Everything Changes

Why do I expect my diabetes to be a constant, static thing?  Where did this belief come from that by simply counting carbs and taking the right amount of insulin I would have control of my diabetes?  I thought that by following this formula I would be perfect.  My blood sugar would never stray from that magic range of normal -- 70 to 120mg/dl.  I would never go low and I would avoid the complications brought on by chronic high blood sugar.

I expected my diabetes to continue through time in the same unchanging way.  As long as I knew the inputs (carbs and insulin) then the output (my BG) would be predictable.  I believed that the output would always be the same as long as the inputs were consistent.  I believed that the more consistent I was in what I ate, when I tested, when and how I exercised I could expect consistent results from my diabetes.  I believed that I could somehow keep my diabetes constant.

But nothing is constant or unchanging.  Throughout our world and all through life the only constant is that things continue to change and transform.

Why do I expect my diabetes to be any different?

(Image Source)

Everything is changing and all things need continual care -- our bodies, our relationships, our gardens, our cars.  In the same misguided way that I think by eating the same things everyday then my diabetes will be the same everyday so to do I believe that by leaving at the same time everyday to go to work then traffic and my commute will always be the same.

I know that my diabetes needs continual care.  I'm beginning to accept that it is always changing.  No amount of discipline or perfection on my part will make my diabetes constant.  There are too many external factors that act on my diabetes that I don't have any control over.

The challenge I've been facing lately is how to accept my diabetes for what it is but not succumb to it.  Understanding that I will never truly master this disease because it is always changing; yet, not becoming complacent in caring for it.  How to strike a balance somewhere between simply accepting the changing nature of my diabetes and striving for an unattainable perfection.

I don't know what that balance looks like, where it is, or how to get there.  I do know that everything changes, that diabetes changes, and that I must change the way that I think about my diabetes to find that balance.

PUPDATE!

Last May we learned that our beloved golden retriever Kona had a tumor on his front leg.  His leg was amputated and he has been managing very well on three legs since then.  I'm very happy to report that at his last visit to the veterninary oncologist there were no signs that the cancer has spread!

A Valentine for My Diabetes

You don't make me happy

You don't bring me joy
You showed me how uncertain the future is
and that there are no guarantees

You taught me that I make my own happiness and joy
You taught me how to appreciate what I have right now, 
in this moment

I don't love you, but I've learned to live with you.


Happy Valentine's Day Diabetes

Cooking - A Diabetes Analogy

There's nothing like cooking up a yummy pot roast on a cold February Sunday.  Slowly simmering it in the oven, the aroma filling the house.  Scents of red wine, basil, onions, carrots.  A mouth watering one pot meal - dinner tonight and leftovers to make busy weeknights easier.

The recipe is followed to a tee.  Oven heated to 350F, roast browned, smothered in precisely measured herbs and wine, onions placed on top, pot is covered and ready to spend 4 hours in the oven.

The timer beeps.  And....

The roast and veggies are black.  All the liquid is cooked off.  Disaster.

Double check the recipe - yep, did everything right.  I made the same recipe a few weeks ago and it turned out perfectly - tender, not dry, just the right amount of liquid.  What the heck happened?!?

Diabetes is a lot like cooking.  What works one day, doesn't work a damn the next day.  You can follow all the directions and do all the right things and still end up with a crappy blood sugar or a meal thats going right in the trash.

(Editor's Note:  Upon further reflection I realized that I was using a 2lb roast when the recipe called for a 3lb roast.  Probably didn't need to spend 4 hours in the oven, 3 would have sufficed.  Lessons learned.)

Shouldn't this be better?

The chats I have with my nurse coach every few weeks have me wondering about the patients they talk to who aren't doing so great.  Patients whose norm is blood sugar in the 300s.  Patients who maybe don't know what type of diabetes they have nor understand how it works or why their medication is important.

One of my first chats with my nurse was a review of diabetes - how insulin is important and when the pancreas stops making it it cause blood sugar to rise, why I need to take my insulin, etc.  It sounded like a standard spiel they give to their patients.  I feel like five years into it I have a pretty good grasp on my disease but I wondered, what if this had been the first time I had heard this.

Granted, when I was first diagnosed I did not have a clue about diabetes and how to treat it.  Fortunately I was able to see a diabetes educator within days.  I get the sense in speaking with my nurse coach that maybe alot of people don't get the education or explanations they need to treat this disease.

How many patients are sent home from a doctor with a diagnosis, a prescription, no follow-up, and not a clue about what it all means?  

I'm getting the sense that this program I'm in could be huge help for patients that haven't had a full explanation about diabetes and the steps they can take to treat it.  And it leaves me feeling conflicted - feeling fortunate to have all the diabetes tools I need at my disposal but saddened that so many people might be able to do better with their diabetes if they could have this kind of education and follow-up.  

Shouldn't this be better?

Life

Ninety years ago a 14 year old boy received the very first insulin injection.  It was 1922. There were no tiny home use glucose meters nor continuous glucose monitors.  There were no insulin pens nor insulin pumps.  I can get so frustrated and angry with this disease.  The ups, the downs, highs and lows.  It can drive me to tears.

But when I really stop to think about it.  To think about what I have.  It really is a miracle. Its not perfect but without it I would have died in 2007.

When I reflect on this I can't help but think I've been given a second chance.  And the thing that I have been wrestling with lately is what to do with the time that I have.  I don't exactly know the answer to that question.  What I do know and what last year's gracias project helped me to realize is that its important to make the most of what I have.  I have a new outlook on how I want to spend the rest of my life and this quote sums it up nicely (emphasis is mine):

“To laugh often and much; to win the respect of intelligent people and the affection of children; to earn the appreciation of honest critics and to endure the betrayal of false friends. To appreciate beauty; to find the best in others; to leave the world a bit better whether by a healthy child, a garden patch, or a redeemed social condition; to know that even one life has breathed easier because you have lived. This is to have succeeded.” - Ralph Waldo Emerson

Finding ways to succeed in this manner in everyday, routine life isn't easy but it is something I'm aspiring to do.

We don't get many second chances.

Droppin' Knowledge

I’m not very open about my diabetes at work.  I’m not outspoken about it with people who aren’t close to me.  I keep it under the radar.  But when faced recently with some serious and potentially dangerous misinformation about diabetes, I opted to step up and set the record straight.  I put my diabetes out there for strangers to see.  It seems like a small step, but for me, it was a big step in feeling comfortable in identifying myself as someone with diabetes.

At my place of work we have an online health forum where people can get advice from co-workers on various health-related topics.  Recently a woman posted concerns about some symptoms her husband had been experiencing and whether they may be diabetes related.  As soon as I read them (unexplained weight loss, insatiable appetite, more frequent trips to the bathroom, fatigue, father has Type 1) I thought yeah, diabetes is definitely a possibility. I didn’t think about responding until I saw some of the responses from others and I knew I had to step up and set the record straight.

First, someone dismissed the woman’s concerns about diabetes stating that people develop diabetes because they gain weight not lose weight. This not only perpetuates a stereotype but it is flat out wrong.  I went through great lengths to describe how all the symptoms her husband was experiencing can be a result of high blood sugar - including the weight loss.  I tried to convey what a vicious cycle it is - insulin gone/diminished causing blood sugar to rise and leaving the body to turn to other sources (body tissues and fat) for its energy needs which causes the weight loss.  How the high blood sugar is toxic causing the body to look for ways to get rid of it - frequent urination, constant thirst. How the fatigue arises because the body isn’t getting the energy it needs and is constantly hungry and the eating which continues to drive up blood sugar because of the lack of insulin.

Another response was clearly describing symptoms of severe low blood sugar where people can be mistaken by police and paramedics to be drunk and don’t get the attention they need but used the term ketoacidosis instead.  I posted a response describing the differences between diabetic ketoacidosis and hypoglycemia because if this woman’s husband has diabetes, there is no way he is going to go low at this point.  

These misconceptions about diabetes can be potentially dangerous to someone who is seeking advice.  I can only hope that the information I relayed was useful in convincing this woman to try and get help for husband.  Based on what she described - if he does have diabetes - he is on his way to the ER very soon.