Better Than Therapy

Going to the endocrinologist is good for me. I don’t just mean it helps me stay healthy, I also mean that it helps me stay sane.


I’d gotten reasonably zen about diabetes management, especially since I was doing really well. Then I got pregnant, and zen immediately slipped from my grasp. My control on my blood sugar suffered, not due to any lack of effort or education, and my stress went through the roof in response.

In a zen state, I’d have said, “OK, my blood sugar is going higher than it should. All I can do is what I can do. Crying and feeling guilty just wastes energy.” But I was not in a zen state. You see, not only was I hormonal and dealing with life changes, but I was also reading blogs, forums, websites, and books on pregnancy with diabetes.  Everywhere I turned I read about all the horrible things that can happen if your blood sugar is high, and a high blood sugar seemed to pretty much be anything out of that super tight range for pregnancy.  I seemed to absorb other women's obsession or anxiety over this, as if I didn't have enough of my own. Though my endo’s office had called me back right away with my new blood glucose goals (under 100 before eating, under 120 two hours after), it was the internet that made me scared of higher numbers. Not even counting the occasional and mysterious 200+ number that happened even when I did everything by the book, I felt like a horrible mother who was actively mutating my own baby whenever I decided to indulge in a treat (say, a small ice cream?) and came in somewhere closer to 150 two hours later.

*cue internal freak-out and self-guilt-trip*

But visits to my endocrinologist have put things in perspective every time, so far. Never once has she criticized me, never once has she told me that a number is dangerous, never once did she suggest I need to try harder. No. She even told me the first time I came in with numbers that upset me, “I’m not worried.” She doesn’t worry, she deals. “Numbers like these will happen, but we need to figure out how to keep them from happening too often.” Then we’d discuss a game plan.

Yesterday’s visit with her was fabulous. I handed her a sheet with numbers that were much improved, but definitely not even close to perfect. We were both on the exact same page about how to fix them, and she made some adjustments to my morning basal and evening I:C. She said that I was really doing well overall, and I walked out feeling not like I had failed with those less-than-perfect numbers, but that I had done a great job of improving them and was leaving with a plan to make them even better, maybe even get them in line once and for all… Well, once and until my insulin needs change again! Damn hormones!

A Very Important Cog in a Much More Important Machine

"At some point, you have to stop and say, 'Lord, why?'" said my doctor. "But thank God we found this early. God really did protect you! Most people end up in the ICU for a week!"

There are so many things about these statements that do not ring true and clear for me.

I will absolutely never tell people what's right when it comes to religion, spirituality, and a divine being... except, perhaps, that I do not believe any higher power would approve of hurting others except in self-defense or the defense of those who cannot protect themselves. Beyond that, I only know what feels right and what doesn't... and I don't feel that any one organized religion has it entirely "right."

This makes me a grade A agnostic, and there have been times when I considered myself an atheist. So, I'm no authority on God.

But I don't think I would ever stop and say to God, in whatever form I believe in Him/Her/It, "Why would you let me develop diabetes?" If there's one thing I do believe about divinity, and I do believe there is some kind of divinity, it is that we are all very important cogs in a much more important machine that is the universe. Everything happens because that's the way the universe, and the divinity that made or is a part of this universe, works. That doesn't mean there was a conscious divine plan for me to get diabetes, just that it is one of the tiny little processes that make up this amazingly complex and ever changing universe.

And do not believe that I am so uniquely special that a personal god would protect me with an early diagnosis. Not when there are small and innocent children who develop the same disease and don't know it until their parents have rushed their limp little bodies to the emergency room, racing against time and death. This does not mean I consider myself insignificant to a personal god, but rather that I am no more special to Him than those children.

I do not consider myself cynical in this lack of belief in a personal god who makes things happen in my life or protects me. It doesn't even mean I believe there is no god, or that God must be impersonal if He exists. I believe, rather, that any such god would be an eloquent designer who created the universe (and everything that happens in it) exactly as it must be, and who would see all good people as equally deserving of whatever benevolent intervention He might offer.

But developing a chronic disease that puts me in a much higher risk category for other life-threatening conditions has certainly gotten me thinking about belief. I believe that there is divinity in the universe, though I've leaned away from picturing that divinity as a being... But my sudden sense of mortality made me ask: Is there something there for me after I die? And if I were to pray for help, is there someone to listen? And would that someone actually be willing to consider answering my prayers?

I still haven't learned those answers, or even developed much of an opinion on them... but I am no longer content to not ask them. Perhaps this is one good thing diabetes has given me.

Where the hell am I, and how did I get here from there?!

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.