What Goes Around Comes Around

So many of us with diabetes have unhappy, angry, or frustrating encounters with people who are wholly uneducated and have misconceptions about it.  I do try to use those times for education but they can create a cold place in my heart.  We often blog, Tweet, or Facebook about those encounters so others that understand can commensurate and give feedback.

I wanted to tell a story about a nice experience that I had recently since those can be few and far between.

Rob and I were shopping at Target (can someone anyone explain to me why I arrive with a list of five items to buy and end up with an entire cart full of goodies that cost me $200?).

My CGM (Continuous Glucose Monitor) signaled I was low (I have my alert set at 70).  Rob asked me if I wanted to schlep over to Starbucks and grab something to eat or drink.  I figured we wouldn't be there long (really?) and I had a steady arrow (versus one pointing down which indicates a fast moving blood sugar) so I felt like I'd be OK.

A few minutes later I got the 55 alert (which Dexcom programs because the situation has now become dangerous).  Rob asked again about Starbucks but I figured he was there to help me and we'd be done soon.  He wasn't happy about that answer but I'm know to throw a fit so he went along with it begrudgingly.  I was still on my feet and acting pretty "normal."

As we got to the checkout counter, I actually started to feel low (shaking and sweating like crazy) and the CGM showed a blood sugar of 42 so I grabbed some Sour Patch Kids from the display.  The woman that was checking us out asked, "Do you want that in the bag or in your purse?"  I told her I'd take them because my blood sugar was low and I needed to eat them ASAP (I've never been one to hide my diabetes but I'm sure the hypo caused me to overshare at that moment).

Her response was awesome!  She said, "I've got scissors here to help you open the package, please start eating them now."  I told her I'd be OK and would scarf them in the car (I didn't want to hold up the line).  She said, "Please eat them now, the other customers will be fine."  I was surprised by her response and must have looked at her a bit quizzically because she told me a quick story.

"My Dad had Type 1 Diabetes.  I know how this all works.  He helped me move a few years ago and went shopping without me while I unpacked.  His blood sugar dropped and he passed out in the store.  A clerk, who also had a diabetic father, dropped what she was doing and helped him the best she could (including trying to wake him enough to drink juice) while 911 was called.  I'll never forget the fear and helplessness of that day but I'll also remember the woman who helped my Dad.  Please be safe and eat your candy."

I felt overwhelmed by her story and by her concern about someone she didn't know except for the fleeting moments I had been in her line.

We had a true 'what goes around moment.'  Her Dad was helped by someone whose Dad also had diabetes.  She, in turn, wanted to help me.  It was a sort of threesome that only someone with diabetes could hope for.

One Of Us

I was sitting at a bar the other day . . .  If you know me at all, you know full well that many most of my stories begin that way!

Two times in the last month I HAVE been sitting at a bar and had what I'd call a "Diabetes Encounter."  No, that's not the same as seeing a UFO or Close Encounters of the Third Kind but it's even better.

We were returning from a vacation in Mexico a week or so ago and had to connect in Houston.  A six hour layover necessitated a visit to the bar near our gate.  Rob (AKA Angry - He's now OK with my using his real name) asked me if I noticed the bartender's arm.  I assumed he had a cool tattoo.  Chris, our bartender, turned to show me his biceps and he was wearing and Omnipod.  I yanked my Animas Ping from my waistband and showed it to him.  A mini show and tell where only the cool kids had insulin pumps!!  We chatted on and off for the next two hours about pumps, continuous glucose monitors (CGMs), and diabetes.  He told me that he also wears a Dexcom CGM.  I asked him his favorite place to wear it and he said, "We can only wear them on our stomachs."  I told him that many (most?) of us don't limit ourselves and that he should try other spots if he was willing and comfortable.  He was excited that he could actually do that and was planning which place to try next (I think his arm was the winner but he was pondering using his chest as well).  Liz to the rescue?

I often wear my Dexcom transmitter on my arm (and now maybe bartender Chis will too!).  Now that it's warm enough to wear short sleeves without freezing to death (a bit earlier than usual in Wisconsin!), it is plainly visible.

Last weekend we were at one of our favorite restaurants hanging at the bar.  A woman sat down next to me and asked, "Type 1 or Type 2?"  She had spotted my Dexcom on my arm and we started chatting about diabetes and CGMs.  She was quite impressed with the cute, coordinating Pump Peelz stickers I was using on my transmitter and receiver.

My June Peelz. Cute!

I find it amazing that lousy old diabetes can bring people together, even at bars.  Common ground is common ground no matter what the circumstances may be.  I really enjoy feeling like I've found 'one of me' in the wild!

I Call BS (meaning Bull Shit, not Blood Sugar)!

A story written by DiabetesMine broke the news that United Healthcare has decided that, as of July 1st, patients with diabetes (over the age of 18) should only be allowed choose a Medtronic insulin pump if their doctors / health care team prescribe pump therapy.

A heath insurance company should not make medical decisions.  EVER.  If a doctor decides that a patient needs a certain medication, therapy, medical device etc., then that is the best choice for the patient and they should not have to sacrifice and use something that an insurance company says is the "only option."  Remember that the sacrifice may cause even worse health issues and can be extremely costly to the patient (can you say "out of network?"). 

Why did United Health Care do this?  I'm not sure (NO ONE is sure except them).  Maybe they and Medtronic have a special 'deal' and Medtronic has some sort of payback system?  Maybe they are too lazy to work with other pump manufacturers / suppliers?  I can't answer these or any of the other questions this generates.

The press release (linked above) was put out by Tandem Diabetes Care (they also make insulin pumps).  They state, most perfectly, "Having diabetes isn’t a choice. How people manage it should be. Insulin pumps are not a one-size fits all solution. Selecting which pump is the best fit for a person to manage their therapy needs should be a decision made between a person and their healthcare provider."

United Health Group is the parent company of United Healthcare.  If you visit their website, you will see their mission statement:

"We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities." 

 "We work with health care professionals and other key partners to expand access to quality health care so people get the care they need at an affordable price." 

"We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions."

Hmmmm. . . I don't think so guys.  I think you seek to make money, lots and lots of money.  And I think you seek to screw your customers in that process.

My friend Stephen Shaul at Happy-Medium wrote about this topic more eloquently that I can (please, please use the link and read his take).  He says, "Eliminating choice for patients is wrong, it reduces innovation, and in no way does it “improve the overall health and well-being” of People With Diabetes, or even save them money."  And he points out, "Choice isn’t just important… choice is necessary."

Is there a fix to this situation?  I'm going to tweet, blog, and Facebook about it as much as I can.  I'm going to tell everyone I know about it.  I hope that people who are looking for employment tell companies, "I'm sorry, I'd love to take the job but can't do so because your provider is United Healthcare."  Companies looking for good employees may be 
'forced' to change to a new provider if people don't want to work for them.  Maybe if United Healthcare loses business, they will realize what they've done.  Will any of this help?  I can only hope.

A Rose By Any Other Name

 

Most people associate February with Valentine's Day but let's talk about another very important part of February, the Spare a Rose, Save a Child campaign.

I'm lucky that I live with diabetes in a place where I have access to insulin, to education, and to a lot of help/advice from the Diabetes Online Community (DOC).  While I may wonder what will happen to my blood sugar as I eat my lunch; I have access to insulin to cover those carbs I'm munching on.  Unfortunately, many children aren't so lucky and they need your help.

The Spare a Rose, Save a Child campaign raises donations for Life for a Child which is currently helping over 17,000 children with diabetes in 46 countries.  Lack of access to insulin is a common cause of death. The estimated life expectancy of a child who has just developed diabetes could be less than a year in some areas.

Here's the idea:  Buy one less rose this Valentine's Day ('spare a rose') and donate what that rose costs to 'save a child' with diabetes in a developing country.  What do roses cost now a days?  $5 provides a month of life to a child with Type 1 diabetes.  That seems pretty reasonable doesn't it?  Even if you aren't the rose buying type, join the cool kids by jumping in feet first and donating too.

Need a bit more motivation to donate?  Visit the Spare a Rose, Save a Child Facebook page and learn about some of the children that you can help.  Bam! There it is!

It's this simple:  Visit this link and choose a one time or monthly donation amount.  You will be directed to PayPal but you don't need to have an account to donate (just click on the "Pay with a debit or credit card" link at the bottom of the page).  Remember that if you live in the US your donation is tax deductible (more motivation!).

You can help save a life by giving a child access to insulin.  You would also be giving ME a Valentine's Day gift without having to step out your front door.  You know you want to.  And I know that I would love it.

How Many "Pricks" Before A Change?

Lancets - The lovely little things that prick our fingers to produce a precious drop of blood so we can test our sugar.

The companies that make them say we should change them every time we test.  Of course they do; they make more money if we use more.  I test my blood sugar an average of 8 times a day (I often do it more than that).  That's approximately 2,920 lancets a year.  They usually come in boxes of 100 so that's a bit over 29 boxes a year.  The average cost (from a Google search) ranges from $7 to $15 a box.  While not the most expensive part of diabetes - YIKES!

Lots of us don't bother changing them regularly.  There are many memes (funny as hell!) floating around like these:

There are articles and blogs about this as well.  Some of the experts (CDEs and doctors) seem to think it's OK to keep using the same lancet.  Read their thoughts here, here, and here if you are interested.

I DO change mine but not for every test.  Except, if I use that son of a bitch for too long it starts to hurt.  And I'm a wimp.  A. Total. Wimp.  That means I want to I'm forced to dig out a new one and make the big change.  Sometimes I can go a couple of weeks and sometimes it's a couple of days.

I read Kerri's blog about this and still was not moved to the once a day change.  I just re-read it while doing research for this post and now I feel like she's hit the nail on the head.  I guess I'm older and wiser?  Well, older for sure.  Once a day doesn't seem so bad.  That's only 365 lancets a year.  I think I'll try to follow in her footsteps.

Change is good, right?

A Rollercoaster That He Didn't Want To Ride

Angry and I were on vacation in Mexico in June.  Being brand new to my continuous glucose monitor (Dexcom), I had decided to leave it at home.  We were going to spend the majority of time in the pool.  I didn't want to chance ruining a brand new receiver and it doesn't read through water very well anyway.  It would have come in handy at least one time though when I had one of the lowest lows I've ever had.  

Angry wanted to tell his side of the story.  Those that love us D Peeps will understand and he wanted them to know that they are not alone in their very own struggles and worries.

This 'story' is written as he told it to me:

We got back to the room after dinner and I wanted to watch some TV.  You went to bed and fell asleep pretty fast (I could hear you snoring!).  About half an hour later you asked if it was "hot in here."  I told you no and I figured it was a hot flash speaking.  A couple of minutes later you asked me again. 

My first thought after that was "Oh shit" and I went to the bed planning to touch your back to see if you had the cold sweats.  I could SEE before I had to touch you that your hair was wet.  I knew I had a problem on my hands.  But you were conscious and talking to me so I was hopeful that this wouldn't be too bad.

I asked you if you wanted to test your blood sugar and you, for once (actually I think that was the first time ever), said yes.  I got your meter and sat next to you on the bed.  You were turned away from me so I couldn't see the result but you said, "It's low."  I was surprised because you usually say "I'm fine."  And normally that's where our battles begin.

I offered you some crackers and you told me that those wouldn't  work fast enough.  This got me feeling good as I assumed you weren't too low.  You'd not be able to understand that if you were.  The mini fridge in our room had juice so I got both the apple and orange juice bottles and asked you which you'd like.  You got me a bit worried when you told me you don't like apple juice.  Yes you do!  Was your normal 'fight' response coming out?  You did drink some orange juice but then became obsessed with the carb count.  You kept turning the bottle around and around trying to read and understand how many carbs were in there.  I tried to reassure you that everything would be fine and finally just took the bottle away from you in frustration.  I was getting pissed that you wouldn't drink it!

Even though you had just barely had any juice, you kept insisting that you needed to check your blood sugar.  I handed you your meter and you tested at 25!  In the 26 years we've been together I don't remember ever seeing a number that low.  My adrenaline was already pumping and now I felt a bit panicked.  Then you dumped the bottle of test strips on the bed and that really bothered you.  You couldn't pick them up no matter how hard you tried and just kept fumbling and fumbling.  The words "What about those?" were repeated over and over as you were struggling.  I told you several times that they'd be fine and you needed to worry about getting your blood sugar back to normal.  You just kept at it and I finally picked them up myself. 

You asked again, "Did I test my blood sugar?  I think I should test my blood sugar.  What about my blood sugar."  I told you that you had just tested and and we were going to drink some Sprite instead.  You wouldn't touch the soda until I let you test.  The meter (about 10 minutes since the last try) said 29.  I told you, "See it's only 29 so let's drink some more."  You asked me "Is that bad?" and I told you "Yes."  Then you asked me "How do I know that the reading is right?"  My answer was "Because it's always right."  The argument was still winnable or so I thought.

But no, that answer didn't work as you kept asking "What was my blood sugar?  Do I need to test my blood sugar?"  I told you several times that you had just tested a minute ago and it was low so you needed to drink the damn Sprite.  But you just kept saying over and over, "I need to test my blood sugar.  I should test my blood sugar.  Did I test my blood sugar?  How do I know what my blood sugar is?"  I explained that you had tested three times already and you said I needed to show you the used strips to "prove it."  I was not digging in the garbage for the fucking test strips so I told you to "trust me."  But you kept asking to test since I couldn't prove you had.  So you tested again, four minutes later, at 28.  It wasn't moving up yet but I knew that it wasn't going anywhere THAT quickly. 

I kept trying to get you to drink more Sprite but you decided that it now tasted "yucky."  I hoped that between 1/2 a bottle of orange juice and maybe 1/2 a can of Sprite something good was going to happen with your blood sugar.

You sat quietly for about fifteen minutes while I watched to be sure you didn't pass out.  Then out of the blue you asked me what was going on.  I told you that we had a bit of a problem and I suggested another test because you seemed to be feeling better.  About an hour from "Is it hot in here?" and you were reading at 64.  Thank God!! 

I felt like we had it under control and that you'd keep rising and you surprised me by actually taking a couple more sips of that "yucky" Sprite without me asking you.  Your pajamas were soaking wet but you didn't want to change because you didn't bring any extra.  I told you to wear one of your cotton tank tops and a dry pair of underwear instead but you made a goofy face and said, "No way; that's not pajamas!"  I let you win that argument even though I felt bad.  Was I going to wrestle you to change?  No way.

At that point you said you felt sick to your stomach but you were going to try to get back to sleep.  I would have liked you to stay up a bit longer and test again but I was pretty sure you'd be OK.

I tried to get to sleep myself but I felt like I had just run a marathon.  My heart was pumping, my hands were sweating, and I was trying to get over being completely freaked out by those numbers.  I've been through a lot of lows with you but I've never seen numbers that low.


That's what Angry told me.  I vaguely remember picking the orange juice.  I do remember testing at 64, tasting yucky Sprite, and feeling like I was going to puke.  I don't remember anything else.  Over an hour of my life had disappeared without a trace. 

We discussed what happened at breakfast the next morning and he asked me what my original test was since he didn't see it.  I checked the meter and it was 27.  As I scrolled through the night's readings I wasn't sure I ever remembered seeing numbers that low either.  That's when he told me, "That was like a rollercoaster.  I didn't enjoy the ride though."

I feel guilty for episodes like this one.  I hate that he worries.  I hate that he knows I may need help at any time.  I hate that he wonders what will happen to me if I'm alone during a hypo like that.  I know that the CGM has helped alleviate some of those fears but they still exist, even if they are buried a bit deeper in his brain.

But I also feel blessed that he's my partner in all things, including my diabetes.  I have a husband who has spent our time together supporting me and helping me.  He loves me despite and because of my diabetes.  I couldn't ask for anything more.  I'll try to keep him off the rollercoasters from now on but I'm not promising anything.

Diabetes Online Community #DOCBurnout2015 - Let's All Behave!

I'm very new to the DOC (Diabetes Online Community).  In fact, until March of 2014 I didn't realize it existed!  I knew if I used Google I could find plenty of information about things like pumps and CGMs.  Other than that, I knew bupkis.

Thanks to Diabetes Daily, I'm participating in the first ever Diabetes Online Community Burnout (#DOCburnout2015) Experience

I jumped into the DOC after the first Diabetes UnConference and started blogging (all be it sporadically).  I read a ton of other blogs and am I member of several Facebook communities related to diabetes.  I don't do a lot of posting or reading on the great site TuDiabetes because I sometimes feel a bit overwhelmed there.  I plan to get more involved because there are so many good people using that site.

One thing we all need to keep in mind is that behind every computer keyboard there is a human being with feelings.  If you read, contribute to sites, blog, or do anything else in the DOC you need to remember that.  Always.

I think that cyber bullying is one main reason we can and do burnout.  It's not necessary nor it is nice acceptable.

Use some restraint if you feel a question has been asked "a zillion times" and give a helpful answer (or skip over that post if it bothers you that much). That question is new to that person!  They may be confused or frightened.  I've personally been too upset to do "a search" for an answer and thankfully people responded to me positively.

Use some restraint if you disagree with someone's diet, exercise program, choice of medical devices (or not using them), testing routine etc.  Each of us deals with our diabetes in different ways.  What works for me may not work for you.  As we often always say, "Your diabetes may vary."  If someone says that they found something that helps them, how about saying "good job" or some other encouraging words?  If their ideas don't appeal to you keep your criticism to yourself and move on.

Remember, cinnamon does not cure diabetes.  Don't post or forward incorrect medical information.    If you see someone else doing so, notify the site administrator so that it can be removed.  The spread of erroneous information hurts us all.

If you are being bullied, walk away.  A bully loves your anger or fear and they will feed on that forever.  You will never, ever win a cyber fight with a bully.  Ignoring them makes them fade away.  It can be hard but take a deep breath and move on.  If you have been personally attacked, contact the site's administration to report the person and their content.

The DOC is a very important part of our lives.  Reaching out with questions, successes, failures, and ideas is helpful to all.  I personally found the "me too" factor beyond words.  How very comforting to know I'm we're not alone.  We should be, at a minimum, courteous to those who are on this ride with us.

Sometimes It's The Simple Things

Lest we not forget how simple things can affect our blood sugars . . .

I have a TON of filing to do at work.  When I say a ton, I'm not kidding.  I decided to take about an hour today to work on some (which now puts me only ONE YEAR behind so that's a win victory).

My blood sugar was about 135 or so before I started.  I had just checked to see if I was spiking after breakfast.  As I filed, it dropped to 87 with a down arrow.  Is filing considered exercise?  Man, I'd rather go to the gym! 

Filing is exercise? I vote no.

I finished and sat back down to work on something else.  Suddenly my Dexcom receiver buzzed, warning me that I was at 70.  "OK" I thought, "I'm not moving around anymore so I'll be fine."  Nope.  A minute or two later, another buzz and I'd dropped to 57.  Well now, that's no good.

At least I didn't have a down arrow.

I had to finish one thing before testing and considering how to treat the darn low.  I have to stop doing that.  Work can wait; hypos can't.

Angry texted me a few moments later to let me know he'd seen my low.  He knows me all to well and always assumes I'm waiting to treat.  His text prompted me to stop what I was doing and test my blood sugar (the meter read 58 so Dexcom was spot on this time).  I decided to treat by eating an early lunch.

It's hard to remember that anything and everything we do can have an effect on our blood sugars.  I was reminded of that today.

Stay safe out there!!

Luck Be A Lady

I'm a lucky gal.  Am I lucky to have diabetes? No. But I'm lucky to have a great team to help me stay healthy.

I visited my Endocrinologist yesterday.  I really, really like her.  She's a great doctor but she's also a super friendly and sweet person.  Our first bit of conversation was about how hard it is to keep up with all our passwords.  She was logging into the hospital's computer to see my records and we started chatting about how and where to keep these things.

Once we moved on to discussion of my health and diabetes, she was all business. 

Angry and I joined a gym and started personal training a little over a year ago.  I've had several discussions with my CDE about adjustments in my basal rates (on my pump) to stop the highs and lows associated with that exercise.  We talked about that yesterday and I told her I found a "sweet spot."  She took notes and asked me if she could share my adjustments with some of her other patients.  A few are still struggling even with her and her team's help.  I felt like a diabetes champ when she told me, "I like your approach and your self-awareness."

We also discussed statins.  She explained to me that the ADA is now recommending that all people with diabetes over the age of 40 and a LDL of 70 mg/dl or above take a statin for "heart health."  Mine is well below the recommended 100 mg/dl "optimal" number so I told her, "I'm not taking a stain unless I will die without it."  She looked at me and said "OK."  What?  A doctor that listens to her patients?

I started my CGM (a Dexcom) about three months ago so we also discussed that.  We chatted about my feelings about it, how I was using it, and if I'd recommend it to others.  We didn't download any data.  She said that she felt she didn't need to babysit me because I was making great adjustments on my own.  I did give her the low-down on the trends I was seeing and she was glad I had that information at my fingertips now.  When I told her I didn't know how I had lived all these years without the CGM she told me that she was glad I finally decided to try it (I had been terrified of it before).  She also asked if it was helpful with my hypo unawareness.  "Holy crap, YES!" was my heartfelt response.  Her feelings were that this was the most important factor for me (and thank goodness that I was getting some help that I needed).  Her last questions was, "Do you or did you feel overwhelmed by it?"  I explained that I had been to the Diabetes UnConference in March and learned a lot about them there.  I had also joined Facebook groups to get info and support before I got mine.  In other words, no I was not overwhelmed.  "Awesome!" was her response.

I walked out, having spent almost an hour with her, feeling like a person that mattered, that was respected, and that had someone who actually listened and cared about me and what I was doing to stay healthy and happy. 

I certainly am lucky.

I Get By With A Little Help From My Friends

I recently saw a post on a diabetes Facebook group that made me sad.

A woman posted that her husband's family just didn't understand how horrid having a low blood sugar is and how it affects him.  She said that his family believes his Type 1 can be cured with vitamins and they won't listen to him or her as they try to explain how diabetes actually works.  She asked for suggestions for ways to get them to listen and to be more supportive.

I thought about this post for a while and realized how lucky blessed I truly am.

These tasted like crap. Literally.

I was diagnosed at the age of 7 and honestly don't remember NOT being diabetic.  My life has always included the hustle and bustle of blood sugars, insulin reactions (as we used to call hypos), glucose tablets (who remembers the square, hard as a rock, and gross tasting BD version?), insulin bottles, syringes, insulin pens, a pump, and most recently a CGM.

Growing up, my friends were always there for me.  They'd remind me to take my shots if we were in the midst of a crazy party.  They'd watch for lows and help me if I wasn't able to help myself (even calling an ambulance once when I was in college).  They never judged me.  They never acted as the 'diabetes police' by asking "Should you be eating that?"  The friends I've made as an adult are exactly the same.  How would I handle life if they didn't have my back?

Way back when, we were told we couldn't have any sugar.  None at all.  My childhood friends' parents were always aware of how to cook for me.  No judgement was passed when I DID grab some cake or ice cream.  There was always Tab or sugar free Kool-aid for me to drink.  They made sure there was plenty to eat for breakfast and snacks if I was at a sleepover.  They made sure everyone waited for me when I needed an extra minute or two to take a shot when everyone else wanted to eat or go to bed.

This sucked but it was all we had for a while.

Then this came along! Not much better really.

My family loved me and always, always helped and supported me in any way possible.  For heavens sake, they had to give me shots until I learned to do it myself!  They never judged or berated me for 'cheating' when I snuck candy bars in my pocket before school.  My Dad, when I was 7 and crying about having to take shots, always tried to cheer me up by suggesting that he could give me one in my tongue.  That always made me laugh!

My co-workers understand that I may flip my lid if my blood sugar is low or high.  They let me blow off that steam without getting mad at me.  They also know that I may need help if I'm low and have said if they aren't sure what to do, they'll call 911 and let the experts take care of me.

And most important of all is my wonderful and amazing husband, Angry.  When we started dating, I told him I was diabetic.  He didn't know squat about diabetes but he learned quickly.  I had several very bad hypos while we were dating and he never let it phase him (even when he was covered in honey and Pepsi while wrestling with me to force feed me).  When we got engaged, I asked him if he could "handle" that for the rest of his life.  He said he loved me and that meant he loved my diabetes too.  He's literally saved my life several times and can smell a hypo from miles away.  We've had ups and downs because of diabetes but he's never given up on me, or been mad at me, or judged me.  He's always supported any decision I've made and tried to whisk away my frustration when I've made mistakes.  When I was ready to get my CGM I was pretty scared.  He told me to think of it as a new, even better chapter in my life.  I couldn't ask for more.  His love gives me a lifeline that I couldn't live without.

My heart goes out to those that don't have the kind of support I have (and have had all my life).  I hope that those who don't can find some in the DOC.  There are lots of us out here in the cyber-world who are ready and willing to encourage, reassure, or give comfort.  Sometimes we just need to hear "I understand." or "I've done that too!" or "Keep up the good work." or even "It's OK, things will get better."