[URL="http://www.theheraldbulletin.com/story.asp?id=17642"]http://www.theheraldbulletin.com/story.asp?id=17642[/url][/URL] Jack Williams: The ups and downs along the diabetic turnpike With a sugar cookie in one hand and a piece of peanut butter fudge in the other, I'm celebrating a smooth relatively smooth year of diabetes management through insulin pump therapy. I've been in therapy for nearly a year now, wired to an insulin pump that gives me a continuous rate of insulin throughout the day, just like my old pump, my pancreas, used to do before it crashed and turned me into a statistic. That is, one of 20 million Americans with insulin dependent diabetes. With a pump clipped to my pants or discreetly hidden in any of the 10 pockets of my cargo pants, I can program my insulin delivery based on whether I'm fruitcake loading at yet another Christmas party, whether I'm exercising or exercising my option to remain sedentary and whether my current blood glucose readings are normal or rising and falling like a roller coaster. With an insulin pump, I don't have to duck into a dark alley and shoot up with syringes anymore like we used to do in the Dark Ages. I had almost made it through the year without incident until the week before last. That's when I jumped in the car and headed to Washington, D.C., to pick up my son, antsy to return from a semester in the nation's capital. It was to be a quick 10 hours out and 10 hours back, a day trip and less. No eyeballing honest Abe at the Lincoln Memorial or shopping at the National Mall, just out and back. But somewhere on the way out, a connecting piece on my insulin pump worked itself loose, my insulin pump quit pumping insulin and my blood sugars began a steep, steady climb. By the time I hit the Beltway, my insulin deficit needed the administration's attention. Now, I've suffered from elevated blood sugars over a 24- hour period, due to vacation, irregular work schedules or holiday gluttony, but I've never become violently ill. So the nausea, as nausea tends to do, took me by surprise as we left D.C. and headed up through Maryland in search of the Pennsylvania Turnpike. But it was the barfing through the hills of southwestern Pennsylvania that got my attention, as well as those riding with me, no doubt. My doctor tells me now he tells me that whether you're heading to the nation's capital or not, you should treat your diabetes as if you're on high terror alert. In other words, you should always be prepared for an emergency. Packing your supplies is the best way to be smarter than the disease. Fifty miles southeast of Pittsburgh, while we edged along at 20 miles per hour in a blinding snowstorm, I realized that I was dumb and dumber than the disease. With each breath becoming more difficult was like having a heart attack. On the ambulance ride to the hospital, I asked the EMT where we were. "Kyle" told me we were in Somerset and welcomed me to "Disaster Central." That is, we were just miles from Johnstown, site of one of the worst disasters in our nation's history in 1889 when a flood wiped out a working class city, killing 2209. Just miles from the site of a coal mine that trapped nine miners for 77 hours in 2002. And, most famously, just miles from the crash of United Airlines Flight 93, the last of the four planes hijacked on 9/11, originally en route to San Francisco from Newark, and believed to be headed back to D.C., possibly the White House, on a terrorist mission. While the EMT and all of history confirmed that I was indeed in Somerset, Pa., my doctor tells me I was heading towards the town of "ketoacidosis," a condition in which blood sugars are out of control, the body becomes poisoned and you're just an exit away from a diabetic coma. Fortunately, the nurses and doctors at Somerset Hospital treated me with medication, insulin, fluids, x-rays and a battery of other tests, and had me back on the road well, back to the motel by three in the morning. It was a straight shot the next day, off the mountains, through the tip of West Virginia, and across Ohio. Back home again in Indiana, I was ready for a session in insulin pump therapy. Jack Williams' column appears on Tuesdays. He can be reached at firstname.lastname@example.org.