Tuesday, January 22, 2013

Antifragility is Unwelcome But Necessary

Two days, three instances of diabetes near-breakdowns. One had life-threatening potential; one was an unfortunate mishap; the last, simply sad.

No matter how much work we do, diabetes defeats us, at turns random and unpredictable. And sometimes, another force--call it God, or maybe parental instinct--rallies to save the day.

Yesterday, I went online for hot lunch carb counts. The numbers there are highly exact--12.2g for low-fat white milk, etc, and though I know there's a margin of error when it comes down to the lunch lady spooning out the one-third cup of peas, I trust in this higher math. Yesterday, though, a count felt wrong to me. 53.6 grams of carbs seemed high for breadsticks at the school, though not, say, at Olive Garden--the school's portions tend to be smaller. Yet I trusted in the math, calculated Theo's lunch shot, wrote it on a slip of paper for the secretaries and sent it, carefully folded, in his pocket.

Late morning, my gut told me to do some investigating. First, I scrolled through previous months' lunch counts to find the same menu option; no luck. Next I googled the name of the brand I thought the school used, with some success--two seven-inch breadsticks would add up to the right number. And yet: four-inch breadsticks existed.

A call to the school determined that indeed, that brand's smaller breadsticks were used. The note in his pocket, then, added up to approximately two more units of insulin than was required. Two units are smaller than a single teardrop, but they are everything. Theo's been quite low before, but this could have sent him unconscious.

Instinct, God, dumb luck: thank you. All of you.

Today, the principal gave Theo his lunch shot. How wonderful that the man has trained to help out in this way when the office is busy. Today, something told him to look at the insulin pen after the shot, at which time he noticed that a portion of the dose was still in the pen. But because we weren't sure what had happened, we had to wait two hours to learn that yes, he received too small a dose, and yes, his blood sugar was 413.

Earlier in the day, a random email I sent unearthed the detail that pizza would be served in Theo's classroom tomorrow. He is not a kid who would sneak food, and even if he was, his classmates would probably call him on it. But he would have been left out. Everyone eating pizza and Theo watching. Sad. Not dangerous, but sad.

In Antifragile, Nassim Nicholas Taleb writes that "we can almost always detect antifragility (and fragility) using a simple test of asymmetry: anything that has more upside than downside from random events (or certain shocks) is antifragile; the reverse is fragile."

Taleb is careful to distinguish antifragile from resilient, an adjective meaning "able to withstand difficult conditions"; antifragile not only endures but grows stronger and better as a result of difficulty.

Right now I am feeling at the mercy of the random, not strong and not antifragile. And yet we've come this far.

6 comments:

  1. more poetry from you. you HAVE come this far. sometimes i forget that in the day to day of it all, but here we are, on the other side of it.

    glad you had all those things on your side.

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  2. I don't know, Shannon. The challenges of diabetes level out only to hit us hard with something new, right? Or that how it feels right now.

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  3. Chad Rienstra has led a team of researchers at UIUC to receive a NIH High End Instrumentation grant for $1,936,449, which will be used to purchase a high-field solid-state NMR spectrometer to be housed in the School of Chemical Sciences NMR Facility. The new instrument will be one of the most powerful NMR spectrometers available worldwide, enabling the determination of atomic-resolution structures of membrane proteins, fibrils and nanocrystalline proteins.
    Collaborative projects among these UIUC investigators aim to solve structures of proteins that are central to Parkinson's disease, diabetes, drug metabolism, blood clotting, antibiotic resistance and HIV/AIDS.
    Atomic resolution structural information is the key to rational drug design. Unfortunately for many proteins, standard methods such as solution NMR spectroscopy and X-ray crystallography are not suitable. Solid-state NMR techniques developed by Rienstra will enable these structures to be solved for the first time, utilizing customized, state-of-the-art magic-angle spinning probes to obtain data with the highest possible resolution and sensitivity.

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  4. The diabetes community really appreciates the work of people like Chad. Thank him for us, Carol.

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  5. Can you send me the writing you did on Marilyn Lupkes? She was my cousin and I would love to read your work. Thanks! dkroontje@lyncs.org

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  6. I sent you an email. Did you get it?

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