything lately. I read on another blog, can't remember whose, sorry, that you shouldn't write about why you haven't been posting. The logic was that no one needs to hear the thoughts that happen behind the posts since if its a good post the thoughts will be clear, but I think its something I need to address. If nothing else for my own sake.

I find blogging a permanent marker of where I am at that moment. And I don't always like those markers. Does anyone else feel that way about their blogs? I find that I like to blog when I am in a bad mood because its the only outlet I have for these thoughts, and I don't like the negative mark I leave. I also don't like reliving that negativity later on. When I look at my posts I find that I am quite the pessimist. So, its deterred me lately from blogging.

But it got me thinking that I often avoid the things I don't like. And I can't exactly avoid diabetes. I have tried, oh have I tried. But I can't. I can avoid posting my negative thoughts on the Internet for all to see. Which is why I haven't been posting.

I often feel this way about uploading my MiniMed pump and seeing those reports too. Its a marker of what I have and haven't been doing. Or more often than not things I haven't been doing and should be doing more. I looked at my upload today and was shocked to see that I had only tested my blood sugar twice on Feb 12th. Twice? I ask myself. Really Amber. I can do better than that. I know I can. TWICE? That's it? Looking at my fingers I think I test a dozen times a day. But looking at my recent MiniMed upload tells me otherwise.

That in the last two weeks the most I tested on one day was ten times, and that was because I was forced to (LONG story involving my sister overreacting to a low and calling the paramedics to the apartment I share with Jason, what an ordeal that was). That according to those reports I spend 36% of my time above my target range, and 20% below it. Makes me wonder how it would feel if I could gain back that time out of target range what would I do with myself. Would I have better work outs? Would I sleep better? Wake up earlier because my mind wasn't foggy from a low that made getting up nearly impossible? I don't know.

What caused my sister's overreaction was my inability to respond to her over the phone from a low that I didn't treat. I was even wearing the CGMS. I knew that I was floating too low, but decided that I wanted to sleep instead of get up and treat my low. So I slept with a blood sugar around 60 for a few hours. In my defense I thought it was more around 80 not 60, but its just another excuse for me to say "I didn't need to treat the low". But an excuse is not OK in that situation. I need to treat those shitty lows that interrupt my sleep, even if I don't want to, even if it means I won't get my full 8 hours of sleep, and I have to go to work sleep deprived.

I. CAN'T. IGNORE. MY. LOWS.

That's what I have been chanting to myself since the day when the paramedics arrived at our apartment. And now I am beginning to think that this little mantra extends out to other things I can't ignore: uploading my meters and pump, and blogging. Though the reports often make me feel like a failure and slacker, I need to know the information on the damned things to help my self in the long run. That while I may not like my negativity, I shouldn't ignore it as if it wasn't there. And like the reports, maybe if I acknowledge it more often I can improve my outlook because I am blogging in the moment and that is helpful.

I used to tell myself, "I am looking through a one inch window, now try to imagine what is outside of that window that I can't see". Maybe I need to do this more often with myself, my outlook, and my diabetes.

1.09.2009

Sign the Petition (maybe with out the spelling errors?)

I just wanted to bring attention to this petition asking the FDA to create a diabetes advisory council and help improve therapies and treatments on drugs and research for persons with diabetes!

I signed it and decided to leave a lovely comment, with two or three typos (great, just what we need right? Another idiot who can't spell!! So read over your comments CAREFULLY before confirming them, unlike me). Please forgive my inability to spell and go check it out!

This is a little info from the petition Ask FDA to better Serve Diabetes Patient Needs:

"Due to the very nature of the severity and prevalence of diabetes, the following leaders within the diabetes community, who have signed this petition, implore the FDA for the immediate creation of a Diabetes Advisory Council, whose goal would be to improve options for patients. This council would include practicing endocrinologists, diabetes educators and others communicating directly with patients. Our experience, focus, and keen awareness of the needs of the diabetes community would be an invaluable resource to the FDA as it faces the arduous process1 of evaluating new diabetes treatments. Our aim is to improve options for patients.
We urge the new FDA leadership to recognize the urgent need for more safe and effective treatment options for diabetes and to reduce barriers to innovation. More treatment options will benefit patients. The disease is progressive. Delays in the availability of new treatments will only result in tremendous cost to public health and the economy. Our recommendation can benefit patients without sacrificing their safety.
Make your voice heard!"