Wednesday, January 7, 2015

Diabetes Resolutions

Holy crap, you guys. IT'S A NEW YEAR! I did not blog much last year...or the year before that...or the year before that. I used to blog a lot and read all of your wonderful blogs, but then I just got tired. I got tired of diabetes taking up so much space in my life...ya know?

But I'm starting to get back into it. I've joined a couple Facebook groups and am participating in discussions. I went back on my t:slim pump after a long break. I'm even considering CGMs again. And I've realized that there are things, new things, that I've been missing out on. Like really cool technology. And let's face it, doing just enough to get by...well it isn't enough. I could be doing much better at this whole diabetes thing. My A1c has been hovering between 6.7 and 6.9, and sure—that's okay—but it's not as great as it could be.

And January is a good time for getting back on track. Especially after the months of October, November, and December. I don't know about you guys, but those are the months where things start to slip for me. It starts with Halloween candy. And that mentality of "I never/hardly eat this yummy, delicious thing, so I can have one or two or three or ten pieces." And then you do more of the eating. And more of the justifying. Until you realize that you're eating crappy, sugary food every single day.

Now maybe you think you can eat whatever you want because you have an insulin pump. But that's now how I operate. Regardless of blood sugars, my body doesn't feel good when I do that. And I don't want to keep correcting. That's not the right approach—at least not for me.

So, it starts with the Halloween candy...and then Thanksgiving...and then it's like you have an endless supply of candy, cookies, cake, and other desserts in your house ALL THE TIME. You don't even know where it came from! It's just there.

I'm not saying to follow a rigid diet and not treat yourself. But if there's a lot of chocolate and baked goods around, I'm going to have a hard time not cramming them all into my mouth. And when I start the cycle of allowing and justifying foods I don't normally eat, then I slip in other ways, too. Like I start eyeballing my snacks and eating chips out of the bag without really counting them. All of this adds up. And it's really easy to let it all get out of control before you even know what's happening.

It's a slippery slope. At least for me.

So this month, I resolve to get back on track. And to keep track. I'll eat healthier and plan more meals. I'll pay attention to what I'm putting into my system and how it makes me feel. I'll be more involved with my diabetes care. And I'll practice more self-care.

What are your diabetes resolutions this year?

Thursday, October 23, 2014

Diabetes and stubbornness don't mix

I can be really stubborn when it comes to certain aspects of my diabetes. For example, I use "expired" insulin because I think it works just fine.

However, sometimes that stubbornness can get in the way. Like when I insisted that I could use Apidra in my t:Slim insulin pump, even though I knew it wasn't FDA-approved for it. Insulin is insulin, or so I thought. Plus I used Apidra in my Medtronic pump, so I didn't think it would be an issue.

Every time I got back on my t:Slim, though, I would have issues. Especially by the 3rd day. I would have higher than normal numbers. I would have more occlusion alarms. I knew something wasn't working right, but I ignored it. I would chalk it up to the pump being difficult. Or I chalked it up to me doing something wrong.

But I wasn't doing anything wrong. When you have numbers in the 300s and they don't come down all day even though you continue to bolus and not eat anything, then it's very likely that you're not the problem. Being over 300 for hours is not my usual, but when you've had high numbers for hours or days, you feel defeated—even when it technically isn't your fault. (I mean, yes, I should have taken a shot to correct the high once I realized my number wasn't coming down, but this is where the stubbornness kicks in and stops you.)

When something doesn't feel right or when something hasn't been working right for a long time, though, don't ignore your instincts. It will not get better unless you pay attention to the problem and make a change. I guess this is true with anything in life, right?

So, I finally decided to look into WHY Apidra wasn't good for this pump. I joined the t:Slim group on Facebook, and posted about it. Within minutes, I got tons of responses, and learned some things I had never heard before. Yes, I had been told before that Apidra wasn't tested with this pump, but I didn't know why. Thanks to the wonders of the Internet and social media, I now knew why.

Apparently, Apidra reacts differently in the pump, and tends to gel or crystallize over time. This makes sense considering it usually works fine within the first day or two, and then by the third day, shit hits the fan.

Now, I could have done this months ago, but I didn't because my stubbornness had stopped me. I didn't want to believe that Apidra was the issue, so I stuck it out and kept trying to make it work. However, just like a bad relationship, this never ever makes it better. Once I finally reached my frustration point where I just couldn't take it anymore, I sought answers. I sought out the diabetes community. I sought out help and I got the support I needed.

Sometimes that's all it takes. Because we can't struggle on our own all the time. It's too hard. So, let go of your stubbornness and ask for help. Be open to what others have to say. Let go of what you thought you knew. Embrace change. You might be surprised at what you find along the way.

Monday, October 20, 2014

The switchup: from shots to pump

I've had type 1 for 9 years now. I was on shots for one year. On the Medtronic pump for 5 years. And then in the last three years, I've switched back and forth between my new pump (the Tandem t:slim) and shots. Both solutions—insulin pump and pens—have their pros and cons. When all is said and done, you just have to do what's right for you.

During the summer, I switch to shots. It's hot outside. I'm usually wearing less clothing. And I don't want to deal with my pump. However, it's also annoying to give yourself a shot of insulin when you're wearing a dress. Then again, have you ever tried to reach up or down your dress to access your pump? Awkward.

Like I said, both solutions have their good things and their not so good things. No one solution is perfect.

Now summer is over and fall is well on its way. And with that change of seasons comes the switchup. As of yesterday, I'm back on my t:slim pump. In my personal experience, getting back into the right rhythm of pump life is difficult.

I don't know about you guys, but when I go back to the pump, I'm high all day and then, BAM, I drop low. You think I wouldn't be high at all since I'm overlapping my basal rate from the pump with my shot of lantus, but this isn't the case for me. So, despite increasing my basal rate and giving myself a correction, I stayed high for hours. And then it hit me. At 9pm, I dropped way low. 39 low. The bad kind of low where you're sitting on the kitchen floor, staring off into space after chugging 37g of orange juice and waiting to come back to life.

My boyfriend asked if 37g was too much, and I said at that point, I needed it. I came back up to a normal rate, ate dinner and bolused for it, and then...dun dun dun...I dropped low again. This time in the 50s. I had a hard time getting that low back up. I thought I had finally gotten it right, but I woke up in the middle of the night to a high of 240. I corrected, fell asleep. Woke up. Still high. Corrected. Back to sleep. By morning, I was at 78. Ta-da.

But today is a new day of challenges. I haven't eaten in 5 hours because I've been battling a high that won't come down. And I also don't want a repeat of yesterday's low.

No matter how long you've had diabetes, you will never have it all figured out. There will be plenty of moments where you feel like you've got this down, and then there will be plenty of moments where you wonder what the hell you're doing wrong. This is one of my "what the hell am I dong wrong" moments.

Sometimes it feels like a long, aggravating, and exhausting battle. You do what you can, and when the numbers don't reflect your hard work, it's disappointing. It leaves you feeling like shit. And it's okay to feel sad and mad, but pitying yourself for too long isn't going to change anything. So you tell yourself what you have to tell yourself in order to move on. Tomorrow is a new day. You'll figure it out soon. It'll be better the next time.

In the meantime, I'll keep adjusting.

Wednesday, September 24, 2014

I don't need you judging my diabetes

It's really easy for people who don't have diabetes to judge others who do have it.

Should you be eating that?

Why did you let your blood sugar get so high?

Your blood sugar is low...again?

You forgot your insulin? How can you forget?

Someone who has diabetes doesn't say these things to another person with diabetes. Only people who have regular-functioning organs say things like this because they haven't been in the position where they have to take responsibility for what their body just does for them normally.

Let me tell ya something. It's not always easy to "control" diabetes. And it's very easy to forget to give yourself insulin before eating a meal, no matter how long you've been injecting or pumping. It's like forgetting anything else...your keys, your phone, that appointment you had. Sure, it's more serious than those things, but I am human, which means I make mistakes. I forget to do things. I can't be perfect.

So, before you judge a person with diabetes or tell them what they should be doing, remember that they probably already considered whatever it is you're about to tell them. They've already felt bad about that high blood sugar. And judged themselves for forgetting their insulin. You telling them that "if they just follow a healthy diet and take their medications, then everything will be fine" is not actually going to be helpful.

Now, if you're in a position where you're helping to care for someone with diabetes because they're not taking care of themselves, then it's a different ball game. I've never been in that position and I can't speak to that. I can only speak about what I know.

And what I know is this. This morning, my blood sugar was 74. I remembered thinking I could give myself less insulin or just give myself a dosage after I eat. Well, by the time I was done making my breakfast and eating it, I completely forgot about this conversation I had with myself. It wasn't until a couple hours later that I remembered I hadn't given myself any insulin. I had one egg, three pieces of turkey bacon, coffee, and one piece of wheat toast with a bit of jelly. My reading was 224. Instead of getting upset with myself, I gave myself insulin, and went about my day. Because sometimes that's all we can do. And sometimes, it's all we should do.

Wednesday, September 17, 2014

Diabetes: the Silent Disease

How many times have you tried to hide your diabetes? Smile and fake laugh when someone makes a diabetes-related joke? Avoid a chance to educate someone about it?

Hiding it doesn't make it better. Being silent doesn't make you strong.

These are the two things I'm constantly learning as a person with diabetes. When I was diagnosed, I cried. But after getting over the initial shock of it, I took it on like it was no big deal. I didn't want it to get the best of me. I didn't want it to affect me. Anytime I poked myself with a needle or mentally counted carbs or took a sugar break, I adopted the attitude of, "It's no big deal, guys. I'm fine. Don't look at me. Go on with things like you normally would! EVERYTHING IS NORMAL AND NOTHING IS DIFFERENT."

But as people with diabetes, we know that's not true. Nothing is normal. Everything is different.

It's going to affect us. Sometimes for the better (hello, better eating habits and a stronger commitment to my health) and sometimes it's for the worse (hello, anxiety about low blood sugar and stressing over high ones).

But hiding it and pretending that everything is normal is not the best approach—for you or for anyone else. I can't tell you how many times (in the last 9 years of having T1D) people have found out that I have type 1 diabetes and they say things like "but you're so skinny" or "well, you look really healthy." Newsflash, people who just don't know. I may look fine on the outside, but that doesn't mean I am okay on the inside.

I may go to the gym, but that doesn't stop the high blood sugars that make me feel lethargic and crappy. I may make better food choices but that doesn't stop the lows that lead to shaky hands and back sweat. I can make all the healthy choices I want, and diabetes can still rage on.

But the more you pretend it's okay, the more people will remain uneducated about diabetes and think it's okay to lecture you on food choices or make dumb jokes. When you hide it, you're perpetuating the idea that diabetes is something that needs to be hidden—as if it's a weakness or something to be ashamed of.

Don't hide in the bathroom when you have to give yourself a shot. Don't stay silent when someone makes an untrue or hurtful comment. Don't pretend it's okay when it's not. The only way to change peoples' perceptions about something is to speak up.

Friday, August 22, 2014

Pushing your limits

People with type 1 diabetes have to push through many different types of challenges. One of those challenges is knowing when to push yourself and when to not push yourself. This is one challenge that I struggle with quite often. 

I wasn't diagnosed until 21, so I can remember what life was like before diabetes. I grew up living a fairly active lifestyle. I played sports growing up and I went to the gym regularly as an adult. Because I was diagnosed in my 20s, I have always been the number one person in charge of my diabetes and overall health. My parents were there as a support system, of course, but it has always been up to me to know the ins and outs of how my diabetes works. I say "my" diabetes because—like many chronic conditions—diabetes varies for everyone.

A couple months ago, I started going to a weight lifting class at my gym. A friend of mine kept talking about how great it was, so I decided I needed to get back into the groove of going to classes. I'm also constantly working on ways to challenge myself because trying new things and pushing myself outside of my regular routine can be scary. 

The point of weight lifting is to build strength, to push yourself, to fatigue your muscles so you can get stronger. It's very different from a cardio workout, which often makes my blood sugar drop quickly. For me, a cardio workout means I need to test my blood sugar every 20 minutes or so. Now, you might not do this, but I do it because I know how my diabetes works, and I want to be extra safe when I'm at the gym. 

But when I'm in a strength-building class, my blood sugar stays pretty much the same (or drops very little). Because of this, I feel less anxious about what my blood sugar is doing during my workout. I often go through the one-hour workout without checking. But the challenge here is knowing how to read the signs, which can be tricky with diabetes. 

A low blood sugar can leave me feeling spacey, tired, weak, shaky. And these are the very things that can happen during my weight lifting class! I never leave a class without my arms and legs feeling wobbly. So, I often debate with myself during the class about whether it's a low blood sugar or if I'm just feeling what I am supposed to be feeling during an intense workout. The key for me is whether or not I feel spacey. It's hard to explain, but there are little (personal) things that can help you distinguish. However, there are times where you can't feel your lows, so I believe that when in doubt, test, test, test. Once I know my number, I know how to proceed—whether it's knocking back some sugar or continuing my workout knowing that it's safe for me to keep going. To keep pushing myself. 

There are times, though, where I don't want to check my blood sugar and I just want keep going like the all the other people in the class. I don't want to feel different. I don't want any weird looks. I don't want others to slow down because of me. I want everything to keep going on as it normally would. Keep on going, I think. I can keep up!  

But my life isn't the same. Diabetes has forced me into a new way of living and reacting. And sometimes I need to slow down and stop because of it. I need to listen to what my body is telling me and know when to stop pushing myself. And that doesn't make me a weak or less capable person. Being okay with this is my challenge. 

Friday, January 24, 2014

What Diabetes Means to Me

I've been thinking a lot lately about what diabetes means. Like anything in life, it means something different for everyone. Some of us have type 1. Some have type 2. Others don't have it but know someone who does. And then there are those who know nothing about it, but feel like they should comment on it anyway.

So, here's a little list of what diabetes me.

1. Testing my blood sugar anywhere from 5 to 10 times a day. This means poking my fingers over and over again. With it comes the waiting and the analyzing. Why is it high? Why is it low? Oh, it's normal—yay me.

2. Yes, I actually congratulate myself on my blood sugar. That's what happens when you take over the work of your organ. But this can also mean I get frustrated or blame myself for the "bad" numbers.

2. I favor fingers without thinking about it—until I look at them closely and realize the sides are calloused or have little black dots from all the pokes.

3. Waking up in the middle of the night and having my first thought be, "you should test your blood sugar." Sometimes it's normal. Sometimes it's not.

4. I carry some form of sugar with me at all times—just in case. Even the thought of not having enough glucose tabs or forgetting to grab my juice can make me feel panicked. Having sugar around is like having a security blanket.

5. Constantly reminding myself that it's going to be okay. This is especially true for when my blood sugar is low. "You've had lots of lows. Remember that time your blood sugar was 30? It's only 50 now. That's not so bad. Your glucose tabs worked then, and they'll work now. You'll feel better soon."

6. If I'm alone when my blood sugar is low, sometimes I call my parents. It goes back to feeling reassured—that someone who loves you will take care of you if you can't take care of yourself.

7. The fear of passing out. I've never passed out and hope I never do.

8. I have it pretty good considering how much things have advanced since diabetes was first diagnosed. Sure, things aren't perfect. Insulin is not a cure. But things have come a long way, and I'm grateful for that.

9. I should be more prepared. Every time I hear of a natural disaster or really anything that could be considered a crisis, I think about how I should really have all my diabetes stuff in one place, preferably within a bag that I could easily grab.

10. Sometimes I have to take breaks and ask for help. This is something I'm much better at. For the longest time, I didn't want to be viewed as different. I didn't want anyone to think I couldn't handle something. Now I have to face the fact that I can handle it—I just may need a little break to drink some juice or take some insulin.

11. I pay attention to everything I eat and do. It's not all about sugar, people. It's carbs. It's fiber. It's fat. It's protein. All of those things affect your blood sugar. Same goes for sitting, walking, or running. Being stressed. Being sick. Being on your period. The weather. Taking a hot shower after taking insulin.

12. I think about diabetes a lot. But, I also DON'T think about it a lot. It's hard to explain. A lot of diabetes is second nature. I've been doing this thing for 8 years now. I'm pretty used to it. But because I pay attention to every little thing, and because it's always THERE, that means I'm always taking it into consideration.

13. It's not funny. I'm okay with the half robot jokes. I allow people I know well to make what I will call sarcastic jokes about the diabetes-sugar correlation. But really, I'm tired of that whole joke. There aren't many chronic illnesses out there that get made fun of quite like diabetes (correct me if I'm wrong).

14. Worrying whether anyone else in my family will be affected one day. This includes my future children that I may or may not have. Still on the fence about that one.

15. My life is automatically harder, but it doesn't mean that it's worse. Sure, diabetes can be a difficult diagnosis. There's fear, there's paranoia, there's guilt, there's denial. It's with you all the time. It affects everything and everything affects it. But that doesn't mean everything has to go downhill because of it.

There are so many more things I could get into, but I will leave it at that—a glimpse into the life of a person with diabetes.