樂悠30胰島素保冷(溫)袋

樂悠30 ~ 追夢吧! 任何人都不能阻礙你內心的渴望 !

~IDDM第一型美國大兵的故事

翻譯自美國糖尿病學會(ADA)網站: http://www.diabetesarchive.net/diabetes-forecast/jul2005/back.jsp

你可以想像一個美國士兵身處在遍佈沙漠的伊拉克是怎樣的處境，各種威脅隱藏在你想像不到的地方。到處都是乞討食物的孩子，在他們當中夾雜的攜帶AK47步槍的民眾，你完全無法預測他們的意圖， 一不小心就可能有生命危險。 絕大多數的人一定不想待在這樣的環境當中，然而馬克.湯普森~一個IDDM的美國大兵，卻極力爭取請調伊拉克。這當中的故事是什麼?他如何在嚴酷的環境挑戰下維持身體的健康且完成自己的夢想!?

湯普森，28歲，是愛荷華州人。他已經結婚9年，並有一個兒子。他總是有一種探索世界的渴望, 這種渴望啟發湯普森從軍。因為大學時聽到年紀較大的室友，曾在越南戰爭中擔任士兵的冒險故事，這讓陸軍步兵聽起來像是一場探索與冒險。當時湯普森也需要錢，所以在1996年，簽署了4年志願兵役，希望先從軍存錢，然後完成大學教育。但湯普森之後就沒有回到校園。因為發現軍旅生活是他最熱愛的地方。

但在2000年，湯普森體種快速下降。常常感到口渴和疲憊。一天早晨，在行走過程中暈倒。當進醫院檢查，血糖值超過600mg/dl。醫生診斷他患有第一型糖尿病。這診斷可能意味著湯普森的軍旅生涯即將結束。很多士兵因為身體健康因素而被迫退役, 因為他們不能證明身體的健康程度能從事軍隊的工作。但是湯普森決定不想落得像那些戰士一樣。並確信IDDM不會影響他熱愛的工作。

湯普森接受胰島素治療，而軍隊中的醫療委員會審閱他的病歷，要決定是否能繼續在軍事單位服務。湯普森在2002年期間HbA1C 平均6.2%。血糖控制的很好，最後委員會批准為“適合軍旅工作。”

湯普森保住了熱愛的軍旅生涯。可以繼續在軍隊服務，但他卻被限制前往無冷藏設備及醫療用品來之不易的作戰地區。

為夢想奮戰

當時湯普森是部隊中人力資源單位的職業顧問，幫助士兵在軍隊的職業生涯規畫選擇。但湯普森覺得自己沒有實戰經驗，要如何輔導士兵呢?他總覺得缺少些什麼!

2002年，阿富汗戰爭爆發。一年後，美國士兵移防到伊拉克。在2003年春天，湯普森的第1步兵師，接收到命令，將在2004年1月部署到伊拉克。湯普森被分配到“後備支援”這意味著他要在第1步兵的大本營~德國美軍基地留守。

“後備支援是一項重要工作，” “但是這不是我想要的，這不是我加入軍隊目的。” 湯普森說。

所以湯普森必須先做一些功課，來說服他的長官讓他前往伊拉克。

首先，他要確保在伊拉克-提克里特的美軍基地醫院有足夠的胰島素庫存以便他用胰島素幫浦來注射，同時也準備注射器以備不時之需。為保持胰島素的效果，買了冰箱，就近在營區裡面使用。

湯普森佩帶胰島素幫浦，面臨最主要的挑戰是必須將胰島素保持在30°C(86°F)以下，然而所在的每一個地方，溫度都可以飆升超過100°F。他找到了可重複使用的的樂悠胰島素保冷袋(FRIO Pouches)，這是一種特殊材料製成，浸泡水後就可以有效的保存胰島素，避免藥物失效。這保冷袋不需要電力就可以在這樣的高溫的天氣中維持胰島素涼涼的。如果胰島素幫浦壞掉，也可以使用隨身攜帶備用胰島素和注射器。

湯普森的研究得到了回報。陸軍第一步兵師的醫生，邁克爾中校，起初認為太冒險了。但中校醫官邁克爾說 :“他全面的了解自己的身體，飲食以及胰島素需求，而且也有深入的應變計劃”。湯普森被核准前往伊拉克，但有幾個條件：他要準備8個月用量的胰島素，導管，備用血糖儀，注射器。如果他的血糖波動太大，或是健康處於危險之中，他會被遣返回德國美軍基地。

在伊拉克

湯普森走遍伊拉克，造訪第1步兵師的各單位。 “我得隨身攜帶所有的食物包括營養穀物食品，熱量補充品….等等。”當戰事平靜時，士兵可能只是穿防彈背心。但大部分時間，他們必須穿上全副武裝：背心，防彈衣，保護眼鏡，頭盔，彈藥和物資。這整個重量至少有60磅。

2004年4月，糟糕的情況發生了，胰島素幫浦壞掉。加上因為某種原因無法進行正常的食物供，湯普森和他同行士兵只能吃一些事先預備的加工食品或不易腐爛的飯菜。這些食物很難計算碳水化合物量，而且沒有胰島素幫浦，很難保持穩定的胰島素注射。

但湯普森告訴自己，他不會被遣送回家。在接下來的4個星期，每天10次測量血糖值。用預先準備的注射器，一直到收到新的胰島素幫浦。最後應急計劃有了成效：湯普森這段在伊拉克的時間，糖化血色素停留在6.5％左右。

夏天來了，難以想像的熱。到了6月，全師已停止穿著全副武裝，因為溫度達130°F這根本無法忍受。在沙漠的空氣吹來 “整顆頭像是在烤箱中烹調的感恩節火雞一樣”湯普森說。但湯普森hold住了。隔年2月，湯普森在伊拉克完成他的任期。

湯普森感到自豪，他達成這不可能的任務，成為他軍旅生涯永生難忘的經驗之一。

這場為自己的夢想奮戰的結果是~他贏了。

糖尿病和軍事

在美國的軍事規定上，糖尿病人禁止從事戰地軍事。然而在馬克·湯普森的故事之後，軍方已作出一些改變。

糖尿病患者能否從事軍事活動的關鍵是：

•能否優秀的管理您的糖尿病

•專業人士要能向軍事審查小組提出證明糖尿病如何影響你，為什麼它不會影響你的工作。

有關詳細信息，請致電1-800-342-2383在美國糖尿病協會。

Diabetes Forecast July 2005

FOR TYPE 1/TYPE 2

Back From Iraq: A Soldier's Story

Staff Sergeant Mark Thompson convinced the Army that having type 1 diabetes shouldn't keep him from serving in Iraq.
by Laurie Meyers

The soldiers set off in their Humvee. Sandbags were wedged against their doors, stuffed behind them, even resting under them, as seats. The bags wouldn't offer much protection if they hit a land mine or faced a roadside attack, but they were better than nothing. Even garbage in the road was a threat—a possible hiding place for explosive devices.

They passed children with hands outstretched, begging for food, and men carrying AK-47s. Were the men hostile or friendly? No way to know: Just keep the weapons pointed outward and shoot to kill if approached.

They drove for 2 days, stopping only once, for the convoy to refuel. Stopping was like putting on a big red bull's-eye. Insurgents could and would appear out of nowhere. They had to keep moving until they reached base.

That drive—from Kuwait to Tikrit, Iraq—is not one most of us would want to make. But Staff Sergeant Mark Thompson fought his own personal war to be part of it.

This Soldier's Story

Thompson, 28, is an Iowa native. He's been married for 9 years and has a son, Kyle, who's 2. He's always had something of a travel bug, and it was this desire to see the world that inspired Thompson to join the Army.

That, and the stories he heard from his college roommate—an older student who had served in the Vietnam War. As Thompson listened, the Army started to sound like an adventure. Thompson also needed money for college, so in 1996, he signed on for 4 years, expecting to do his time and then finish his education.

But Thompson never went back to campus. He had found his place, and it was in the Army. He was a "lifer."

Then in 2000, Thompson began losing a lot of weight. He felt thirsty and tired all the time. One morning he collapsed during a run. When Thompson made it to the hospital, his glucose level was over 600. The doctors told him he had type 1 diabetes.

This diagnosis could have meant the end of his career. Plenty of soldiers who are diagnosed with serious medical conditions must leave because they can't prove they're healthy enough to do the Army's work. Thompson was bound and determined to not end up like one of those soldiers.

He went from having an A1C of 12.5 percent at the time of diagnosis to 6.2 by the time the Army's medical board reviewed his case in 2002. Because he was able to control the disease so well, the board found him "fit for duty."

Thompson's victory wasn't absolute. He was told that while he could continue serving, he would not be allowed to do it from combat zones where refrigeration and medical supplies are hard to come by.

The Battle At Home

But Thompson wanted to go where he was needed most, and by 2002, war had broken out in Afghanistan. A year later, American soldiers also were moving into Iraq. Thompson is a career counselor, which means that he helps soldiers choose career paths within the Army and asks them to reenlist.

"I'd be sitting across from a soldier with a [combat] patch, counseling him, and I wouldn't have the combat experience," Thompson said. "It just didn't seem right."

In the spring of 2003, Thompson's division, the 1st Infantry, received word that it would be deploying to Iraq in January 2004. Thompson was assigned to the "rear detachment," which meant staying at the 1st Infantry's home base in Germany.

"Rear detachment has an important job," Thompson said. "But it's not where I wanted to be. It's not why I joined the Army."

So Thompson did some homework.

He called to make sure the military base hospital in Tikrit could stock a 5-month emergency supply of the insulin he uses—fast-acting for his pump, and some NPH to mix with it if he needed to use syringes. He bought a camping refrigerator that he had converted so that it could be plugged into a Humvee.

Thompson wears an insulin pump, and his main challenge would be keeping the insulin at 86°F or less, all while on the go in a place where temperatures can soar well over 100°F. He discovered reusable Frio pouches, which are made of a special material that is activated when the pouches are immersed in water. They keep contents cool for well over a day in such temperatures. If the pouches failed or if the pump broke, he could get insulin from the hospital and switch to the backup syringes he would be carrying.

Thompson's research paid off. Lieutenant Colonel Michael Brumage, MD, division surgeon, 1st Infantry Division, initially thought it was too risky. But Thompson "showed me that he had a comprehensive knowledge of his body, his diet, his insulin needs, and that he also had an in-depth trouble-shooting plan," Brumage said.

Thompson had the permission he needed, but with a few conditions: He would carry an 8-month supply of insulin, catheters, spare blood glucose meters, and syringes everywhere he went. And if his glucose levels fluctuated too much, or if his health was in danger, he would be on the next plane back to Germany.

In Iraq

After that initial 2-day drive into the heart of Iraq, Thompson traveled around the country, visiting the 1st Infantry's various units. "I kept multiple baggies of food with me all the time—Nutri-Grain bars, power bars, any quick source of food I could pick up at the dining hall."

When things were relatively calm, soldiers could just wear bulletproof vests. But most of the time they had to wear full combat gear: vests, body armor, eye protection, helmet, ammunition, and supplies.

The whole ensemble weighs at least 60 pounds, and it was too much for Thompson's pump. In April 2004, the pump broke under the pressure. It was the worst possible time. Thompson and his peers were subsisting on prepackaged, nonperishable meals that feed soldiers when regular food supplies are for some reason cut off. These meals made it hard for Thompson to calculate carbohydrates, and without his pump, it was hard to keep a steady supply of insulin.

But Thompson told himself he was not going to be sent home. He checked his levels 10 times a day for the next 4 weeks until his replacement pump arrived, and he put the new pump in a lower pocket to protect it.

The checking and emergency planning paid off: Thompson's A1C during his time in Iraq stayed at about 6.5 percent.

Home Again

Summer came, bringing a blast of unimaginable heat. By June the whole division had stopped wearing full body armor because it was simply unbearable. Temperatures hit upwards of 130°F; even the rock candy Thompson's mother had sent from home melted.

The desert air, especially if there was any wind, "felt like sticking your head in the oven while cooking the Thanksgiving turkey," Thompson said.

But Thompson was holding his own, and so were his pouches. He never even needed the refrigerator. And by February of this year, Thompson had completed his tour of duty in Iraq.

Thompson thinks often of his time there, of that harrowing drive to Tikrit, of the sinking feeling he had the day he realized his pump was broken.

He also feels proud, because while the final chapter of the war in Iraq has yet to be written, Thompson waged his own war, of sorts, to be part of the experience there.

And he won.

Laurie Meyers is an associate editor of Diabetes Forecast.

Fit For Duty: Diabetes And The Military

Under the Americans with Disabilities Act, the Rehabilitation Act of 1973, and many state anti-discrimination laws, it is unlawful for an employer to have a blanket ban that prohibits anyone with diabetes from holding a given job. Rather, an employer must look at each case individually. The exception is when another federal law or regulation "trumps" those laws. This happens very rarely. One place it does happen, however, is in the military, where people with diabetes are prohibited from serving. However, as Staff Sergeant Mark Thompson's story shows, the military has made some exceptions.

The keys to staying in the military following a diabetes diagnosis are having:

• Excellent management of your diabetes
• Health care professionals on your side who can explain to military review panels how diabetes affects you and why it will not prevent you from doing your job

For more information, call the American Diabetes Association at 1-800-342-2383. You can request a free packet on employment discrimination. You can also ask to speak with the legal advocate about your situation.