I didn't really know how to expect my treatment to affect my life when I first found out. Actually, I still don't fully know. But one thing stood out to me immediately: We had to stop trying for a baby.
We'd been trying for a while, though I wasn't to the point of obsessing, charting my cycle, and calling my husband to meet me at home during lunch because my temperature just jumped half a degree. But still, we're ready to start a family.
And now I'm on birth control.
You can have a healthy pregnancy and a healthy baby as a diabetic, but you have to get your blood sugar under control to make it happen. Plus, I have one other factor to consider: Like many diabetics, I also have very high cholesterol.
Actually, high cholesterol doesn't affect pregnancy much. But when my doctor said I'd have to start cholesterol medication but that she understood if I was too overwhelmed to start right away, I decided that the more overwhelming prospect was to not do everything possible to get my health under control... Get my cholesterol down, please!
But I also told her that I want to have a baby as soon as I'm healthy enough to do so, and she explained that I absolutely must not become pregnant on cholesterol meds. She clearly felt that hormonal was the best stand-alone method, and in fact insisted that condoms alone were "not good enough," considering the risks. So we discussed options and I left with a pack of Crestor samples, a prescription for NuvaRing, and a promise that she had no worries about me stopping both once my blood sugars are normal and stable enough for pregnancy. Oh, but not until I got the scary "worst-case side effects of cholesterol meds" warning about cramping muscles. Even though I know the serious side effects are rare, it still scared the crap out of me.
And reading the NuvaRing information before starting it today, all those warning sections were scaring me all over again. Diabetics with certain complications (none of which I have, most likely) were listed under "who shouldn't use this product," and Diabetes in general was under the list of conditions that indicate a need to discuss NuvaRing with your doctor (which I already did, of course). Scary, scary, scary.
And here's hoping that this hormonal birth control doesn't throw a wrench in the gears of my improving blood sugar (it can raise it), and that it doesn't make me crazy depressed (the pill did). But I was the one who mentioned NuvaRing as a specific option, because I've been told before that it has the lowest dose of any of the current hormonal birth controls. I'm hoping that will mean fewer side effects, as a previous doctor suggested to me.
So there you have it. I originally went to the doctor about cracks at the corners of my mouth, and now I'm on insulin and birth control and will soon be starting statins... all of which are a little scary for me. This is a topic to be fleshed out in another post, but I'll just say: All of this has me praying for the first time in years.
Sunday, May 30, 2010
Saturday, May 29, 2010
Food
I have a conflicted relationship with food now. Wait, that's not right... I've always had a conflicted relationship with food.
I love food and I hate food. I've been in good places with it, and I've been in bad. I remember one night in college, back when I was unhealthily heavy and seemingly unable to change it, I was standing over my food drawer in my dorm room, eating Doritos and crying because I couldn't stop. And then, by about a year after college, I was down to a normal weight and was eating mostly organic food that I loved... Largely because I was a happier person and didn't have much of a need to eat emotionally. I'd have my vegetarian lunches of a cheese and broccoli slaw sandwich on whole wheat (honestly so good!), light miso soup, and seriously tasty organic chips. I was satisfied, eating in moderation, and avoiding most sweets because I just didn't crave them.
So to show you those two polar opposite pictures gives you a little background. For the past couple of years, I've been more like the average person. I ate a little too much and there was more junk food to be had when I was under periods of stress, but it was about what you'd expect from an average American working girl. I gained enough that I wanted to get back to better habits and lose weight again, but most of those better habits never formed permanently.
But for the past year or so, I was more or less eating whatever I wanted without gaining weight. Nothing insanely unhealthy, but I ate all the time because I was hungry all the time, and I either held steady or lost a little weight. At one point, after a couple days of eating way too much junk and sugar, I got on the scale and thought, "Wow, I didn't gain! I guess since most of what I eat is on the healthier side, I do OK with eating as much as I do and having the occasional sweet treat."
How bizarre, to think that I was maintaining what seemed like a "healthy" weight only because my body was anything but healthy... because it wasn't working properly... because my cells couldn't get the fuel they needed.
I didn't fix my eating habits the moment I discovered I was diabetic, but I did as soon as I started my extremely conservative insulin regimen a few days later. At first, since I knew I was really only taking insulin for my existing blood sugar and not what I was about to put in my mouth, I began eating meals of no more than 30 carbs each. Once I started calculating my insulin to account for my food a few days after that, the dietitian assured me that I could eat more carbs as long as I didn't go crazy. 45 to 60 carbs per meal is the realistic range.
But I still keep most of my meals around 30 carbs. Sometimes 40, rarely up to 60. I know there will be times when I eat more than that (damn it all to hell if I can't have a little piece of real cake on my own birthday!), but that's fine with me for now.
It's a combination of things. First of all, I'm satisfied with that 30 to 40 range. I mean... my hunger stops! I may be consuming far fewer carbs than I used to, but my body is able to use so much more! So my physical cues to "eat more fuel" aren't there.
Second, I currently don't like giving myself the larger amounts of insulin that go along with higher carb meals. This is all still new to me, and I feel nervous every time I take a larger dose of insulin than I have before.
Third, I'm realizing that a lower carb diet will not only mean possible weight control now that my body is working normally, but also savings on medicine... The fewer carbs I eat, the less insulin I need! I'm not going to make decisions for my body based on financial issues, but it's something that's crossed my mind. And is it somehow better to need/take less insulin, anyway? I think the true answer is "stay healthy and take the insulin to support that health," but haven't fully adopted that attitude. To be healthy on less medication is better than to be healthy on more medication, in my mind.
And I can't leave out the the fact that I worry I'll blow up like a balloon now that my body can use and store the fuel I give it. I got the green light to do start doing some light exercise (should have started already, definitely will this coming week), but all of this has made me want to become a freaking athlete. Diabetes puts you at risk of so much, including cardiovascular disease, that I want to reduce as many other risks as I possibly can. That means losing and then maintaining my weight and getting fit in general... especially my heart. I'm a 30 year old woman who is still menstruating, and that gives me a good window to get my heart up to speed before I become more at risk for heart attacks at menopause. I'm going to take advantage of that window, damn it! (This will have to be an entire post unto itself. There are many layers of fear and frustration surrounding exercise, fitness, and risk for cardiovascular disease.)
Another thing I've considered, regarding food, is starting the Nutrisystem Diet again. The prepackaged, perfectly portioned entrees would make it easy to know exactly how many carbs I'm putting in my body, and they have a low-glycemic version called "Nutrisystem D" that's designed to help Type 2 Diabetics gain control over their disease through food. A low-glycemic diet could not control Type 1 Diabetes, but it would support the medical treatment. I'm struggling with this decision though, because it's fairly expensive once you start adding in the grocery items. And the last time I did Nutrisystem, I grew tired of the dinners and lunches fast. (But man, do they have awesome breakfasts and snacks!) That, and I actually suspect I may end up consuming slightly more carbs than I currently do. Many of the meals would be 40 carbs once the salad and veggies are added. Not bad, but maybe not what I want.
But I think it could be a really great choice for someone who's eating a few more carbs than I currently do. Hell, it still may be a great choice for me, anyway. (And, FYI, the first time I did Nutrisystem was awesome. I loved the food while it was new to me, I was only tempted to do some very minor and rare "cheating," and I think I lost about 20 pounds!)
I love food and I hate food. I've been in good places with it, and I've been in bad. I remember one night in college, back when I was unhealthily heavy and seemingly unable to change it, I was standing over my food drawer in my dorm room, eating Doritos and crying because I couldn't stop. And then, by about a year after college, I was down to a normal weight and was eating mostly organic food that I loved... Largely because I was a happier person and didn't have much of a need to eat emotionally. I'd have my vegetarian lunches of a cheese and broccoli slaw sandwich on whole wheat (honestly so good!), light miso soup, and seriously tasty organic chips. I was satisfied, eating in moderation, and avoiding most sweets because I just didn't crave them.
So to show you those two polar opposite pictures gives you a little background. For the past couple of years, I've been more like the average person. I ate a little too much and there was more junk food to be had when I was under periods of stress, but it was about what you'd expect from an average American working girl. I gained enough that I wanted to get back to better habits and lose weight again, but most of those better habits never formed permanently.
But for the past year or so, I was more or less eating whatever I wanted without gaining weight. Nothing insanely unhealthy, but I ate all the time because I was hungry all the time, and I either held steady or lost a little weight. At one point, after a couple days of eating way too much junk and sugar, I got on the scale and thought, "Wow, I didn't gain! I guess since most of what I eat is on the healthier side, I do OK with eating as much as I do and having the occasional sweet treat."
How bizarre, to think that I was maintaining what seemed like a "healthy" weight only because my body was anything but healthy... because it wasn't working properly... because my cells couldn't get the fuel they needed.
I didn't fix my eating habits the moment I discovered I was diabetic, but I did as soon as I started my extremely conservative insulin regimen a few days later. At first, since I knew I was really only taking insulin for my existing blood sugar and not what I was about to put in my mouth, I began eating meals of no more than 30 carbs each. Once I started calculating my insulin to account for my food a few days after that, the dietitian assured me that I could eat more carbs as long as I didn't go crazy. 45 to 60 carbs per meal is the realistic range.
But I still keep most of my meals around 30 carbs. Sometimes 40, rarely up to 60. I know there will be times when I eat more than that (damn it all to hell if I can't have a little piece of real cake on my own birthday!), but that's fine with me for now.
It's a combination of things. First of all, I'm satisfied with that 30 to 40 range. I mean... my hunger stops! I may be consuming far fewer carbs than I used to, but my body is able to use so much more! So my physical cues to "eat more fuel" aren't there.
Second, I currently don't like giving myself the larger amounts of insulin that go along with higher carb meals. This is all still new to me, and I feel nervous every time I take a larger dose of insulin than I have before.
Third, I'm realizing that a lower carb diet will not only mean possible weight control now that my body is working normally, but also savings on medicine... The fewer carbs I eat, the less insulin I need! I'm not going to make decisions for my body based on financial issues, but it's something that's crossed my mind. And is it somehow better to need/take less insulin, anyway? I think the true answer is "stay healthy and take the insulin to support that health," but haven't fully adopted that attitude. To be healthy on less medication is better than to be healthy on more medication, in my mind.
And I can't leave out the the fact that I worry I'll blow up like a balloon now that my body can use and store the fuel I give it. I got the green light to do start doing some light exercise (should have started already, definitely will this coming week), but all of this has made me want to become a freaking athlete. Diabetes puts you at risk of so much, including cardiovascular disease, that I want to reduce as many other risks as I possibly can. That means losing and then maintaining my weight and getting fit in general... especially my heart. I'm a 30 year old woman who is still menstruating, and that gives me a good window to get my heart up to speed before I become more at risk for heart attacks at menopause. I'm going to take advantage of that window, damn it! (This will have to be an entire post unto itself. There are many layers of fear and frustration surrounding exercise, fitness, and risk for cardiovascular disease.)
Another thing I've considered, regarding food, is starting the Nutrisystem Diet again. The prepackaged, perfectly portioned entrees would make it easy to know exactly how many carbs I'm putting in my body, and they have a low-glycemic version called "Nutrisystem D" that's designed to help Type 2 Diabetics gain control over their disease through food. A low-glycemic diet could not control Type 1 Diabetes, but it would support the medical treatment. I'm struggling with this decision though, because it's fairly expensive once you start adding in the grocery items. And the last time I did Nutrisystem, I grew tired of the dinners and lunches fast. (But man, do they have awesome breakfasts and snacks!) That, and I actually suspect I may end up consuming slightly more carbs than I currently do. Many of the meals would be 40 carbs once the salad and veggies are added. Not bad, but maybe not what I want.
But I think it could be a really great choice for someone who's eating a few more carbs than I currently do. Hell, it still may be a great choice for me, anyway. (And, FYI, the first time I did Nutrisystem was awesome. I loved the food while it was new to me, I was only tempted to do some very minor and rare "cheating," and I think I lost about 20 pounds!)
Sunday, May 23, 2010
Things I Hear
Things I hear from people, having been recently diagnosed with Type 1 Diabetes:
Did you have any symptoms?!?!
This is probably out of sheer surprise. I'm at an odd age for either type of diabetes, and I wasn't clearly ill. I have to admit that, at first, this question bothered me because I felt like maybe I should have gone to get tested far before I did. Yes, as a matter of fact, I did have some symptoms... but I sure as hell never thought I had full-blown diabetes! I remember one day thinking, "Why am I so thirsty lately?" I also started getting up to pee in the middle of the night, whereas I hadn't needed to before. And every once in a while, I lost a couple pounds when I expected to gain from all the sweets I'd been eating, but I attributed that to eating an otherwise decent diet. Plus, I was hungry all the time and didn't have a lot of energy, which was especially frustrating to me. But when you hear stories of diabetes symptoms, you hear that people drink gallons of water, pee every 30 minutes, lose 10 pounds in a week, and are flat out sick right before diagnosis. After the fact, when I shared the above symptoms with my doctor, she was still surprised at the lack of obvious symptoms. My dentist was also surprised by how well-hydrated my mouth was. Go figure.
You're doing so well!
I hear this one a lot, from all sorts of people. It means a lot from the people I know well. For a while, I felt slightly uncomfortable hearing it from people I'm not as close to... Maybe because I felt they could have no idea how I was doing. Did they really think I was "doing so well" simply because I showed up to work and managed to stare at the computer and not cry in front of people? They weren't there for the time that I a cried over having to do 9 injections a day (before they got closer to my correct ratios), or miscalculated how much insulin I needed and made my blood sugar go borderline-low, or threw a genuine tantrum because I dropped my lunch all over our carpet after I'd already given myself my bolus insulin. But hearing it from the people closest to me really matters. I feel good that my mom is proud of me, and that my husband is impressed with the way I've adapted... especially since they've both let me cry and rant during my moments of frustration and self-pity. It also means a lot from the members of my health care team, because I thrive on any sort of teacher-student dynamic and appreciate feedback that tells me I'm doing a good job.
This is a real, life-changing event.
People seemed quick to point this out at the beginning, often following it up with some sort of reassurance like, "But you can do it," or, "But you'll adjust in no time." This statement has created the most conflict in me, because I just don't know what my opinion is on it yet. Some days, I don't think it changes life that much. I have a friend who is type 1, but I never would have known if it hadn't come up in a conversation. Her lifestyle is very similar to what mine has always been. Another type 1 I knew more casually had the pump, and that was the only sign of her diabetes. But then, some days, I'm daunted by the idea of counting carbs and possibly battling the insurance companies for the rest of my life (come on Obama, get that health care reform moving!). Some days, I'm terrified by the thought that my pancreas will soon be totally kaput, and then I'd die without my medication. Some days, I read about other people's struggles to keep within their target range and worry that it will be that hard and time-consuming for me, too. Yes, things are going to be different, but I just don't know what to think about how utterly life-changing this will be, yet.
I'm diabetic, and I can tell you you'll be fine. Let me know if you need to talk.
I'm lucky to be receiving so much support from all of my friends and family, but I'm especially comforted by support and encouragement from people who are diabetic or who have a spouse/child/parent/sibling who is diabetic. It's primarily that they're experienced in this, and yet they think I'll be OK. It's so good to hear that. Now that I know what a low blood sugar feels like and that I'm able to identify it before it gets really bad, my greatest fear is the major complications. Hearing from diabetics without major complications eases the worst of my fears. I really, truly, honestly intend to give myself the best possible treatment, and these people make me believe that it will be worth it.
Did you have any symptoms?!?!
This is probably out of sheer surprise. I'm at an odd age for either type of diabetes, and I wasn't clearly ill. I have to admit that, at first, this question bothered me because I felt like maybe I should have gone to get tested far before I did. Yes, as a matter of fact, I did have some symptoms... but I sure as hell never thought I had full-blown diabetes! I remember one day thinking, "Why am I so thirsty lately?" I also started getting up to pee in the middle of the night, whereas I hadn't needed to before. And every once in a while, I lost a couple pounds when I expected to gain from all the sweets I'd been eating, but I attributed that to eating an otherwise decent diet. Plus, I was hungry all the time and didn't have a lot of energy, which was especially frustrating to me. But when you hear stories of diabetes symptoms, you hear that people drink gallons of water, pee every 30 minutes, lose 10 pounds in a week, and are flat out sick right before diagnosis. After the fact, when I shared the above symptoms with my doctor, she was still surprised at the lack of obvious symptoms. My dentist was also surprised by how well-hydrated my mouth was. Go figure.
You're doing so well!
I hear this one a lot, from all sorts of people. It means a lot from the people I know well. For a while, I felt slightly uncomfortable hearing it from people I'm not as close to... Maybe because I felt they could have no idea how I was doing. Did they really think I was "doing so well" simply because I showed up to work and managed to stare at the computer and not cry in front of people? They weren't there for the time that I a cried over having to do 9 injections a day (before they got closer to my correct ratios), or miscalculated how much insulin I needed and made my blood sugar go borderline-low, or threw a genuine tantrum because I dropped my lunch all over our carpet after I'd already given myself my bolus insulin. But hearing it from the people closest to me really matters. I feel good that my mom is proud of me, and that my husband is impressed with the way I've adapted... especially since they've both let me cry and rant during my moments of frustration and self-pity. It also means a lot from the members of my health care team, because I thrive on any sort of teacher-student dynamic and appreciate feedback that tells me I'm doing a good job.
This is a real, life-changing event.
People seemed quick to point this out at the beginning, often following it up with some sort of reassurance like, "But you can do it," or, "But you'll adjust in no time." This statement has created the most conflict in me, because I just don't know what my opinion is on it yet. Some days, I don't think it changes life that much. I have a friend who is type 1, but I never would have known if it hadn't come up in a conversation. Her lifestyle is very similar to what mine has always been. Another type 1 I knew more casually had the pump, and that was the only sign of her diabetes. But then, some days, I'm daunted by the idea of counting carbs and possibly battling the insurance companies for the rest of my life (come on Obama, get that health care reform moving!). Some days, I'm terrified by the thought that my pancreas will soon be totally kaput, and then I'd die without my medication. Some days, I read about other people's struggles to keep within their target range and worry that it will be that hard and time-consuming for me, too. Yes, things are going to be different, but I just don't know what to think about how utterly life-changing this will be, yet.
I'm diabetic, and I can tell you you'll be fine. Let me know if you need to talk.
I'm lucky to be receiving so much support from all of my friends and family, but I'm especially comforted by support and encouragement from people who are diabetic or who have a spouse/child/parent/sibling who is diabetic. It's primarily that they're experienced in this, and yet they think I'll be OK. It's so good to hear that. Now that I know what a low blood sugar feels like and that I'm able to identify it before it gets really bad, my greatest fear is the major complications. Hearing from diabetics without major complications eases the worst of my fears. I really, truly, honestly intend to give myself the best possible treatment, and these people make me believe that it will be worth it.
Saturday, May 22, 2010
Not Going Broke in an Emergency
Here's a tip for anyone who gets a diagnosis that requires maintenance medication that doesn't have a clear and consistent dosage: Make sure your doctor has either written the prescription to reflect that fact, or that (s)he is totally confident they've prescribed enough for that 30 days.
My doctor initially wrote all of my prescriptions as 30 day supplies, but I ran out of blood glucose test strips long before 30 days... and my insurance refused to refill it even when she revised the prescription.
Buying test trips out-of-pocket is expensive. My copay for 100 strips was less than $30, but out-of-pocket for 50 of them was about $70... ON SALE!!! (Freestyle Lite strips. You can find them for less than that if you do some googling, but they're still a little pricy.)
Well, even that 50 I picked up while waiting to see if the insurance company would decide to cover my refill after the revision wasn't going to last once they gave us a final "no." I wasn't about to shell out another $70 if I could find another option.
And, gosh, OK, fine, I found that other option at a store we all love to hate: Walmart.
I picked up a Relion Micro (a Walmart brand) glucose meter for $12 and a 50 pack of the corresponding strips for $20. That's less than half of what I would have paid for a 50 pack of the Freestyle strips, and now I have a back-up meter if I ever lose or break my nice one.
Though the Relion Micro is a little more cheap looking than my Freestyle Freedom Lite, I'd done my research and found good reviews and posts about it, and found that the Relion Ultima (different model by the same company) was declared a "top pick" by Consumer Reports. And while I say it looks a little cheap, I should also point out that the Micro is little and cute, and it comes with interchangeable colored faceplates!
Mine included a bold red option, so now I have a sexy little red glucose meter!
I bitch about Walmart sometimes, but it's times like this when I realize the value (haha) it must hold for people who who live patcheck to paycheck. I could have gotten by with buying another pack for my pricy brand name strips, but some people could not. And if you don't have insurance, this meter might be one of the best financial choices a diabetic could make.
I should point out that I also had the same prescription issue with the needles that go on my insulin pens. Though I hadn't run out, I counted and knew I didn't quite have enough to make it until my refill. Cue tons of research on whether or not reuse is safe... And as it turns out, most people in forums said they reuse their needles once or twice and the ADA has recommendations on how to safely reuse needles:
Reusing syringes may help you cut costs, avoid buying large supplies of syringes, and reduce waste. However, talk with your doctor or nurse before you begin reusing. They can help you decide whether it would be a safe choice for you. If you are ill, have open wounds on your hands, or have poor resistance to infection, you should not risk insulin syringe reuse. Syringe makers will not guarantee the sterility of syringes that are reused.
Here are some tips to keep in mind when reusing syringes:
Also, on a related note, did you know that you don't need a prescription to buy regular insulin in the United States, except in Alaska? It's just kept behind the pharmacy counter. And apparently, it's not insanely expensive (someone on a forum said they got a vial for $22 at Walmart). So if you were ever in a real bind but can scrape up a little cash, there's a way you might be able to get by. (You should absolutely still talk to your doctor about how to use regular insulin before buying it, unless it's the kind you already use!) Here's a chart that lays out the legality of buying insulin and syringes, by state.
My doctor initially wrote all of my prescriptions as 30 day supplies, but I ran out of blood glucose test strips long before 30 days... and my insurance refused to refill it even when she revised the prescription.
Buying test trips out-of-pocket is expensive. My copay for 100 strips was less than $30, but out-of-pocket for 50 of them was about $70... ON SALE!!! (Freestyle Lite strips. You can find them for less than that if you do some googling, but they're still a little pricy.)
Well, even that 50 I picked up while waiting to see if the insurance company would decide to cover my refill after the revision wasn't going to last once they gave us a final "no." I wasn't about to shell out another $70 if I could find another option.
And, gosh, OK, fine, I found that other option at a store we all love to hate: Walmart.
I picked up a Relion Micro (a Walmart brand) glucose meter for $12 and a 50 pack of the corresponding strips for $20. That's less than half of what I would have paid for a 50 pack of the Freestyle strips, and now I have a back-up meter if I ever lose or break my nice one.
Though the Relion Micro is a little more cheap looking than my Freestyle Freedom Lite, I'd done my research and found good reviews and posts about it, and found that the Relion Ultima (different model by the same company) was declared a "top pick" by Consumer Reports. And while I say it looks a little cheap, I should also point out that the Micro is little and cute, and it comes with interchangeable colored faceplates!
Mine included a bold red option, so now I have a sexy little red glucose meter!
I bitch about Walmart sometimes, but it's times like this when I realize the value (haha) it must hold for people who who live patcheck to paycheck. I could have gotten by with buying another pack for my pricy brand name strips, but some people could not. And if you don't have insurance, this meter might be one of the best financial choices a diabetic could make.
I should point out that I also had the same prescription issue with the needles that go on my insulin pens. Though I hadn't run out, I counted and knew I didn't quite have enough to make it until my refill. Cue tons of research on whether or not reuse is safe... And as it turns out, most people in forums said they reuse their needles once or twice and the ADA has recommendations on how to safely reuse needles:
Reusing syringes may help you cut costs, avoid buying large supplies of syringes, and reduce waste. However, talk with your doctor or nurse before you begin reusing. They can help you decide whether it would be a safe choice for you. If you are ill, have open wounds on your hands, or have poor resistance to infection, you should not risk insulin syringe reuse. Syringe makers will not guarantee the sterility of syringes that are reused.
Here are some tips to keep in mind when reusing syringes:
- Keep the needle clean by keeping it capped when you're not using it.
- Never let the needle touch anything but clean skin and the top of the insulin bottle.
- Never let anyone use a syringe you've already used, and don't use anyone else's syringe.
- Cleaning it with alcohol removes the coating that helps the needle slide into the skin easily
Also, on a related note, did you know that you don't need a prescription to buy regular insulin in the United States, except in Alaska? It's just kept behind the pharmacy counter. And apparently, it's not insanely expensive (someone on a forum said they got a vial for $22 at Walmart). So if you were ever in a real bind but can scrape up a little cash, there's a way you might be able to get by. (You should absolutely still talk to your doctor about how to use regular insulin before buying it, unless it's the kind you already use!) Here's a chart that lays out the legality of buying insulin and syringes, by state.
Wednesday, May 19, 2010
I Choose to Fight
Three weeks ago, I thought I was a pretty normal, healthy person. I didn't have a lot of energy, but I was starting to exercise and was determined to create habits that would let me live a long, healthy life. I wasn't afraid.
Now, have a chronic disease with some serious potential complications... including heart disease.
I feel... changed. Diabetes is very manageable (thank god!), but its very real dangers has made me... mortal. And I am afraid.
I visited my doctor yesterday, for the first time since I got this diagnosis. She told me, "You're really doing great, you're doing everything you need to do. I see a lot of people run and hide from something like this."
But the truth is, I'm just much more afraid of the complications than I am of the treatment and day-to-day concerns. I was faced with a fight or flight scenario, and I chose to fight.
I'm scared, but I think it's a healthy fear. That fear is making me follow my Diabetic Educator's every direction, eat a healthier diet, and look forward to the green light to exercise.
The fact is that diabetes is faster than you. If you run, it will catch up with you, and it will take you down from behind. But face it head-on, and you have the advantage. You can see and respond to its every move, and you can stay on your feet.
I'm scared, but that's why I choose to fight.
Now, have a chronic disease with some serious potential complications... including heart disease.
I feel... changed. Diabetes is very manageable (thank god!), but its very real dangers has made me... mortal. And I am afraid.
I visited my doctor yesterday, for the first time since I got this diagnosis. She told me, "You're really doing great, you're doing everything you need to do. I see a lot of people run and hide from something like this."
But the truth is, I'm just much more afraid of the complications than I am of the treatment and day-to-day concerns. I was faced with a fight or flight scenario, and I chose to fight.
I'm scared, but I think it's a healthy fear. That fear is making me follow my Diabetic Educator's every direction, eat a healthier diet, and look forward to the green light to exercise.
The fact is that diabetes is faster than you. If you run, it will catch up with you, and it will take you down from behind. But face it head-on, and you have the advantage. You can see and respond to its every move, and you can stay on your feet.
I'm scared, but that's why I choose to fight.
Sunday, May 16, 2010
"You have to live, and you WILL live."
I've been monitoring and using insulin for over a week now, and really calculating my insulin needs for about half a week. I'm not going to lie; I've had my frustrations. But I can say that it's doable, the shots don't hurt, I've had enough flexibility since getting clarification on scheduling, and can already tell it's getting easier.
Every now and then, it strikes me as so strange that, unless they perfect something like an artificial pancreas, I'll never again be able to just eat without adding up carbs in my head and somehow delivering insulin (whether through injections or through a pump). The dietitian said it'd get easier; I'll know about how many carbs are in a piece of cake in the work break room by simply judging the size of it. I hope that's true, but I also know there will always be variables.
Another great frustration is that my husband and I had been trying for a baby, and now we have to wait until my blood sugar and A1C reach certain numbers and stay stable. I'm reasonably confident I can tightly manage my blood sugar once everything settles down and we have my insulin at the right doses, but it sounds like the A1C could take a very long time to get down to normal numbers no matter what I do. And I may not be at the end of my childbearing years yet, but I am 30 and don't feel that I have oodles of time left. My husband and I want two kids, and neither of us are spring chickens. We're both open to adoption, but that can also take a great deal of time.
Everyone keeps reminding me that diabetes isn't a death sentence, but it sometimes seems like a life sentence. I know it'll get better. A friend of mine who has had type 1 since she was 8 recently said to me about not having a doom and gloom attitude like some people do, "You have to live, and you will live."
Every now and then, it strikes me as so strange that, unless they perfect something like an artificial pancreas, I'll never again be able to just eat without adding up carbs in my head and somehow delivering insulin (whether through injections or through a pump). The dietitian said it'd get easier; I'll know about how many carbs are in a piece of cake in the work break room by simply judging the size of it. I hope that's true, but I also know there will always be variables.
Another great frustration is that my husband and I had been trying for a baby, and now we have to wait until my blood sugar and A1C reach certain numbers and stay stable. I'm reasonably confident I can tightly manage my blood sugar once everything settles down and we have my insulin at the right doses, but it sounds like the A1C could take a very long time to get down to normal numbers no matter what I do. And I may not be at the end of my childbearing years yet, but I am 30 and don't feel that I have oodles of time left. My husband and I want two kids, and neither of us are spring chickens. We're both open to adoption, but that can also take a great deal of time.
Everyone keeps reminding me that diabetes isn't a death sentence, but it sometimes seems like a life sentence. I know it'll get better. A friend of mine who has had type 1 since she was 8 recently said to me about not having a doom and gloom attitude like some people do, "You have to live, and you will live."
Friday, May 14, 2010
Tough Day
I got really frustrated today because of all of the "correction" doses of insulin I've been having to do between meals, and because I thought my meal schedule was too inflexible due to them... Then everything in the world was suddenly so overwhelming, and I just let myself cry. But after faxing my blood sugar records into my Educator and Dietitian (and after expressing my frustration), they changed my carb-to-insulin ratio and set me straight about my meal/insulin schedule. I can eat any dang time I want and take the right amount of insulin to cover it. It's only the insulin I take based on my existing blood sugar that I can't take too close together.
*big sigh* I feel so much better now, but everything caught up to me for a little while, there.
Seriously, if you are a newly diagnosed diabetic, go to a diabetes educator. And try to find one who'll do more than just teach you in a class then tell you numbers without explanation. Yvonne, my educator, has been so totally awesome. She clearly cares, explains the "why" for everything, and gave me her cell phone and email so I can always get in touch with her.
On another front, my mom has been talking to the Diabetes Educator at the hospital where she works. She went ahead and asked about insulin pumps (a topic my Educator has briefly mentioned as a future likelihood), and she thinks I'll be able to get one in a reasonably short amount of time. They just have to get me started and make sure I know what I'm doing first. The pens/needles honestly aren't so bad, but I'm already looking forward to the reduced hassle of a pump!
*big sigh* I feel so much better now, but everything caught up to me for a little while, there.
Seriously, if you are a newly diagnosed diabetic, go to a diabetes educator. And try to find one who'll do more than just teach you in a class then tell you numbers without explanation. Yvonne, my educator, has been so totally awesome. She clearly cares, explains the "why" for everything, and gave me her cell phone and email so I can always get in touch with her.
On another front, my mom has been talking to the Diabetes Educator at the hospital where she works. She went ahead and asked about insulin pumps (a topic my Educator has briefly mentioned as a future likelihood), and she thinks I'll be able to get one in a reasonably short amount of time. They just have to get me started and make sure I know what I'm doing first. The pens/needles honestly aren't so bad, but I'm already looking forward to the reduced hassle of a pump!
Wednesday, May 12, 2010
See You Later
I went to my "Intensive Insulin Therapy" training today. I learned how to give myself appropriate amounts of insulin for meals and for corrections. They also started increasing my long-acting insulin dose, and told me it'll probably be increased a few more times. I'll talk about this more later, but I'm afraid I need to keep my computer session short.
There's been a lot I've wanted to write about, but being on the computer for too long hurts my eyes... which may be partly related to my insulin therapy! Weird!
Having high blood sugar for an extended period of time makes your lenses bloat, and starting medication for diabetes brings your blood sugar and that bloating down. This can cause temporary vision changes. Sometimes that means blurry vision, but it is rumored to have occasionally improved vision!
How bizarre is that?
Personally, I'm far-sighted and sometimes get eye strain after reading or sitting too closely to a computer screen for a very, very long time. Right now, that eye strain is happening more easily than usual. I've been having to lower the resolution on my computers to use them comfortably. I even picked up a bookmark style magnifying glass in case it starts becoming tough to focus at work. Man, it makes me feel old!
What's next? Seriously! The past week and a half as been one of the most life changing times of my life.
There's been a lot I've wanted to write about, but being on the computer for too long hurts my eyes... which may be partly related to my insulin therapy! Weird!
Having high blood sugar for an extended period of time makes your lenses bloat, and starting medication for diabetes brings your blood sugar and that bloating down. This can cause temporary vision changes. Sometimes that means blurry vision, but it is rumored to have occasionally improved vision!
How bizarre is that?
Personally, I'm far-sighted and sometimes get eye strain after reading or sitting too closely to a computer screen for a very, very long time. Right now, that eye strain is happening more easily than usual. I've been having to lower the resolution on my computers to use them comfortably. I even picked up a bookmark style magnifying glass in case it starts becoming tough to focus at work. Man, it makes me feel old!
What's next? Seriously! The past week and a half as been one of the most life changing times of my life.
Saturday, May 8, 2010
12 hours into treatment...
I've given myself 4 injections so far: 3 in the belly, 1 in the thigh. It's not bad at all. The only time it hurt a tiny bit was the second time, when I put the needle in too slow. But the pens make it so easy. At some point soon, I'll post pictures.
The rapid-acting insulin I take before I eat is currently measured on a "sliding scale." A blood sugar of 150 is supposed to be sort of a baseline number, and I inject 1 unit for every 50 over that (or half that amount for my evening snack). The educator told me I'd be doing it differently after the class; I'll be factoring in both my blood sugar levels and the amount of carbs I'm about to eat. For now, I'm just counting carbs to keep from going overboard.
I'm now wishing that I'd been testing my blood sugar before this so I'd be able to see the difference. It's a little frustrating at the moment because it's still high, and it will be for a while. I feel like the amount of insulin I'm taking just isn't enough (and it is intentionally on the conservative side until I learn more about it), but I can't drop my glucose too fast. My levels have been so high that close-to-normal levels might feel like hypoglycemia to me right now. I plan on doing my damnedest to keep my blood sugar at whatever goal my doctors set for me, but I guess I have to work my way down there first.
On a related note, the educator put all exercise off limits until they give me the green light. Apparently, it's dangerous to exert yourself if your blood sugar is over 240. And these past few months, I've been trying so hard to exercise... And I might have been hurting myself instead of helping. What a frustrating thought....
The rapid-acting insulin I take before I eat is currently measured on a "sliding scale." A blood sugar of 150 is supposed to be sort of a baseline number, and I inject 1 unit for every 50 over that (or half that amount for my evening snack). The educator told me I'd be doing it differently after the class; I'll be factoring in both my blood sugar levels and the amount of carbs I'm about to eat. For now, I'm just counting carbs to keep from going overboard.
I'm now wishing that I'd been testing my blood sugar before this so I'd be able to see the difference. It's a little frustrating at the moment because it's still high, and it will be for a while. I feel like the amount of insulin I'm taking just isn't enough (and it is intentionally on the conservative side until I learn more about it), but I can't drop my glucose too fast. My levels have been so high that close-to-normal levels might feel like hypoglycemia to me right now. I plan on doing my damnedest to keep my blood sugar at whatever goal my doctors set for me, but I guess I have to work my way down there first.
On a related note, the educator put all exercise off limits until they give me the green light. Apparently, it's dangerous to exert yourself if your blood sugar is over 240. And these past few months, I've been trying so hard to exercise... And I might have been hurting myself instead of helping. What a frustrating thought....
Diabetes Education, Part 1
I went to meter and insulin "training" yesterday. I didn't even learn about diet and calculating the insulin I'll need before eating, and it was still so much information.
The educator was great though, and she spoke from personal experience as a Type 1 Diabetic.
After going through lots of information on each, she had me test my blood sugar while I was there (about 350). I used a super fine lancet that Mom had gotten for me, and it didn't hurt at all. She then had me, Chad, and Mom practice using an insulin pen on little cushions. Since I hadn't injected any insulin yet, but she couldn't have me inject the kind I had at the time, she also made sure that I could manage to stick myself with a needle before leaving. She sat next to me and stuck herself first, and I followed her example... with no pain at all. Really. It felt like a tap and then I could tell it was there, but that's it.
That was a relief.
She was a little displeased with three things my doctor had done (or not done): First, that she had told me not to start the insulin right away. Second, that she had given me such a conservative starting point, with no rapid-acting insulin (the kind you take when you eat), when my blood sugar was so high. Third, the doctor could have referred me to the dietitian in the same appointment, but hadn't. She ended up calling the doctor and having her prescribe rapid-acting insulin and referring me for "Intensive Insulin Class," where I'll really learn how to calculate it properly and learn about proper diet.
MAN, I'm telling you, this is eating up my personal/sick leave...
The educator was great though, and she spoke from personal experience as a Type 1 Diabetic.
After going through lots of information on each, she had me test my blood sugar while I was there (about 350). I used a super fine lancet that Mom had gotten for me, and it didn't hurt at all. She then had me, Chad, and Mom practice using an insulin pen on little cushions. Since I hadn't injected any insulin yet, but she couldn't have me inject the kind I had at the time, she also made sure that I could manage to stick myself with a needle before leaving. She sat next to me and stuck herself first, and I followed her example... with no pain at all. Really. It felt like a tap and then I could tell it was there, but that's it.
That was a relief.
She was a little displeased with three things my doctor had done (or not done): First, that she had told me not to start the insulin right away. Second, that she had given me such a conservative starting point, with no rapid-acting insulin (the kind you take when you eat), when my blood sugar was so high. Third, the doctor could have referred me to the dietitian in the same appointment, but hadn't. She ended up calling the doctor and having her prescribe rapid-acting insulin and referring me for "Intensive Insulin Class," where I'll really learn how to calculate it properly and learn about proper diet.
MAN, I'm telling you, this is eating up my personal/sick leave...
Thursday, May 6, 2010
Introductions, of all kinds.
I am 30 years old, and I was diagnosed with Type 1 Diabetes 4 days ago.
This was a shock on so many levels. My doctor decided to test my fasting blood sugar when I had cracks at the corners of my mouth (this is usually a type of yeast infection, and yeast loves high blood sugar). I came back to her office for those tests with a fully healed mouth, which made her think that the blood sugar probably wasn't an issue... but she wanted some "baseline" test results anyway.
Thank goodness she went forward with the tests.
She called me back in to discuss the results. I half expected her to say I might be pre-diabetic. I did not expect her to tell me that I had a fasting blood sugar of 342 (anything over 170 indicates the possibility of diabetes, but 342 is really high!). She said she felt the need to make sure that was a "real number," and ordered another blood sugar test plus some other related tests.
I then spent a long weekend camping with friends and psyching myself up to deal with my likely diabetes with diet and exercise, which can sometimes be a successful method of managing Type 2 Diabetes even without medication... and I certainly knew that it must be Type 2... even though 30 is pretty young to be getting Type 2 unless there are other significant factors that didn't really apply to me. But Type 1 just happens to kids.... right?
Wrong. Late Monday afternoon, my doctor called me with the results.
"You're diabetic... and I think it's type 1, but I don't know why."
Cue confusion, tears, and denial. I'd cried when I heard the first test results and felt that I'd come to terms with the likely diagnosis... but here was something I hadn't prepared for. I thought I'd be taking a pill and changing my lifestyle for the better, but now I was being prescribed insulin and a glucometer.
And I'd be using them for the rest of my life, barring medical breakthrough.
Flabbergasted, I started googling when I got home (as did my husband and my mother, who is a nurse)... Oh, it's not so uncommon for adults to develop Type 1? That's news to me. But still, most of the information out there is geared toward parents of children with type 1, or adults developing type 2.
I'd like this blog to contribute to the gap that exists.
How does it feel to be diagnosed with Type 1 at 30? Unbelievable. Scary. Out of control. Confusing. Overwhelming.
I think I had a little more knowledge of diabetes and its treatment than the average person, but I still feel totally lost... and I keep having thoughts that I logically know are wrong. Such as, what if I did this to myself? What if herbal supplements wiped out my pancreas? Too many vitamins? Or could it have been drinking, my yo-yo weight, or some medicine I didn't take correctly?
That irrational guilt crosses over into other areas, like feeling terrible that my husband and family will have to deal with this along with me. I even find myself worrying that I'll bum people out with the news.
Even though I know it's not my fault... that doesn't necessarily mean I feel it's not my fault.
This week, I've bounced back and forth between areas of the grieving process. A good amount of depression, a healthy dose of anger, occasional denial, the rare instance of acceptance, and certainly some bargaining.
One of the worst parts is that I've been in limbo. I know I'm diabetic and I've gotten all my "gear," but my doctor recommended I not start insulin treatment until my "training" tomorrow morning. I could have had my mother help me and get me started, but I also saw the value in waiting so I could get comfortable with it over the weekend, before doing and glucose monitoring it at work. (I don't have to worry about insulin at work just yet, though.)
I am so eager to start being proactive in taking care of my body, and I'm interested to see how different I feel. My GP is starting me on what seems to be a very conservative treatment plan, and I imagine that's partly so my endocrinologist can make the decisions on how to really tackle this. But jeez, something will be so much better than nothing!
This was a shock on so many levels. My doctor decided to test my fasting blood sugar when I had cracks at the corners of my mouth (this is usually a type of yeast infection, and yeast loves high blood sugar). I came back to her office for those tests with a fully healed mouth, which made her think that the blood sugar probably wasn't an issue... but she wanted some "baseline" test results anyway.
Thank goodness she went forward with the tests.
She called me back in to discuss the results. I half expected her to say I might be pre-diabetic. I did not expect her to tell me that I had a fasting blood sugar of 342 (anything over 170 indicates the possibility of diabetes, but 342 is really high!). She said she felt the need to make sure that was a "real number," and ordered another blood sugar test plus some other related tests.
I then spent a long weekend camping with friends and psyching myself up to deal with my likely diabetes with diet and exercise, which can sometimes be a successful method of managing Type 2 Diabetes even without medication... and I certainly knew that it must be Type 2... even though 30 is pretty young to be getting Type 2 unless there are other significant factors that didn't really apply to me. But Type 1 just happens to kids.... right?
Wrong. Late Monday afternoon, my doctor called me with the results.
"You're diabetic... and I think it's type 1, but I don't know why."
Cue confusion, tears, and denial. I'd cried when I heard the first test results and felt that I'd come to terms with the likely diagnosis... but here was something I hadn't prepared for. I thought I'd be taking a pill and changing my lifestyle for the better, but now I was being prescribed insulin and a glucometer.
And I'd be using them for the rest of my life, barring medical breakthrough.
Flabbergasted, I started googling when I got home (as did my husband and my mother, who is a nurse)... Oh, it's not so uncommon for adults to develop Type 1? That's news to me. But still, most of the information out there is geared toward parents of children with type 1, or adults developing type 2.
I'd like this blog to contribute to the gap that exists.
How does it feel to be diagnosed with Type 1 at 30? Unbelievable. Scary. Out of control. Confusing. Overwhelming.
I think I had a little more knowledge of diabetes and its treatment than the average person, but I still feel totally lost... and I keep having thoughts that I logically know are wrong. Such as, what if I did this to myself? What if herbal supplements wiped out my pancreas? Too many vitamins? Or could it have been drinking, my yo-yo weight, or some medicine I didn't take correctly?
That irrational guilt crosses over into other areas, like feeling terrible that my husband and family will have to deal with this along with me. I even find myself worrying that I'll bum people out with the news.
Even though I know it's not my fault... that doesn't necessarily mean I feel it's not my fault.
This week, I've bounced back and forth between areas of the grieving process. A good amount of depression, a healthy dose of anger, occasional denial, the rare instance of acceptance, and certainly some bargaining.
One of the worst parts is that I've been in limbo. I know I'm diabetic and I've gotten all my "gear," but my doctor recommended I not start insulin treatment until my "training" tomorrow morning. I could have had my mother help me and get me started, but I also saw the value in waiting so I could get comfortable with it over the weekend, before doing and glucose monitoring it at work. (I don't have to worry about insulin at work just yet, though.)
I am so eager to start being proactive in taking care of my body, and I'm interested to see how different I feel. My GP is starting me on what seems to be a very conservative treatment plan, and I imagine that's partly so my endocrinologist can make the decisions on how to really tackle this. But jeez, something will be so much better than nothing!
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