Monthly Archives: February 2011

Ready to Start Coding

It’s been a week since I announced that I was going to write an iPhone app. I’m still excited about it, even though someone told me that Medtronic is working on their own version of the same thing I proposed — a working prototype, she said. Well, I for one am glad that they seem some value in having a mobile app, but I plan to keep working on mine. Competition is good. We’ll see who can get their app out there first: the newbie picking up iPhone development skills or the large medical company who is going through FDA approval.

Since last Saturday I’ve learned a lot. I’ve picked up the syntax of Objective-C, which is causing this C++ programmer to “think differently.” I like what I’ve seen from it so far, but we’ll see what I think after building something real. I’ve made a couple “Hello, World!” applications, just enough to get a few basic skills using Xcode and Interface Builder.

Now the hard work begins.

I’ve made a list of requirements for the first couple of (internal) versions of the app; so I know what needs I plan to satisfy. I’ve picked an external library to plot the CGM data. And I’ve started working on the functional design, sketching a few different views that people will use to interact with their data. (I usually hate graphical user interface design, but something about the UIKit components seem to be amplifying my scanty abilities with interaction design.) I still have to figure out the data model — that is to say, the architecture — but I think that should follow from the views I create, which of course is supposed to visualize items in the pump/CGM data model.

Tomorrow I’ll try to put a few components together. Stay tuned!

Posted in CGM, Computing, Data-betes, Diabetes, Fodder for Techno-weenies, Software Engineering | 1 Comment

666

Here it is, the post that answers the question of what I will write about on my 666th post on this weblog. Someone suggested an exorcism, but I’ve already done that. Someone else thought Satan would be appropriate; but 666 is really more of an antichrist thing.

Plus, that kinda freaks me out. There are few things in the world that frighten me. Creepy religious things are just about it. “Rosemary’s Baby,” “The Exorcist,” and “The Omen” might be the scariest films I’ve seen. (Although, the original Japanese version of “The Ring” had me on edge the whole time.)

Now I’m not gonna say that these feelings are definitely related to events in my childhood, but . . . Well, you be the judge.

When I was very young, my father was in Bible college and very into Christian eschatology (i.e., all things End Times). Every once and a while he would teach my older brother and me about the whole millennial timeline: rebuilding the Temple, Antichrist, signs, seals, horsemen, Rapture, Tribulation, second coming, final judgement, lake of fire, creation of a new Heaven and Earth, etc. When you learn this stuff as a four year old, it takes a while to realize that not everyone is steeped in this mythology.

Anyway, is that really what this post is supposed to be about? I’ve forgotten a lot of the details, if I ever really knew them at all. And I’m not so easily freaked out. After all, the short-lived, extremely dark television series “MillenniuM” is one of my favorites — despite containing a story arc that’s heavily influenced by the scarier parts of Christianity — and from time to time I think it would be interesting to read the Left Behind series, although I’ve heard that it’s very poorly written.

But there is one thing that until very recently got me scurred: giving large boluses of insulin. (You knew it was going to come back to diabetes at some point, didn’t you?) It was kind of a ridiculous fear, since I kinda knew that I would end up having high blood sugar if I didn’t give that big dose. Yet, I still couldn’t really do it for fear of having wicked hypoglycemia.

CGM has helped me overcome this phobia, along with any doubts that I had about delivering boluses 10-20 minutes before eating. I mean just look at this CGM trace from yesterday afternoon through today.

CGM trace

The first part of the trace in the “dark” portion of the graph is right after I ate half a thin-crust pizza with cheesy bread. No so healthy, but just the tiniest little spike. And then there’s the pre-bolus for my breakfast cereal this morning. A little up, a little down, but nowhere near the 250 mg/dL spikes I used to have but never saw before CGM.

I seem to be rambling.

So there it is. The 666th post is an aimless, crazy post about nothing in particular.

Posted in CGM, Diabetes, This is who we are | 2 Comments

Capping Medical Payments

I’ve been thinking a lot recently about how to keep healthcare costs down. There are a number of options, and the one that Massachusetts is set to implement will create accountable care organizations (ACOs) with “global payments.” In this system, there’s a big pool of money shared by all of the health care providers. It’s a bold act, but it’s necessary, since the Commonwealth’s universal coverage mandate requires that prices come down so that we don’t go completely bankrupt.

Today’s WBUR CommonHealth blog contains this fascinating nugget in an interview with Dr. Marc Bard about ACOs and global payments.

Now, what is being proposed in Massachusetts creates somewhat of a zero-sum game, doctor against doctor and doctors against hospitals; and that’s a less comfortable battle. And, it’s potentially going to be even less comfortable because with the ACO, there’s going to have to be more support for primary care, and if you’re operating with a fixed global payment budget, that means that the high-end providers, the high-end physicians and hospitals, are going to take the greatest haircut. That’s reality.

And by the way, I’m a strong advocate of capitation. Of all the payment strategies that have been used over the past decades, the one that truly fostered innovation was capitation, because it required the invention of new ways to deliver care on a fixed budget. So I like responsible capitation, it’s just that I’m realistic enough to appreciate that introducing it in Massachusetts is going to be very difficult.

Think of a bell-shaped curve. There are people at one end who absolutely need the high-end procedure and no one would dispute that. At the other end, I don’t need a total hip replacement. But there are a lot of people in the middle of the bell-shaped curve. The real question is: Do they need the procedure and do they need it now? And those kinds of borderline cases are going to come under much greater scrutiny. Who really needs a stent? Who really needs a bypass? What’s the data to support bypass vs. stent? The best example is Prostate Specific Antigen testing for men. There are going to be long-term studies that ask the question, who really needs surgery or radiation and if so, when?

That last paragraph scratches the surface of the shades of gray that are at the heart of the choices we might have to make if we can’t bring costs down any other way.

Posted in Health Care | Leave a comment

Helpful iOS Apps for Diabetes

I’ve been thinking about iPod/iPhone/iPad apps for good reason lately. My research into how to write such an app of my own continues apace, and I’ve contemplating exactly what I can make it do.

I’ve also been thinking thinking about the apps I have now that I find useful for diabetes. To be perfectly honest, none of them are the typical journaling apps. I downloaded a few, used a couple, but stuck with none. Journaling just takes too much time and/or sustained attention. You either stick with it and get a lot of use out of it, or you have a life. I’m trying not to make that same mistake with my own app. Let the machines collect the data, I say. We’ll use our brains to make decisions based on their hard work. Thinking, that’s our proper role.

Anyway, what apps do I have on my iPod Touch (a.k.a., cheapo iPhone) that help me with my diabetes?

  • Tap & Track: Calorie Tracker ($3.99) — It has a ridiculous amount of foods in its onboard database, including loads of restaurants and name-brand packaged foods. No network connection required. Easily access things you eat regularly. Get details about your own recipes. A bargain at twice the price.
  • Twitter (Free) — Gotta keep in touch with my diabetes online community.
  • Things ($9.99) — This GTD app is a bit pricey, but it’s the best I’ve found. Among other things, I use it to keep track of my diabetes and health-related projects and tasks. I can set it to remind me to get my A1c drawn months in the future, when it’s actually relevant. It reminded me to “write that weblog entry about iPod apps” before DSMA. Oh, and since I made a recurring task to take my vitamins, I’ve gotten much better at doing that. I like checking things off a To-Do list. :^)
  • Due ($2.99) — I try to bolus for breakie 15 minutes before I eat. This little reminder app has reminded me more than once that it’s finally time to stop working and go eat that cereal.
  • Reeder ($2.99) — This RSS aggregator hooks up to Google Reader and helps me keep up to date with all y’all’s weblogs. (Thanks to Pearlsa for recommending this.)
  • iBooks (Free) — I keep my running plan that I built on a running web site in a PDF here, along with a few exercisey things that I scanned from magazines. (What I really want is a tear-sheet app, but until then . . .)

So what am I missing? What do you use? Please leave a comment!

Posted in Computing, Data-betes, Diabetes, Fodder for Techno-weenies, Health Care | 6 Comments

Diabetes Swims with the Fishes

This post is part of February’s DSMA Blog Carnival.

I feel like I’ve done a lot of great things despite having diabetes. I’ve gone many places and had some wonderful experiences, but I think the most awesome thing I’ve done despite having diabetes is snorkeling on the Great Barrier Reef.

Great Barrier Reef

From the very beginning, when we started planning last year’s trip to Australia, we knew that we wanted to go to the Reef. And almost as soon, I started worrying about how my diabetes would affect our plans — just a little bit. Would I be able to swim without going hypo? How would I handle insulin delivery while I’m in the water or on the beach? Should I take some Lantus with me for the beach/reef part of our trip? Would the tour operators let me swim with diabetes? I hadn’t gone swimming in so long, and I had no idea whether I would even be strong enough to do it.

So we went to the pool three times a week, and I went from almost being unable to swim in September to swimming a mile each Saturday in April. My BGs weren’t so awesome before swimming, and I dropped like a rock during my evening visits to the pool. But I figured I would be conservative when we went to the Reef, and I decided to hope for the best, trusting in the months of swim+insulin practice.

Despite some dicey weather on the way from Cairns to Flynn Reef — we had high seas driven by 20 knot winds that led most people onboard to get very green (or worse) — we had a great time. The water was so warm, the coral was so intricate, and the fish! The fish were amazing. There were so many colorful varieties and so many of each kind. They were everywhere! We saw parrotfish, angelfish, clown anemone fish, and an enormous wrasse . . . just to name a few. At the second site of the day, we saw a giant clam and a sea turtle, which swam around at incredible speed. It was just so cool to swim over the top of the coral pedestal and then look down to see it drop away dozens of feet into the darkness.

When it comes right down to it, the reef was one of the most amazing experiences I’ve ever had, and it came as part of one of the most wonderful trips that I’ve ever taken. Ultimately, diabetes played only the smallest role; my blood sugar was a little high the second time I got out of the water, but I didn’t really feel like it slowed me down at all. And that’s the way it should be.

Here are a whole bunch of photos from our time on the Reef. Enjoy!

Posted in Australia, Diabetes, Travel | 4 Comments

Number Needed to Treat

Here’s a little something to get you in the right frame of mind for some upcoming posts.

From Wikipedia, number needed to treat:

The number needed to treat (NNT) is an epidemiological measure used in assessing the effectiveness of a health-care intervention, typically a treatment with medication. The NNT is the number of patients who need to be treated to prevent one additional bad outcome (i.e. the number of patients that need to be treated for one to benefit compared with a control in a clinical trial). . . . The ideal NNT is 1, where everyone improves with treatment and no one improves with control. The higher the NNT, the less effective is the treatment.

This goes hand-in-hand with its fraternal twin, number needed to harm:

The number needed to harm (NNH) is an epidemiological measure that indicates how many patients need to be exposed to a risk-factor over a specific period to cause harm in one patient that would not otherwise have been harmed. . . . Intuitively, the lower the number needed to harm, the worse the risk-factor.

Basically these are the number of people you would have to treat if you were to fix the medical problem or make it worse. If you have your own data set, you can easily calculate NNT and NNH. (Compute them with software, of course! What are we savages?)

How about a diabetes-oriented example, care of the Centre for Evidence-Based Medicine?

“The results of the Diabetes Control and Complications Trial (DCCT) into the effect of intensive diabetes therapy on the development and progression of neuropathy indicated that” the NNT was 15. “We would need to treat 15 diabetic patients with intensive therapy to prevent one from developing neuropathy.”

Compare that to another study that looked at the role of “regular telephone contact with a diabetes nurse educator for advice about adjustment of insulin therapy vs. regular clinic visits and usual contact with the endocrinologist for insulin adjustment.” In this study a positive outcome was defined by examining the “mean HbAlc level and proportion of patients who achieved a reduction in HbAlc level ≥ 10%.” It found that the NNT was 2. Two! For every two patients who get called by a nurse educator, one of them will likely see an improvement in self-management abilities.

These studies aren’t mutually exclusive. In fact, you might say that having nurses call patients is an effective part of “intensive therapy” that contributes to lower incidence of neuropathy.

The main point I want you to take away from this small digression is that whenever you hear medical reporting about the value of new or existing therapies, you should think in terms of NNT and NNH. If we gave everyone this test (or drug or medical intervention) how many would benefit? How many would suffer as a result? If the cost of the treatment is large but it only saves one life in 1,000, is it worth the cost? How many of those 1,000 are harmed? Are there other therapies with better NNT and NNH numbers that could be used instead?

Posted in Diabetes, Health Care, Life Lessons | Leave a comment

Total Diabetes Awareness, The App

I am terrible with personal software projects. At work, I have no problem getting things started and finished. But elsewhere, I’m just a bit too distracted by everything else in my life to engage in some casual programming.

But this morning, as I was putting on my socks — and checking my diabetic feet, of course — I struck upon a project that I would gladly spend at least a few evenings and weekends to get working.

Throughout the day I’ve been talking myself into writing an iPhone app to display all of the data from my pump and continuous glucose monitor. I’ve already learned a great deal from my CGM, but what I need now is a memory device that collects all (or at least most) of my diabetes data in one place, so that I can use what’s worked in the past (as well as what didn’t work so well) in order to make better decisions.

The idea behind the as-yet-unwritten software is to transfer all of the data and events from my part of Medtronic’s CareLink website — it stores my CGM sensor values, blood glucose readings, insulin boluses, temporary basals, infusion set changes, etc. — and store them on my iPod, where I can review and plot them graphically. (And if it works on my iPod Touch, it would run on an iPhone or iPad, too.)

Why do I want to do this? There are many situations that happen regularly but not quite frequently enough for me to remember what happened. What happened the last time I had Thai food? How much insulin did I give? What did I estimate the carbs to be? And what about the last time I went for a long bike ride? What temporary basal did I use? I could write all this down, but (as I’ve recently discovered) there’s a great deal of value in seeing the CGM trace surrounding the event.

So my app will be fairly small to begin with:

  • Import data from a CSV file that I can download from the CareLink site.
  • Plot the CGM graphs and display the insulin, BG, and pump events.
  • Display details about these events. What did I enter into the pump’s bolus wizard? What did I end up doing?

That’s a first version. That will let me carry around a self-updating logbook. Journaling is something we hate to do, so why not just aggregate the data that I already produce minute by minutes?

One or two improvements would make this app truly useful. The pump and CGM have a lot of data, but they lack context. I need to be able to add a tag or two and some notes to the handful of events that I want to highlight. That’s the first step; the next is to be able to search for those events and then look at what happened.

Once I’ve got that app working, who knows what could happen?

Of course, why do I want to make this app, when I’m usually so reluctant to write software away from the office? Plainly put, I need this application to improve my self-management. Observations of daily living are among the most powerful components of managing a chronic illness, but they are a complete pain in the ass to record manually.

Clearly this is something that Medtronic should be doing. It would greatly simplify things if I could sync directly from my pump to my iPod, and I’ve already tried without success to get them to tell me the data protocol of my pump. It’s my data after all, but they won’t talk. (Hell, it would be much better if I could download directly from CareLink to my iPod rather than doing a kind of crazy two step of saving a .csv file and uploading it to my iPod.) Perhaps Medtronic already is working on such an application, but I can’t count on it. Seeing the results of my actions is so useful that I will take one for the team and start writing this application.

My ultimate goal is to share the app and the code with the world. I would like very much to make this an open source project . . . the first salvo in a “test strip rebellion” where we people with diabetes take back the data stored on our medical devices. If the medical device manufacturers won’t make these apps, we must. If the FDA is going to make it difficult for commercial ventures to produce innovative solutions, we patients will have to turn the tables; it’s true that we’ll have to accept the risk for what we do, but at least we will have what we need to improve our health.

Oh! And I will need your help. I’ve never written an iOS application. If you have some skills, I might want to ask you a couple of qustions. First up: I need recommendations for newbies making their first forays into iPhone app development.

Posted in CGM, Data-betes, Diabetes, Software Engineering | 2 Comments

Dear Diabetes

Dear Diabetes:

I know you like it when I have Kanye talk to you. You seem to respect and/or fear him. And I can understand that. AFTER ALL, HE IS THE GREATEST ARTIST OF THE LAST TWO GENERATIONS. AT LEAST!! AND HE MADE W AND HIS WIFE AND MAMA CRY LIKE LITTLE GIRLS— (Sorry, evidently I had the spirit of Kanye come over me.) But he is disappointed that I dedicated a Cee-Lo song to you instead of one of his masterpieces.

So it’s just me talking to you today, paperweight.

For once I’m not here to kvetch. In fact, I just want to say how happy I am with how we’ve been getting along over the last week. Now, it’s true that you’ve been telling the CGM to wake me up once or more each night this week. And it’s certainly true that I’ve still got you in my life, but those flattish CGM graphs after breakfast and lunch this week have been wonderful to see. In fact, they initially freaked me out a bit, since I was sure that meant I was going to crash later. But that hasn’t happened.

And then there was the easy spinning session in the basement yesterday afternoon when my BG ended almost exactly where it was before I started. And that came the day after a good five-mile treadmill run. So we’re making some real progress in our “special relationship.”

I can’t put my finger on exactly what’s causing my 7-day blood glucose average (149 mg/dL) to be less than my weight for the first time since we kicked NPH to the curb all those years ago. Maybe it’s having some extra consistency in the intensity of my exercise recently. Perhaps it’s delivering bigger boluses of our frenemy, insulin, with meals. Or it might be less “defensive eating” than I was doing in the pre-CGM days when I didn’t really know which direction my BG was going. Then again, it could just be the new bottle of insulin or different infusion set locations. Plus, other than the Indian food on Monday and Tuesday, we haven’t eaten too much that requires much carb estimation.

Whatever it is, I’m trying to keep it going. Thanks for helping out these last few days. Now, for Lisa’s sake, let’s try to make the CGM less grumpy overnight.

<3 Me

Posted in Diabetes | Leave a comment

The One Where I’m on a Podcast

After casually dropping enough hints that I might be interested in appearing on Just Talking, Christopher interviewed me yesterday for his diabetes/gaming/all-things-Christopher podcast. It was a hoot!

Listen here . . .

Posted in 101 in 1001, Baseball, Diabetes, I am Rembrandt, Worthy Feeds | 2 Comments

Personalized Health Data (via CGM)

I’m going to start right off by saying that I love my CGM.

Once I made a few calibratrion-related changes and after I decided that it was never going to give me very good information during the first half-hour (or more) of exercise, I’ve started to feel more comfortable with its accuracy.

But that’s small potatoes.

Much more important is that I’ve started to look beyond the actual numbers, as recommended in Beyond Fingersticks, to see meaning in the swoops, peaks, dips, plateaus, and flat lines in my CGM data plots. A rise with a plateau? Probably not enough bolus insulin. A slow, steady climb or fall? Probably an incorrect basal rate or the hangover from exercise (also a basal rate issue). A big spike that comes right back down — after a couple hours, that is? Maybe I should bolus earlier for food or add something to the meal to slow down the hit.

This knowledge is especially empowering. For the first time in a long while I have hope that I can improve how I manually do what my pancreas should be doing. I’m starting to draw better inferences about the relationship between the actions I take and the effects they have on my blood glucose. And because the CGM has low and high alarms that act as a safety net and early warning system, I feel more confident in giving some of the larger insulin boluses that I’ve been too chickenshit in the past to take. Back in the pre-CGM days, I didn’t have the level of trust in those recommendations that I really needed in order to “do the right thing.” Now . . . well, I’m getting there.

All this was already on my mind before I saw the TedMed talk by Wired‘s Thomas Goetz. It’s a must see for people trying to improve their own health behaviors or those in their patients. (It even singles out a very bad ad campaign by the American Diabetes Association. sigh)

Goetz’s argument that we need personalized data to improve health outcomes has three main parts. (1) When it comes to behavior modification, fear is less important to patients/people than a sense of our own efficacy. (2) There’s a powerful and positive feedback loop when we have an emotional connection to data that’s by and about us. And (3) most medical data isn’t presented in a way that helps us create those strong emotional bonds.

The feedback cycle starts with personalized data, which leads to a sense of personal relevance that informs which health options are best and helps us take action. When done right we should be able to see the results of those actions in a new batch of personalized medical information. For those times when we do create new health data, we should be asking ourselves these questions:

  • Can I have my results?
  • What does this mean?
  • What are my options?
  • What’s next? How do I integrate this information into the rest of my life?

This is the amazing power of CGM that I’m beginning to harness: I see the results of my eating, dosing, and exercise decisions in a tight loop. I’m still learning how to understand how these three factors (and others) appear visually on my little CGM screen, but the fact that I can see them in anything approaching realtime is just so powerful.

Goetz concludes by noting that “compliance is not the same as engagement,” which is having the opportunity to act as one’s own agent.

I feel like I have a whole new model for engagement with my diabetes.

Posted in CGM, Data-betes, Diabetes, Health Care, Life Lessons, Video | 4 Comments

T.R. Reid: The Healing of America

Cover photoThis evening I started reading T.R. Reid’s The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care (2010). It’s a more detailed version of the PBS Frontline show he wrote and narrated a couple years ago.

Reid’s journey around the world in search of ideas that the United States can borrow in order to make substantive improvements in healthcare is shaping up to be a good read, and I will post some ideas from it. I’ll get the ball rolling by noting the four axes he’s using to gauge other countries’ health systems:

  • Coverage — How many people does the system cover? Who makes access-to-treatment decisions? Everyone else’s systems seem fairer than the US model.
  • Quality — How can the United State match health outcomes of other countries? People in most other rich nations have better health than we do.
  • Cost — How much do those other systems cost? How do other nations spend less per capita than the US?
  • Choice — What are the options and trade-offs for seeing the doctors you want at the hospital you want in a timely manner?

I may ask you, my dear readers, about some of these issues. Stay tuned!


Posted in Book Notes, Health Care, This is who we are, Video | Leave a comment

If You Have to Ask the Price … (part 3)

It’s been a couple months since I last wrote about healthcare costs here and about a year since I took a more in-depth look at the subject. But the subject of health economics is on my mind all the time. If I didn’t have such a totally sweet gig working where I do — we’re hiring, by the way — I would probably try my hand at helping develop healthcare policy. That’s something for another stage of my life, but that doesn’t stop me from wading around in the shallow end.

I’ve been reading more about the healthcare cost landscape and different ways of trying to reduce (or even constrain the growth of) what the United States spends on medical treatment. Now that the GOP is trying to “repeal and replace” the healthcare reform law, there’s a chance to evaluate a different approach than “Obamacare.”* I am quite interested in seeing what serious conservative ideas for defining and managing the American healthcare system might look like. As always, I’ll apply my rubric for evaluating options:

  1. How will it improve patient health outcomes?
  2. How will it contain or reduce the cost of healthcare?
  3. How will it increase access to healthcare for all Americans?

For now, I’ll just throw a little anecdote out there that I plan to use as a touchstone for further discussion of healthcare choices and costs. It happened last month when I was getting trained on how to use my CGM.

Near the end of the training, after watching me insert a sensor and working through some fill-in-the-blank worksheets about calibration, the Medtronic rep made an unexpected diversion into the cost of all these supplies.

“The little transmitter you have here, it costs about $1000. And each disposable sensor costs $45. I know your insurance paid most of the cost of these things, but I just wanted you to know how expensive they are. A lot of people on insurance don’t know the actual cost at all.”

If I were to use the CGM sensors as they’re currently approved by the FDA, I would change sensors ten times per month, for a cost of $450 to my insurer. I’ll confess to wearing each sensors for a week — everyone uses these things for an extended duration — but that’s still about $180/month of new charges by yours truly.

Believe it or not, despite having really good insurance, I held off getting CGM for quite a while because I wanted to make sure that my additional demands on the healthcare system were actually going to be worthwhile. Don’t get me wrong, my main reason for buying into CGM is to have better blood glucose control so that I can have more freedom and options in my life. But the thinking is that having better self-management abilities should translate to fewer complications, fewer emergency calls for severe hypo and DKA events, and lower medical spending in the long run. But there are no guarantees; I’ve been blessed with good health despite my higher than optimal A1c values. (*touch wood*) CGM might turn out to be the amazing thing everyone says it is, or it could be another high cost aspect of an already expensive disease.

We’ll explore aspects of these arguments more in the coming weeks.


* — I have to confess that when politicians, pundits and Twitter peeps use the word “Obamacare,” I basically stop listening. If people poison the well, I’m not going to drink from it. We’re all adults here; let’s discuss the options and alternatives without resorting to prejudicial code phrases. I’ll try to be open-minded, too.

Posted in CGM, Diabetes, Health Care | Leave a comment

French Films

I love film.* Good films. Well-acted, tightly edited films with reasonable plots that are cinematographic gems. I’m not infatuated with novelty, but if a film has a predictable plot, it had better be perfect in every other way.

As a result, I like foreign films . . . a lot. Not all of them, of course. It’s not that they’re better than American films, but if you think about it, language and distance serve to filter out most of the dregs from other countries so that we usually get the best of their offerings. (Too bad for them it doesn’t work the other way around.)

And I especially like French cinema. I’m not cultured enough to have seen much (if any) of the New Wave offerings, but that’s okay; there are just so many great ones of more recent vintage to watch. Here are about twenty of my favorites**:

  • Jean de Florette [1986]
  • Manon of the Spring (“Manon des sources”) [1986]
  • Au Revoir Les Enfants [1987]
  • Delicatessen [1991]
  • Three Colors: Blue (“Trois couleurs: bleu”) [1993]
  • Three Colors: Red (“Trois couleurs: rouge”) [1994]
  • Amélie (“Le fabuleux destin d’Amélie Poulain”) [2001]
  • Irréversible [2002]
  • A Very Long Engagement (“Un long dimanche de fiançailles”) [2004]
  • Caché [2005]
  • Tell No One (“Ne le dis à personne”) [2006]
  • La vie en rose [2007]
  • Mesrine: Killer Instinct (“L’instinct mort”) [2008]
  • Mesrine: Public Enemy No. 1 (“L’ennemi public n°1″) [2008]
  • The Class (“Entre les murs”) [2008]
  • I’ve Loved You so Long (“Il y a longtemps que je t’aime”) [2008]
  • Summer Hours (“L’heure d’été”) [2008]
  • Micmacs (“Micmacs à tire-loge”) [2009]
  • A Prophet (“Un prophète”) [2009]

You’ll probably notice that the films of Jean-Pierre Jeunet are well represented. You either enjoy films like “Delicatessen,” “Amélie,” “A Very Long Engagement,” and “Micmacs” with their absurdity and vibrant visual style, or you don’t. I certainly do. If these films are all new to you and you feel like dipping your toes, go backwards in time. Better yet, watch the films from 2008 and 2009 and go from there.

How about you? Do you have a soft spot in your heart for movies/films/whatever from a particular country or language? Any French films you think I should add to my Netflix queue?


* — You can always tell a true snob aesthete by the use of the word “film” or (worse) “cinema” instead of “movies.” Just saying.

** — To make it an even twenty, throw in “The Battle of Algiers” (“La battaglia di Algeri”, 1966) or “Three Colors: White” (“Trzy kolory: Bialy”, 1994). The former is actually Italian, but most of the dialog is French. The latter, while French, isn’t as strong as “Bleu” or “Rouge,” although it does have Julie Delpy in it. But her films are worth a post by themselves.

Posted in City of Light, General, Hoarding | 5 Comments

Oy!

I need to write here more often. If only I had more time to read about diabetes, photography, and history; make progress on my fiction reading list; study Hindi; read the newspaper; go running, swimming, bicycling, snowshoeing, and skiing; watch television and films from Netflix; think about health economics; write in my journal; and post here.

I need the transmogrifier from Calvin and Hobbes.

Update: I’m not whining or making excuses or anything. Life is choices, and lately my choices have been heavy on the reading/watching/exercising side and light on writing or creating. I just need to move the fulcrum for that balance and choose to come back here more often. See you soon!

Posted in General, MetaBlogging | Leave a comment

Pumps

Here’s why I don’t feel so bad about diabetes and my insulin pump.

Posted in Diabetes, Video | 2 Comments