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Thursday, January 28, 2010

Struggles and a Nosy Kid

Boy I’ll tell you, diabetes can sure get you down, if you let it. It can suck the fun out of playing basketball, it can make you feel sluggish after a cup of coffee, and it can sometimes make you wonder why you try so hard to get your blood sugars under control. But then, you have a day where your blood sugars are perfect all day and you instantly realize how much fun basketball can be, how helpful coffee can be after a bad night of sleep, and most importantly, why you try so hard to control your blood sugar levels.

I’ve had diabetes for over 18 years now and I’ve had my shares of ups and downs. When I was younger I went through a phase where I just about denied that I even had diabetes. Let me explain…

It was in junior high that having diabetes was not cool anymore! No longer were the teacher allowed in-class snacks worth the attention that I used to enjoy. In 5th grade I loved being able to walk to the back of the classroom during a spelling test and eat some cheese and crackers because “my blood sugars were low.” :) Okay, half the time they weren’t THAT LOW but I was hungry!

What… would the teacher not have wanted me to treat a low blood sugar? I was never the smartest kid in the class, but I learned at an early age to get what I wanted, and if crackers and cheese were what I wanted, well, I am going to find a way to get them. :)

But just 2 years later in 7th grade I remember this nosy little kid snooping around the teacher’s desk when the teacher had stepped out of the class for a minute. The teacher had conveniently placed a seating chart on his desk and below each child’s name was a list of diseases that pertained to that child. So I guess I was the only kid with a disease worth noting on the seating chart, as below my name the teacher wrote very clearly with a pencil “diabetic.” Seriously! You couldn’t have used an abbreviation? I thought this stuff was supposed to be confidential?

So later on in the day this nosy little kid came up to me and said:


(Nosy kid) “Hey, do you have diabetes?”
(Diabetic) “Me, no! Why would you say that?”
(Nosy kid) “Well when I was being a nosey brat in class earlier today I saw ‘diabetic’ under your name on the seating chart”

(Diabetic) “Stupid, you must have read it wrong…my middle name is David maybe it says that?? Or maybe the kid in front of me has diabetes??”
(Nosy kid) “I’m going to look tomorrow”
(Diabetic) “Go ahead, I don’t have stupid diabetes”


So later on that day when we had a short break I decided to take action. I waited in the hallway by the “brilliant” teacher’s classroom until he decided to step out for a restroom break. As soon as he disappeared into the bathroom I took an eraser out of my backpack and I went up to the seating chart and scrubbed the heck out of the “diabetic” description below my name.

After that day as I entered class I would walk very slowly as I passed the teachers desk to make sure the “diabetic” description was not back on the chart. To my luck the teacher and the nosy kid must not have been too smart, because I never heard or saw another mention of diabetes the rest of the year.


As I think back to these years where I went from openly telling people I had diabetes, to completely lying to people when they asked about it and I wonder what had changed? Shoot, some of these people I was later lying to had already known that I had diabetes! Who was I fooling? No one but myself.

So again, what changed? The only things I can come up with are that I was starting to become interested in the opposite sex and didn’t think that girls would be interested in me if they knew I had diabetes, and I wanted others to respect me as a person instead of the “diabetic” who always got a pass when the spelling test was starting. I didn’t enjoy cheese and crackers anymore!

It is unfortunate that I tried to hide my diabetes from everyone for so long. During the time where I was in denial regarding my diabetes I do not think that my HbA1c was ever much lower than 10%. An HbA1c is a blood test that reveals the average of your blood sugars over the past 3 months. An HbA1c of 10% reveals a 3 month blood sugar average of 240. According to the American Diabetes Association a healthy HbA1c is under 7% which is equivalent to blood sugar average of 154. Most doctors hope that their patients can get their blood sugars to fall in the range of 80-120 for most of the day. As you can see, my blood sugar average was 2-3 times higher than most doctors recommend.

I hope that other children do not go through some of these same struggles that I went through. Yes, I will admit that diabetes can get you down at times, it can make you feel singled out at times, and it can lead you to lie to others who only want to help. BUT, IF YOU WORK HARD TO CONTROL YOUR BLOOD SUGARS AND DO NOT LET DIABETES GET YOU DOWN YOU WILL FIND A small APPRECIATION FOR THIS DISEASE. You will find an inner energy and pride that you have never felt before. You will begin to take pride in the fact that it is not as easy for you to be healthy as it is for the nosy kid who gets into everyone else’s business. But, knowing that you accomplished health to the best of your ability gives you confidence that you have control over your life. Just because diabetes can get you down at times doesn’t mean that it has to!

Who would have thought that years after my denial with diabetes I would find a girl who knew me on paper as a “diabetic” before she knew any other thing about me!

“Sometimes, struggles are exactly what we need in our life. If we were to go through our life without any obstacles, we would be crippled. We would not be as strong as what we could have been. Give every opportunity a chance, leave no room for regrets.”

Thursday, July 23, 2009

What did I do?!?

Wow, where did the past 6 months go! As I mentioned in my previous post, I have em(barked)--parenthesis will be explained later} on a new journey in my life. I got rid of the old Brett and have found a new one who feels 15 years older! Maybe I age the same as dogs--or because of dogs--which I'll explain below!




Six months ago I accepted a position with Medtronic Minimed as a Diabetes Therapy Consultant, parting ways with the American Diabetes Association. By accepting this position with Medtronic I decided to move from my cozy little apartment in beautiful Belmont Shores to a city right next to the sun, Burbank! When it got warm inside my Belmont Shores apartment, I would simply crack a few windows and would be immediately cooled off by the fresh ocean breeze. If that didn't work, I'd throw on my board shorts and flip flops and stroll 2 blocks down to the beach. What did I do?!?



Upon moving into the Burbank apartment my girlfriend Amanda and I decided to try this thing called cohabitation. We had been dating for about 8 months at the time--but with all of the questions she asks I feel like we have known each other for much longer :) She really does ask a lot of questions, but her brothers and I have decided that it is not so much the barrage of questions that she unleashes, rather it is the timing in which she asks them ;) Common times for her to mount an attack; the second you walk in the door, 10 seconds left in a 1 point Laker game, the second you walk in the door, when you first open your eyes in the morning, the second you walk in the door--oh did I already mention this one.., when my blood sugar is low, when I am busy at work, and most common--when I am already a little on the grouchy side! What did I do?!?



To make things even more fun--upon beginning a new career, moving to the sun, and moving in with 21 questions, we decided to get a puppy!



PENNY PINSCHER






So let me tell you---she completely fooled us! She was an absolute angel in the store--and she looks absolutely adorable in this picture--but don't be fooled! Stare at the picture for a while and you'll begin to see the sinister demeanor she often portrays! And dogs aren't potty trained! At first Amanda and I wondered if we would ever get her trained but low and behold--at 7 months of age she is potty trained! Please disregard my facebook message from earlier today when I said that Penny jumped up on the bed--looked me in the eyes and then peed on my pillow--after that incident earlier today she is completely potty trained--I was in complete shock that she did that--she'll occasionally have a small accident on the carpet here and there, but my pillow! I'm hoping it was just a little hiccup in the road. What did I do?!?




A small detail I forgot to mention is that Amanda already has a cat that would now be forced to cohabitate with Penny.




SOPHIE




It was a gradual warming up to each other--but after a couple months and a few yanks on Sophie's tail by Penny, the 2 are now best of buds.










So life carried on and after a while it felt like we were really starting to have a life again. School was winding down, work was going well, the Lakers won the NBA Championship--right around the same time Amanda stopped asking me so many questions. Life near the sun was great!





(Backtrack) In February Amanda lost her grandpa to bone cancer, which was a horrible thing for her to go through. Amanda got the bad news on Valentine's day and that also happened to be the same day that we got Penny Pinscher. A very short 3 months later tragedy had struck Amanda again, as she found out that her Grandma also had terminal cancer. Timing is never right for things like this--but this was especially tough on her as she was still mourning her Grandpa's passing and immediately had to transition to mourning for her Grandma as well. I only got to meet her grandparents a few times so it would be unfair of me to give great details on their lives or even attempt to explain how tough it was on Amanda to lose both of her grandparents within 3 months of each other. But I do believe that I am lucky to have met these two great people! The day of her Grandma's funeral we decided that we wanted to add more stress to our lives so we went out and got


ROSCOE




He is now 4 months old and has been a complete pain in the neck! Not really---he has actually been unbelievably easy. Roscoe and Penny are polar opposites in that Penny likes to eat, run, jump, cause trouble, torment the cat, get into the trash can, eat your food when you are not looking...while Roscoe doesn't like to move. He barely eats, doesn't care that the cat exists, hates going for walks, couldn't jump over a quarter, and will never be tall enough to get into the trash can. We were worried that the 2 of them wouldn't get along--but we were completely wrong.











While they may have different personalities they still come together for some good ol tug of war! Believe it or not--but Roscoe holds his own and is not intimidated by Penny. 2 days after we got Roscoe we took him camping with us to Campland on the Bay in San Diego. He could probably care less if he ever goes back--but I think he had fun while he was there! We took them on a 3 seater bike and tough dog Penny was scared out of her mind--while Roscoe woke up for the picture but slept most of the time while the air flopped his ears around as we rode.






So if I haven't lost you by now--you are probably thinking man this guy is obsessed with his dogs! Amanda tells me that all of the time--or rather asks me all the time :) Maybe I am a little obsessed but I'll tell you they make my life better! I remember growing up and always wanting to bring home animals and my dad would say "they are too much work--and you kids say you'll take care of them but I always end up doing it." I'll tell you--I completely agree with him now--taking care of dogs requires a lot of work--and I'll often say "What did I do--my life used to be so simple?"But so far I wouldn't take back any decision that I have made over the past six months. Yes it is hot as hell out here in Burbank--and I would love to move back to Belmont Shores soon--but I wouldn't do it if it required leaving behind any of these monsters (Sophie, Penny, Roscoe, or trivial pursuit) that often cause my blood sugars to go through the roof because of the stress they cause me. Life is too short and there is no time to second guess your decisions by asking "What did I do?"--If you are not happy make a change--and if you are too happy get a puppy or 2 :)

Friday, February 6, 2009

Chapters

Hey all,



It has been a long time since my last post and I really have no other excuse for my absence, so all I can do is promise a more active 2009!



So many things have changed in the past year and I'll try my best to update you on what is happening..if you care? Please care...



First of all, tomorrow (actually today, it is 1:30am) is my last day of work for the American Diabetes Association. I have been with the Association for nearly two years and feel that I am ready for the next step in my life. I began with the Association as a 24 year old kid who was full of energy, new to the nonprofit world, and thought that I had everything figured out! Since then I have ran out of energy, am a veteran in the nonprofit world, and still have everything figured out :)



I have grown up tremendously in the past 2 years (I am now a bigger and older kid) and am grateful to the ADA for exposing me to so many great people. Because of my experiences with the ADA I am now on an insulin pump, I now have countless friends who are affected by diabetes, and I have found many ways that I can help benefit others who have diabetes.



In addition to ADA's influence on me, I have also benefited greatly from the Master's program that I am now a few semesters away from completing. Last semester was one of the toughest and busiest times in my life, as I was taking 3 graduate classes and working (more than) full time-thanks ADA. At times I doubted whether all of this hard work was worth putting myself and family through, but after I received 3 A's and had a few remarkable Diabetes events I found out it was more than worth it. The "icing on the cake" for me was the Holiday party I threw for families that are affected by diabetes at the end of 2008. The event was a lot of fun, and we had 63 people RSVP'd and over 80 people showed up:) From my work in putting on events I know that you usually end up having fewer people attend the event than who RSVP'd...I was in disbelief when we were nearly at capacity for the venue.



So I think that is it...yup..that's all I can think of. HA HA

The other huge and exciting change in my life is that my girlfriend Amanda and I have decided to move in together. We found a place yesterday in Burbank that we both really like and we will be signing a lease next week...scary I know :) Along with my family, Amanda has been the most supportive, caring, and selfless person that I have ever met! I look forward to this new adventure as well...although we have not yet signed the lease so I have some time to catch a one way flight out of here :)



So today is the big day. My last day with the ADA. A chapter of my life closing while the next chapter awaits me...it goes something like that right???



I keep hearing that a chapter is closing but part of me feels like it will never end completely. Relationships don't end unless you walk out on them. The people that have touched me (the 60 families in the Greater Long Beach area network & most of my coworkers) will continue to hear from me, but I will now have more resources for them. That is how I look at it.



Let's be real for a minute, I never looked at the ADA as a job, so now that I am leaving it is hard for me to treat my friends as only being part of my previous job.



I begin my new job with Medtronic Diabetes on February 16th and I hope that 2 years from now I will be able to look back at this blog-post and say "wow, I have come so far!"

Monday, March 17, 2008

Diabetic

"He's the diabetic kid"
"He's a diabetic, he can't have that"
"Aren't you a diabetic"
"I'm a diabetic"

The other day I was conducting a diabetes and health awareness assembly at a school, with a volunteer whom wanted to help out. I was more than happy to have her help out with the presentation. In talking to her before the presentation she mentioned that she became "diabetic" when she was 11 years old. She continued on with how being a "diabetic" has affected her life, and told me about some of the ups and downs she has gone through.

It was now my turn and I told her about myself and that I was diagnosed with "diabetes" when I was nine years old. I talked about how "diabetes" has changed my life by making me more responsible and more health conscious. We talked for a while longer before conducting the presentation to around 300 students at the school.

Minutes before the presentation I could "bite my tongue" no longer. I needed to talk to her about her word choice of "diabetic", rather than "diabetes". And here is what I said;

I was diagnosed with diabetes 16 years ago when I was nine years old. I have lived with diabetes ever since. But I am not a "diabetic".

The different pronunciation of the words diabetic and diabetes is minor, but to me, and many others, the meaning of these words are drastically different.

To refer to yourself as a diabetic, is to describe that a "diabetic" is what you are. It is a label that you or others put on your self.
"He's the diabetic kid"
"He's a diabetic, he can't have sugar"
"Aren't you a diabetic?"
"I'm a diabetic"

In my life I've been called the "diabetic kid", been told he cannot do something because he's a "diabetic", been asked if I am a diabetic", and even told people I am a "diabetic". But to clear things up, I am a person with diabetes that does so much more.

Why is it that a commonly viewed negative trait is the label that I get stuck with? Why am I not the Laker nut, or the college student, or the athlete, or just something I would like to be referred to as? To many, no matter what I do, I am still the "diabetic" who loves the lakers, or the "diabetic" that is in college, or the "diabetic" that plays basketball...etc.

The point is, that we all must be careful of labeling others, and not just people with diabetes. I know I was only corrected of this grammatical error months ago, but I have been more than careful to not label others in a negative way since.

It would be hypocritical of me to take offense to someone calling me a "diabetic", since I was calling my self a diabetic less than a year ago. But consider yourself warned...next time their will be consequences :)

"Words, words, mere words, no matter from the heart"
William Shakespeare

Tuesday, February 19, 2008

Getting the hang of all this...

As I mentioned the other day, I am now on an insulin pump and continuous glucose monitor (CGM) . The insulin pump that my doctor and I selected is made by Medtronic and called the Minimed Paradigm 722. It is about the size of a pager and I wear it on my belt or put it in my pocket. Most people that see it do not appear to notice that it is not a pager as I rarely get questioned about it. The clear tubing coming out of it that carries insulin to my body is the "giveaway" as it is somtimes noticed.

So here is how the insulin pump and CGM work. The first thing I do when preparing my pump for use is I fill up small resevoir insulin. I attach the clear tubing to the resevoir and connect the other side of the tubing to the infusion set. The infusion set is the part of the pump that connects to my body. It is a small item that has a needle, coated by a small tube on it. The way it works is as the needle is inserted in my body (stomache, legs, lower back) to get a small amount of the tube under my skin. After the tube is under my skin I secure the insertion site and pull the needle out of my body, leaving the tube under my skin. The back side of the infusion set is connected to the tubing, which is connected to the resvoir, and now I am hooked up. I change the pump site every 2-3 days to prevent infections and pump site failure.

Now the CGM is a seperate piece that "communicates" with the the pump, giving me an average blood sugar reading every 5 minutes. I go back and forth over whether I am truly comitted to the CGM, as it is not 100% accurate, and it requires an additional insertion site on my body. The CGM is basically started the same way as the pump, with the major difference being that it does not have any tubing. It is inserted with a needle(a little deeper than the pump site, as it needs to read interstitial fluid) and after the site is secured, the needle is taken out, leaving a small tube underneath the skin to read my sugar levels.

As I mentioned, the two issues I have with the CGM is that it is not 100% accurate, and that I do not like having another insertion site on my body. The first day I put on the CGM is usually the worst day of it's accuracy, as the minor swelling around the insertion site prevents an accurate reading. By the second day of wearing the CGM the accuracy typically improves.

The second reason that I am not completely comitted to the CGM is that it requires a second insertion... and at times I feel that I am running out of sites. The times that I like the CGM the most is when I am playing sports, or just "out" with family or friends, and do not feel like checking my blood sugar. Their are many times when you are out of the house and you just want to know a general idea of where your blood sugar level. When connected with the CGM all you have to do is look down at your pump and you at least have a general idea of where your sugar level is at.

When I was being trained on the pump and CGM, I questioned the pump specialist over and over about the CGM and if it is truly worth it. Her being a person with diabetes as well, told me that "she likes the pump and CGM more than what she was doing before". That was good enough for me and I decided to give the CGM a try.

After 5 months or so of being on the insulin pump and CGM I absolutely love the pump, and "I like life with the CGM more than what I was doing before"... on a good day with the CGM I check my blood sugar (the old fashioned way) 2 times a day. A bad day with the CGM I might check my sugar level 8 times a day. These numbers are compared to 8-15 times a day of checking my blood sugar before I started the pump and CGM.

After five months with these 2 devices I still feel as though I am just starting to get the hang of it...and at times, after 16 years of diabetes, I feel as though I am just starting to get the hang of this disease as well.

"I can accept failure, but I can't accept not trying".
Michael Jordan

Friday, February 15, 2008

Sorry...My Bad

It was not until a few minutes ago that I truly missed writing my blog. I want to list a million excuses for why I took a "hiatus" but for the sake of positivity...here I am, back. So a lot of things have changed since the last time I posted and I feel all of my devoted readers (all four of you...I love you guys) need an update on my situation. Here are a few of the more significant changes:

1. I have moved to Long Beach (actually Belmont Shores) from Irvine where I am now living in a studio...by myself. I was living in Irvine with two roommates whom I lived with for a little over 3 years, so the peace and quiet is new to me.
2. I moved to Long Beach for two primary reasons. The first is I have started school at Long Beach State where I am working on a master's degree in Education, focus in Social and Multicultural Foundations. I started two weeks ago and so far I am really into it, give me a couple weeks and I'll be ditching classes again. J/K.
3. The other reason I moved to Long Beach is my job title at worked has changed from "School Walk coordinator" to " Youth Iniatives", which requires me to be in the office(located in L.A) a lot more often. With the new job title I will still be conducting the school walk events but I am also now responsible for creating a Family Resource Network for families with children with diabetes, in Long Beach.
4. I have become a Pau Gasol fan. For all of you who do not follow the Lakers (I guess some of you still exist) he is one of the best players in the NBA and he is now on the Lakers with Kobe.
5. I bought a pub table set, some things for the bathroom, HBO...and oh yeah..
6. I am now on an insulin pump. I started the insulin pump in September last year, pretty much the same time I stopped writing in my blog..no correlation between the 2. But I absolutely love the pump so far and will NEVER go back to injections again. I sometimes have nightmare's that my pump has stopped working, but then realize that it is actually my alarm clock making that beeping sounds...but seriously I have become dependent on the pump. My new best friend...sorry BJ, he doesn't read this anyway.

This weekend (which does include monday..president's day for us gov't employees) I promise will have another posting. The posting will be about my pump and Continuous Glucose Monitor(CGM) that I have been experimenting with for the past few months. Trust me, you do not want to miss it.

Take care and you will be seeing a lot more of me.

"Be the change you want to see in the World" Gandi

Wednesday, September 19, 2007

Basketball Fanatic

So I'm a basketball fanatic. I love watching it, coaching it, but most of all, playing it. I first remember enjoying basketball when I was in 4th grade playing as a chubby youngster. I was a pretty active child and played in baseball and football leagues. But it was not until recently that I realized why as a youngster basketball appealed the most to me. The reason is that in order to play basketball all you need is a hoop and a ball. It is the only sport that can be played by yourself. I did have friends (well..a few) when I was younger, but I have always been a person who does not work well with other's schedules. I could pick up a basketball early in the morning, late afternoon, or at night, and not worry about if I had a friend to play with. I had a ball and a hoop.

4th grade was also the year that I was diagnosed with diabetes, and when my blood sugar was high I constantly had somebody(mom, dad, grandma, you name it..) telling me to go out and exercise. This led to my various workout times and riding a bike was getting boring. So basketball it is. Since the 4th grade, the only time I can remember not playing basketball at least once a week was last year when I broke my ankle. In the 4 weeks that I had a cast on I nearly "lost my mind". It was the longest period of my life that was spent basketball-less. To make things easier I ordered NBA league pass so I could watch every nba game that was played last season, it did not help.

It was not until high school that I started having trouble keeping my blood sugar under control while playing basketball. As mentioned earlier, when I was younger and my blood sugar was high I would go outside and play basketball to lower my sugar level. In high school I tried out for the basketball team and this is when my blood sugar control became worse.

First of all, I made the team (3 years of varsity) but during every practice or game I would feel like my blood sugar was going low. I chose to not check my blood sugar in front of others so I typically would wait until after the game or practice to check it. Assuming it would be low because of the straneous workout would I drank gatorade and continue to play. After the game I would check my sugar and was shocked by the results. Most of my blood sugar reading wer in the range of 200-400, I stopped drinking gaterade and just ignored my "low blood sugar feelings".

A good range of blood sugar is between 80-140, and between 120-150 when working out. These high blood sugar readings were not acceptable. Having high blood sugars causes you to feel fatigued, leads to dehydration, and makes you feel horrible.

I did not get it, if I went outside and played basketball by myself or with friends my blood sugar would drop. But if I was playing with this same group(sometimes there was a group) of friends in a more competitive enviornment (i.e. practice, game) my blood sugar would go through the roof. I talked to my doctor about it and he said the only way to alleviate this problem would be to check my sugar during the game. My response "Yah, thats going to happen". With my "abundance" of friends at the time, I could not afford to lose anymore which I felt would be the case if they knew I had diabetes.

So high school basketball continued with the same pattern for my entire career. I always played my best basketball in the beginning of the game when my blood sugar was normal, but by the second half my skill would always deteriate. I recall many situations where I would have extreme muscle cramping in my legs which is a direct result of dehydration. In one of these situations I had to tell the coach to pull me from the game.

After high school I have continued to play basketball but a more leisure intensity. I take a bottle of gatoreade and a gallon of water with me everytime I play. I also stop as many times as possible to check my sugar throughout the game.

A group of friends and I decided to sign up for a basketball league that plays every Tuesday. Last night was our third game of the season and here is a recap of how it went:

6:18pm blood sugar 130 (game my self 4 units of fast acting insulin)
6:45pm ate a peanut butter sandwich
7:57pm blood sugar 105
8:19pm blood sugar 103
8:20pm game starts- we only had 5 guys so I would be playing the whole game
8:48pm blood sugar 175 (halftime) I game myself 3 more units of fast acting insulin
9:11pm blood sugar 194 The game is over

During the course of this game I drank almost a gallon of water and did not have a sip of gatorade. This is by far one of the most controlled blood sugar experiences I have ever had while competing in a game. I am trying to keep this post positive so I will not tell you the outcome of the game, but I will tell you that I had fun.

At one of our ADA events I was fortunate enough to talk to NBA player Adam Morrison, whom also has type 1 diabetes. He said he has the same problem during games and his doctors told him it is because of adrenaline and nerves. If you ever get a chance to watch him play you will see that he checks himself constantly throughout the game.

With all of this said, I am taking my blood sugar control to the next level. I am going to be starting the insulin pump within the next week or so. The insulin pump that I am attempting to get is made by Medtronic and is called the Minimed Paradigm. When talking to my doctor he informed me that any professional athlete that has diabetes is required (in their contract) to be on a pump. During the games I will take the pump off but since the pump continually supplies my body with insulin throughout the day, my body will not be affected when I take it off for an hour or so.

I am saving most of my talk about the pump for after I start using it.

After you read this blog I do not want you thinking that I am making excuses for why I sucked last night, or why I was not the greatest high school basketball player. I wrote this because I have come a long way in terms of understanding my body, as well as this disease. The varying control I have had in the past is 100% my fault. I have always had the resources(i.e. insurance coverage, medical supplies) to improve my control but chose chose not too. After 16 years of living with diabetes I realize that I have so much more to learn about my body and the disease, lets just hope I start learning something soon.

"For my part I know nothing with any certainty, but the sight of the stars makes me dream."
Vincent Van Gogh
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