Grayson, Oklahoma

Year 2016.... a unique visit

A Beautifully Broken Pancreas

Well... Mr James Cleveland.... I do feel tired today...

Insulin.... the KEY that opens cell doors!!!

And Koo-Koo cells become resistant... they go on lockdown.

Insulin Opens Cell Doors

When insulin is released from the pancreas, it travels through the bloodstream to the body's cells and tells the cell doors to open up to let the glucose in. Once inside, the cells convert glucose into energy to use right then or store it to use later.

As glucose moves from the bloodstream into the cells, blood sugar levels start to drop. The beta cells in the pancreas can tell this is happening, so they slow down the amount of insulin they're making. At the same time, the pancreas slows down the amount of insulin that it's releasing into the bloodstream. When this happens, the amount of glucose going into the cells also slows down.

Balancing Insulin and Blood Sugar for Energy

The rise and fall in insulin and blood sugar happens many times during the day and night. The amount of glucose and insulin in our bloodstream depends on when we eat and how much. When the body is working as it should, it can keep blood sugar at a normal level, which is between 70 and 120 milligrams per deciliter. However, even in people without diabetes, blood sugar levels can go up as high as 180 during or right after a meal. Within two hours after eating, blood sugar levels should drop to under 140. After several hours without eating, blood sugar can drop as low as 70.

Using glucose for energy and keeping it balanced with just the right amount of insulin — not too much and not too little — is the way our bodies maintain the energy needed to stay alive, work, play, and function even as we sleep.

Insulin Helps Our Bodies Store Extra Glucose

Insulin helps our cells convert glucose into energy, and it helps our bodies store extra glucose for use later. For example, if you eat a large meal and your body doesn't need that much glucose right away, insulin will help your body store it to convert to energy later.

Insulin does this by turning the extra food into larger packages of glucose called glycogen. Glycogen is stored in the liver and muscles.

Insulin also helps our bodies store fat and protein. Almost all body cells need protein to work and grow. The body needs fat to protect nerves and make several important hormones. Fat can also be used by the body as an energy source.

How Diabetes Changes the Way This Works

With diabetes, the body has stopped making insulin, has slowed down the amount of insulin it's making, or is no longer able to use its own insulin very well. When this happens, it can lead to several things.

For example, glucose cannot enter the cells where it's needed, so the amount of glucose in the bloodstream continues to rise. This is called hyperglycemia (high blood sugar).

When blood sugar levels reach 180 or higher, the kidneys try to get rid of the extra sugar through the urine. This makes a person urinate more than usual. It also makes a person feel thirstier because of the water he or she is losing by urinating so much.

When a person loses sugar in the urine, it's the same as losing energy because the sugar isn't available for the cells to use or store. When this happens, a person might feel tired, lose weight, and feel hungry all the time.

Other problems caused by high blood sugar include blurry vision and skin infections or injuries that don't heal. Women might have vaginal yeast infections more often.

When the body doesn't have enough insulin to help convert sugar into energy, it often starts burning body fat instead. This sounds like it might work well, but burning too much fat for energy produces a byproduct called ketones. High levels of ketones can lead to a condition called diabetic ketoacidosis (DKA), which can be life threatening if not treated quickly. DKA is more common in type 1 diabetes because the body has stopped making insulin.

Keep Blood Sugar Levels Under Control

For a person with diabetes, the main focus of treatment is to control the amount of glucose in the body so that blood sugar levels stay as close to normal as possible.

People with type 1 diabetes need insulin shots as part of their care plan to control their blood sugar levels. Some people with type 2 diabetes can control their blood sugar levels with a healthy diet and exercise. However, many people with type 2 diabetes will need to include diabetes pills, insulin shots, or both in their diabetes care plans.

People with either type 1 or type 2 diabetes need to pay close attention to how blood sugar levels change at various times throughout the day in order to keep them as close to normal as possible. When blood sugar levels are close to normal, it means the body is getting the energy it needs to work, play, heal, and stay healthy.

Clinical review by David McCulloch, MD
Group Health
Reviewed 03/01/2014

Southern Fluffy Buttermilk Biscuits, Baking with Kids

I'm struggling with this Diabetes Monster!

I listened to my brother..... I tried and hoped to walk in his shoes.(that's where today's pressure and depression hit!)

But my inner voice..... says this is my body functioning at a cellular level (reduced output of insulin... and/or... resistance of beta cells to absorb insulin).    OK.   reality check.   

I cry.   I wish.   I try. I am diligent and intelligent about this diabetes monster.  It's only a number.   It is not the totality of me!  It's been since 2004:  I've gotta stay focused on management of my medical condition as it is right now.   DM (diabetes management) will produce reduced A1c --- reduced weight --- leveling of daily numbers with proper food intake and exercise.

But my God, help me always to focus still on Today.... on your everlasting, everloving care for me.   For I am wonderfully made.... you made me- Heavenly Father.   You know my beginning and my end.

I recall how one of your most faithful servants.... literally wasted away in her final days of death.  In her home, surrounded by her family... it was the most gruesome and unattractive death to endure.   The love was not diminished -- although it takes years for that ugly memory to fade with much less pain.   I felt that way in being in the hospital when daddy died.... the expelling of air, his lips, mouth, eyes, head turned toward the eastern sunrise....    God you know our downsittings and our uprisings. 

To you GOD.... For you I live and die.  I give you the praise and honor and glory.... in my body, my mind, and my soul.   We must work while it is day....

What is a carcinogen?

It's something ugleeeeey for sure!!!

Cancer is caused by changes in a cell's DNA – its genetic "blueprint." Some of these changes may be inherited from our parents, while others may be caused by outside exposures, which are often referred to as environmental factors. Environmental factors can include a wide range of exposures, such as:

• Lifestyle factors (nutrition, tobacco use, physical activity, etc.)
• Naturally occurring exposures (ultraviolet light, radon gas, infectious agents, etc.)
• Medical treatments (chemotherapy, radiation, immune system-suppressing drugs, etc.)
• Workplace exposures
• Household exposures
• Pollution

Substances and exposures that can lead to cancer are called carcinogens. Some carcinogens do not affect DNA directly, but lead to cancer in other ways. For example, they may cause cells to divide at a faster than normal rate, which could increase the chances that DNA changes will occur.

Carcinogens do not cause cancer in every case, all the time. Substances labeled as carcinogens may have different levels of cancer-causing potential. Some may cause cancer only after prolonged, high levels of exposure. And for any particular person, the risk of developing cancer depends on many factors, including how they are exposed to a carcinogen, the length and intensity of the exposure, and the person's genetic makeup.

Medical History for FUTURE Genealogy search by my children....???

Although my daughter/law enforcement officer --- yellow alert all the time..... // although she complains for the OPENESS of blogs and links of personal information in this digital information age....

I tend to think it may be useful -- in helping my children and grandchildren to PATTERN their life in a successful way.   To know that I am diligent in monitoring my diabetic condition !!! !!!

 

Diabetes management is More than A Notion.... WHEW !!

We're talking time . . .  from 9:40 am testing....

Its now 10:20 to consume health breakfast.... food fix-up time, chew slowly....inject Humalog w/least pain....

 

Something New..... Always Monitoring the Diabetes Monstor ~ Deep Within !

A New Free Meter.....     Touch screen + download data....
A Bowl of Oatmeal w/milk....

and slice of Raisin/Cinnamon Toast w/Smart Balance Butter!  No other sugars or jelly!

My drink of the day.....

lemon, lime and orange slices in water!!!

Wells' Syndrome.... it's a flare up via 4 yrs!!!

Itching, itching, and mild swelling... annoying deep skin pain!!

Definition

Wells syndrome is a rare condition of unknown cause. It is also called ‘eosinophilic cellulitis’. What does Wells syndrome look like? Typically the rash is preceded by itching or burning skin and consists of markedly swollen nodules and plaques (lumps) with prominent borders. The patches are usually bright red at first, frequently looking like cellulitis, then fade over four to eight weeks, leaving green, grey or brown patches. They can blister. The rash most commonly occurs on the limbs, but may also affect the trunk. The patient often feels very tired and has a fever in approximately 25% of cases. Recurrent cellulitis followed by an eruption of skin lesions that are usually brawny, filled with fluid, and heavily infiltrated by eosinophils and histiocytes. Also called eosinophilic cellulitis. A blood count may reveal increased numbers of white blood cells called eosinophils – these are often associated with allergy or insect bites. The diagnosis of Wells syndrome can be established by a skin biopsy finding of typical histopathological features with many eosinophils and characteristic ‘flame figures’. However, flame figures are not diagnostic of Wells syndrome and can be seen in other conditions that have increased numbers of eosinophils. An important part of the management of patients with Wells syndrome is to exclude underlying causes such as parasitic disoders (e.g. a worm infestation) or an allergic contact dermatitis with the help of the appropriate tests. Treatment Oral corticosteroid treatment with prednisone can lead to a dramatic improvement within days and the course is typically tapered over one month. Other treatments include minocycline, dapsone, griseofulvin, ciclosporin and oral antihistamines. Mild cases may respond to topical steroid therapy alone.

Approach Considerations

There are numerous treatment options for Wells Syndrome (eosinophilic cellulitis), including the use of topical corticosteroids, calcineurin inhibitors, griseofulvin, H1 antihistamines, cyclosporine, dapsone, and systemic corticosteroids.^[38]
Systemic corticosteroids are the most effective treatment, but they may lead to corticosteroid dependence.

I'm a Rare Disease Person....in addition to diabetes huh?

Wells Syndrome:  Background

In 1971, George Wells first described this syndrome as a recurrent granulomatous dermatitis with eosinophilia.^[1] Wells and Smith renamed it eosinophilic cellulitis in 1979.^[2]
Wells syndrome (eosinophilic cellulitis) is an uncommon condition of unknown etiology. The presentation usually involves a mildly pruritic or tender cellulitis-like eruption with typical histologic features characterized by edema, flame figures, and a marked infiltrate of eosinophils in the dermis.^[3] Papular and nodular eruptions at the clinical presentation have also been reported.^{[4, 5]} The condition can recur and may be preceded by a pruritic papular eruption. Although Wells syndrome is usually sporadic, some familial cases have been reported.
One study showed the successive occurrence of vasculitis, Wells syndrome, and Sweet syndrome in a patient. This finding suggests that there is an overlap between these diseases.^[6] Another report describes a dominant syndrome consisting of eosinophilic cellulitis, mental retardation, and abnormal body habitus in one family.^[7]

Next Section: Etiology

Pathophysiology

At least some cases of Wells syndrome (eosinophilic cellulitis) may represent hypersensitivity to an arthropod bite or sting. An impressive response of peripheral lymphocytes to mosquito salivary gland extracts has been documented in some patients with Wells syndrome.^[8] A dermal infiltrate of histiocytes, eosinophils, and eosinophilic granules occurs between collagen bundles, which forms the classic flame figures. The eosinophilic infiltrate is almost always restricted to the epidermis and the dermis, but it has also been found in the subcutaneous tissue and the underlying muscle. The location of the infiltrate is correlated with the different clinical features.
In one study, immunophenotyping of peripheral T cells revealed an increased proportion of CD3⁺ and CD4⁺ T cells.^[9] These lymphocytes spontaneously release significant amounts of interleukin 5 (IL-5); this finding suggests that activated T cells may be involved in the pathogenesis of blood and tissue eosinophilia. The eosinophils then degranulate in the dermis, causing edema and inflammation.^[10]
With immunofluorescent stains, eosinophil major basic protein is identified in the granules of the flame figures. On electron microscopy, the collagen fibers are intact; this finding suggests that an initial degeneration of collagen is not a factor in initiating the formation of flame figures.

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Next Section: Etiology

Etiology

The etiology of Wells syndrome (eosinophilic cellulitis) is unknown. Wells syndrome may be due to drugs, various infections, and, possibly, nonhematologic malignancies as trigger events.^{[11, 12]}
Wells syndrome is usually sporadic, but some familial cases have been described. Suggested precipitating factors include the following:

• Arthropod bites and stings, including those of the honeybee^[13]
• Cutaneous viral infections; there is a possible link between parvoviral infection and Wells syndrome^[14]
• Cutaneous parasitic infestations, including toxocariasis,^{[15, 16]} ascariasis,^[17] and onchocerciasis^[18]
• Leukemia
• Myeloproliferative disorders
• Atopic dermatitis
• Fungal infections
• Hypersensitivity reactions to medications or metals, including metallic alloy implants^[19]
• Churg-Strauss syndrome: This syndrome has been associated in a few patients^[20] ; these reports are noteworthy for the presence of bullae and of antineutrophil cytoplasmic antibodies^[21] ; only a few other autoimmune diseases have been associated, including a case report of systemic lupus erythematosus^[22] ; sometimes, differentiating between these disorders can be challenging^[23]

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Next Section: Etiology

Epidemiology

Wells syndrome (eosinophilic cellulitis) is rare. Only about 80 cases have been reported worldwide.
Wells syndrome usually affects adults, but it has been known to occur in children.^{[24, 25, 26, 27]} In one case series of 19 patients, the classic plaque-type presentation was the most common variant found in children, whereas the annular granuloma–like variant was the most common variant in adults.^[28]

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Next Section: Etiology

Prognosis

The prognosis for patients with Wells syndrome (eosinophilic cellulitis) is excellent. It tends to resolve in weeks or months, usually without scarring. It occasionally recurs. In these recurrent cases, it can take years to ultimately resolve.

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 Contributor Information and Disclosures

Author  Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School 

Additional Contributors   David F Butler, MD Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.
Rosalie Elenitsas, MD Herman Beerman Associate Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System
Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology and American Society of Dermatopathology
Disclosure: Lippincott Williams Wilkins Royalty Textbook editor; DLA Piper Consulting fee Consulting
Takeji Nishikawa, MD Emeritus Professor, Department of Dermatology, Keio University School of Medicine; Director, Samoncho Dermatology Clinic; Managing Director, The Waksman Foundation of Japan Inc
Disclosure: Nothing to disclose.

References

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2. Wells GC, Smith NP. Eosinophilic cellulitis. Br J Dermatol. Jan 1979;100(1):101-9. [Medline].
3. Brehmer-Andersson E, Kaaman T, Skog E, Frithz A. The histopathogenesis of the flame figure in Wells' syndrome based on five cases. Acta Derm Venereol. 1986;66(3):213-9. [Medline].
4. Ghislain PD, Van Eeckhout P. Eosinophilic cellulitis of papulonodular presentation (Wells' syndrome). J Eur Acad Dermatol Venereol. Mar 2005;19(2):226-7. [Medline].
5. Holme SA, McHenry P. Nodular presentation of eosinophilic cellulitis (Wells' syndrome). Clin Exp Dermatol. Nov 2001;26(8):677-9. [Medline].
6. Consigny S, Courville P, Young P, et al. [Histological and clinical forms of the eosinophilic cellulitis]. Ann Dermatol Venereol. Mar 2001;128(3 Pt 1):213-6. [Medline].
7. Davis MD, Brown AC, Blackston RD, et al. Familial eosinophilic cellulitis, dysmorphic habitus, and mental retardation. J Am Acad Dermatol. Jun 1998;38(6 Pt 1):919-28. [Medline].
8. Koga C, Sugita K, Kabashima K, Matsuoka H, Nakamura M, Tokura Y. High responses of peripheral lymphocytes to mosquito salivary gland extracts in patients with Wells syndrome. J Am Acad Dermatol. Jul 2010;63(1):160-1. [Medline].
9. Plotz SG, Abeck D, Behrendt H, Simon HU, Ring J. [Eosinophilic cellulitis (Wells syndrome)]. Hautarzt. Mar 2000;51(3):182-6. [Medline].
10. Espana A, Sanz ML, Sola J, Gil P. Wells' syndrome (eosinophilic cellulitis): correlation between clinical activity, eosinophil levels, eosinophil cation protein and interleukin-5. Br J Dermatol. Jan 1999;140(1):127-30. [Medline].
11. Kaufmann D, Pichler W, Beer JH. Severe episode of high fever with rash, lymphadenopathy, neutropenia, and eosinophilia after minocycline therapy for acne. Arch Intern Med. Sep 12 1994;154(17):1983-4. [Medline].
12. Hirsch K, Ludwig RJ, Wolter M, et al. Eosinophilic cellulitis (Wells' syndrome) associated with colon carcinoma. J Dtsch Dermatol Ges. Jul 2005;3(7):530-1. [Medline].
13. Lin HL, Lin JN, Chen CW, Kuo LC, Lee WC. Eosinophilic cellulitis after honeybee sting. J Formos Med Assoc. Dec 2009;108(12):964-6. [Medline].
14. Cherng E, McClung AA, Rosenthal HM, Hicks J, Levy ML. Wells' Syndrome Associated with Parvovirus in a 5-Year Old Boy. Pediatr Dermatol. Dec 9 2011;[Medline].
15. Hurni MA, Gerbig AW, Braathen LR, Hunziker T. Toxocariasis and Wells' syndrome: a causal relationship?. Dermatology. 1997;195(4):325-8. [Medline].
16. Bassukas ID, Gaitanis G, Zioga A, Boboyianni C, Stergiopoulou C. Febrile "migrating" eosinophilic cellulitis with hepatosplenomegaly: adult toxocariasis - a case report. Cases J. Nov 28 2008;1(1):356. [Medline].
17. Tsuda S, Tanaka K, Miyasato M, Nakama T, Sasai Y. Eosinophilic cellulitis (Wells' syndrome) associated with ascariasis. Acta Derm Venereol. Jul 1994;74(4):292-4. [Medline].
18. van den Hoogenband HM. Eosinophilic cellulitis as a result of onchocerciasis. Clin Exp Dermatol. Jul 1983;8(4):405-8. [Medline].
19. Zhu L, Hu D, Wang Q, Hou J, Li M. Diffuse polymorphic eosinophilic cellulitis in a patient with metallic alloy implants: a possible association?. Int J Dermatol. Dec 2011;50(12):1535-7. [Medline].
20. Lee SH, Roh MR, Jee H, Chung KY, Jung JY. Wells' syndrome associated with churg-strauss syndrome. Ann Dermatol. Nov 2011;23(4):497-500. [Medline]. [Full Text].
21. Fujimoto N, Wakabayashi M, Kato T, Nishio C, Tanaka T. Wells syndrome associated with Churg–Strauss syndrome. Clin Exp Dermatol. Jan 2011;36(1):46-8. [Medline].
22. Yin G, Xie Q. Systemic lupus erythematosus associated with Wells' syndrome. Rheumatol Int. Feb 22 2011;[Medline].
23. Omiya W, Fujita Y, Baba K, Shibaki A, Odani T, Shimizu H. Unusual cutaneous manifestations of Churg-Strauss syndrome mimicking Wells' syndrome. Eur J Dermatol. Jun 15 2012;[Medline].
24. Anderson CR, Jenkins D, Tron V, Prendiville JS. Wells' syndrome in childhood: case report and review of the literature. J Am Acad Dermatol. Nov 1995;33(5 Pt 2):857-64. [Medline].
25. Nielsen T, Schmidt H, Sogaard H. Eosinophilic cellulitis. (Well's syndrome) in a child. Arch Dermatol. Jul 1981;117(7):427-9. [Medline].
26. Shams M, Hudgens J, Lesher JL Jr, Florentino F. Wells' syndrome presenting as a noninfectious bullous cellulitis in a child. Pediatr Dermatol. Mar 2012;29(2):224-6. [Medline].
27. Powell JG, Ramsdell A, Rothman IL. Eosinophilic cellulitis (Wells syndrome) in a pediatric patient: a case report and review of the literature. Cutis. Apr 2012;89(4):191-4. [Medline].
28. Caputo R, Marzano AV, Vezzoli P, Lunardon L. Wells syndrome in adults and children: a report of 19 cases. Arch Dermatol. Sep 2006;142(9):1157-61. [Medline].
29. Spinelli M, Frigerio E, Cozzi A, Garutti C, Garavaglia MC, Altomare G. Bullous Wells' syndrome associated with non-Hodgkin's lymphocytic lymphoma. Acta Derm Venereol. 2008;88(5):530-1. [Medline].
30. Odia SG, Purschel W, Worret WI, Rakoski J. Hypereosinophilic cellulitis(Wells' syndrome) resembling urticaria. Acta Derm Venerol (Ljubljana). 1994;6:193-195.
31. Mutasim DF, Cooper CH. A case of Wells' syndrome in a patient with lymphocytic lymphoma. Geriatr Dermatol. 1996;4(1):11-14.
32. Falagas ME, Vergidis PI. Narrative review: diseases that masquerade as infectious cellulitis. Ann Intern Med. Jan 4 2005;142(1):47-55. [Medline].
33. Leiferman KM, Peters MS. Reflections on eosinophils and flame figures: where there's smoke there's not necessarily Wells syndrome. Arch Dermatol. Sep 2006;142(9):1215-8. [Medline].
34. Moossavi M, Mehregan DR. Wells' syndrome: a clinical and histopathologic review of seven cases. Int J Dermatol. Jan 2003;42(1):62-7. [Medline].
35. Stern JB, Sobel HJ, Rotchford JP. Wells' syndrome: is there collagen damage in the flame figures?. J Cutan Pathol. Dec 1984;11(6):501-5. [Medline].
36. Peters MS, Schroeter AL, Gleich GJ. Immunofluorescence identification of eosinophil granule major basic protein in the flame figures of Wells' syndrome. Br J Dermatol. Aug 1983;109(2):141-8. [Medline].
37. Aberer W, Konrad K, Wolff K. Wells' syndrome is a distinctive disease entity and not a histologic diagnosis. J Am Acad Dermatol. Jan 1988;18(1 Pt 1):105-14. [Medline].
38. Herr H, Koh JK. Eosinophilic cellulitis (Wells' syndrome) successfully treated with low-dose cyclosporine. J Korean Med Sci. Oct 2001;16(5):664-8. [Medline].
39. Church MK, Maurer M, Simons FE, et al. Risk of first-generation H(1)-antihistamines: a GA(2)LEN position paper. Allergy. Apr 2010;65(4):459-66. [Medline].
40. Brown J, Schwartz RA. Wells' syndrome (eosinophilic cellulitis). Cesko-Slovenska Dermatol. 2002;77:261-263.

 

 

 

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Happy Wednesday !

Rejoicing over Diabetes....

Hurray.... for a being a GOOD DIABETIC  !! live long, live well!

Black Folk eating good ol' Greens (aka Kale)

Yippee! My Vitamin D ~ Guide sheet

The Aretha Franklin Snicker Commercial

Habits form when you associate pleasure to an action, whether that action is going to serve you in reaching your goals or not is another story. However, you can use this information to your advantage and practice creating new, positive associations to habits you want to form - like eating a salad instead of having fries, or drinking a glass of water before anything in the morning....


CRAP vs. FOOD   Wellness Blogger/site

I've found a blog friend named Annie's Ruby Slipperz

Annie's Ruby Slipperz

Luvin my Healthy Life Choices