I like to think of myself as intelligent and full of a decent amount of common sense. And while I definitely struggle with stressful situations, I can generally deal with them by making a list and pumping my veins with diet soda. But when I'm high? Uh.... forget all of that.
Today, I did a pump site change around 5:15 PM. It was a bit ouchy, but I wasn't concerned. My blood sugars had been a bit on the low side all day, and my dexcom was reading 135 mg/dl after some ice cream an hour earlier. Unfortunately, those nasty ???'s showed up on the dex around 5:30. Since I'd been pretty steady, I decided to wait about two hours to do a manual blood sugar check post-site change, while waiting for the sensor to get its thinking straight.
So what did I do in those two hours? I was SUPPOSED to be writing a paper. What actually happened was that I did a bit of paper research and watched netflix. This productivity deficit alone should've tipped me off to a funky blood sugar... but alas, it did not. So when a nasty 344 mg/dl showed up on my meter at 7:30, I was moderately surprised. I tried to bolus, and I got a no delivery alarm. I was frustrated about the bad site, but went into my room to pull it and try a new one in my stomach.
I put the site into the inserter, filled the tubing, held it to my stomach, and pressed the white buttons to plunge the needle in. But it only went in about 1/8 a cm! I pulled it out, stopped the resulting bleeding, and called my mom to see if she had any suggestions. She suggested I try again, since the needle didn't appear disturbed, and so I repeated the insertion on the right side of my stomach. Same result! And then I saw it... the white paper that I should've pulled off to reveal the tape... well, it was still there.
DUH! How many site changes have I done in my life? I don't even want to calculate that... but it's been one every 2-3 days for the past 10.5 years of my life. Changing these sites is like brushing my teeth. I know the routine. I could do it in my sleep. But not, apparently, when I'm 344 mg/dl.
My brain was definitely foggy. My mom, bless her, stayed on the phone with me and walked me through the things I should do- leave the pump site alone for a bit, give a shot instead, drink some water, and then try again. But I'm honestly not sure I wouldn't have just kept trying with the paper on the sites had I not been on the phone troubleshooting with her.
I'm lucky to have a support system I can call when diabetes is kicking my ass. I just hate how stupid highs can make me, sometimes!
What stupid things have you done when high that you'd usually have no problems with?
Thursday, April 28, 2011
Wednesday, February 2, 2011
A Response to Recent CWD Forum Discussions...
I have a paper to be writing... but I'm a bit too flustered after reading this thread to think of anything but my feelings about it.
This is a response to this forum:
http://forums.childrenwithdiabetes.com/showthread.php?t=61587
I'm choosing not to post on the site, because I need a place to... vent? Also, my post would be about a day too late- others have already made similar statements, and I don't really want to create drama... I just want to say my piece in a more sheltered environment.
To give this a bit of context, the site CWD (children with diabetes) is a forum site where parents post about their children with diabetes. The current issue was about an interview between diaTribe and Jeffrey Brewer- the new president and CEO of the Juvenile Diabetes Research Foundation. Brewer has a son with type 1. You can read that article here: http://www.diatribe.us/issues/29/diabetes-dialogue.php
Most of the reactions in the thread started off of this quote from Brewer:
"The first very big transition is we’re moving away from the over reliance on the cure as the central part of our message and funding. This does not mean JDRF is any less committed in its focus to find a cure, but we have some work to do in order to get there. And in the meantime, there are many people who will live with diabetes for a relatively long period of time. We have a responsibility and an opportunity to help them live better, healthier, longer, and less stressful lives. And so one of the big changes that we’re undergoing is focusing on improving the lives of people living with diabetes on a day-to-day basis."
Personally, I find this thrilling. Do I want a cure? Of course. Even though it would change very much of my identity and the way I think and organize and execute my life... I still want a cure. I want to live in a world where I don't have to worry about whether or not my blood sugar is high enough for me to walk from the bus stop to my home. I want to live in a world where many of the patients I might see in my future career no longer need a pediatric endocrinologist. I want to sleep through the night. I want to go to the beach without wondering how much sand will inch its way into my two medical devices or the sites where they are attached to my body. I want to be able to live my life in a way that is not at all based around where I'll obtain my health insurance.
But at the same time... I am incredibly strong and driven. And that strength and drive did not arise from an easy life. It arose from a struggle- it arises daily from a struggle. I am intrinsically motivated to work to make my own life easier and to make the lives of children and adolescents with diabetes easier. I would not have that dream if I did not have diabetes- or if I did, it would not be as motivated or powerful. I guarantee it. Challenges bring strength, if you let them. But I CAN NOT execute my dreams if I am unhealthy. I CAN NOT care for others if I, myself, am not taken care of. And that's why I love the idea of researchers working to make my life better NOW. Because what I'm doing now? Well... it's important. It's good. And because there is no cure now- and because I'm adult enough to know that when the time comes, I want to be healthy enough to actually benefit from one- I KNOW that I need to praise anyone who supports my LIFE WITH DIABETES. Because for now, that's what my life is. And it's a wonderful life! It has value. It has purpose.
I am not a parent. I hope that I will be one day, but right now, I am not. It is ignorant for me to suggest that I can understand the emotions involved in caring for my own child when they suffer from a disease like type 1 diabetes. But I've been the child. And here is my response:
I know it must be hard for a mother to give her child shots when the child doesn't want to get them. I know it must be hard for a dad to force his son to drink juice when he just finished off his dinner. I know it must be hard to sleep too little, worry too much, and feel like you have no outlet for the stress this difficult life brings. I know this because I've watched my mom and dad do it. I've seen them upset when I've suffered. And because of that... I understand the outrage of the parents in the forum. That forum is their release. That forum is their place to vent. But here is what they need to remember: that forum is online. It is accessible. And it is not, under any circumstance, a place for hatred, name calling, or uninformed posting. Why? Because it is probably read by others- people without a diabetic child who stumble upon it and are curious. And do you know what those people see? Rudeness. They don't understand the frustration, because they haven't felt it first hand. And who wants to give to a cause of rude people? Very few. So... remember that the internet is public, my friends. Post wisely. Post kindly. Post smart.
Back to a point that got lost... I've been the child. Now, I am an adult. Now, I am the one who gives myself shots, even though it hurts- and even though I can choose not to, because who is forcing me? I still do it, because I am strong. Now, I am the one who forces juice down my throat when I feel like another swallow will cause me to lose it. I inflict these things on myself. It is not easy. It hurts. IT SUCKS. But I do it. Because I am strong. I do not mean to say that I don't have others supporting me- I do. But at the end of the day, it is me against this disease. Because I'm not under constant supervision. I have to be self-sufficient. I change the sites, even when I'm scared. I push in the huge CGM needle, even when I know it hurts sometimes. I push the buttons on my pump site inserter, even though I'm all too familiar with the stinging burn that comes afterwards all too often. Now, I feel the low and treat it, even though my head is swimming, my limbs feel like they can't be lifted, and I'm not sure I can get myself from my couch to the juice in the fridge. I feel the high and treat it, even though my brain is fuzzy and my mouth feels like cotton. I do all of this while living a wildly successful life. But I do it. And I will be the one doing it until there is a cure.
...I am strong. Not because I want to be- not because I'm a hero. But because this is my life. So excuse me, for asking for anything and everything to make it easier while I wait for a cure. And excuse me, for feeling desperate for support from an organization like JDRF. Kids grow up. I grew up. And I still have diabetes. And I still need as much help and encouragement and HOPE as I can get. PLEASE REMEMBER THIS!!!!!!! At the end of the day, it is the diabetic that deals with the disease for life. (I do not mean this disrespectfully at all- I mean it honestly. My parents are great- and they took wonderful care of me. But I need a life of my own, apart from them, and that means self-management. And this is the reality that will fall onto all of the children whose parents are posting on the CWD forums.)
And... that's all I have to say.
This is a response to this forum:
http://forums.childrenwithdiabetes.com/showthread.php?t=61587
I'm choosing not to post on the site, because I need a place to... vent? Also, my post would be about a day too late- others have already made similar statements, and I don't really want to create drama... I just want to say my piece in a more sheltered environment.
To give this a bit of context, the site CWD (children with diabetes) is a forum site where parents post about their children with diabetes. The current issue was about an interview between diaTribe and Jeffrey Brewer- the new president and CEO of the Juvenile Diabetes Research Foundation. Brewer has a son with type 1. You can read that article here: http://www.diatribe.us/issues/29/diabetes-dialogue.php
Most of the reactions in the thread started off of this quote from Brewer:
"The first very big transition is we’re moving away from the over reliance on the cure as the central part of our message and funding. This does not mean JDRF is any less committed in its focus to find a cure, but we have some work to do in order to get there. And in the meantime, there are many people who will live with diabetes for a relatively long period of time. We have a responsibility and an opportunity to help them live better, healthier, longer, and less stressful lives. And so one of the big changes that we’re undergoing is focusing on improving the lives of people living with diabetes on a day-to-day basis."
Personally, I find this thrilling. Do I want a cure? Of course. Even though it would change very much of my identity and the way I think and organize and execute my life... I still want a cure. I want to live in a world where I don't have to worry about whether or not my blood sugar is high enough for me to walk from the bus stop to my home. I want to live in a world where many of the patients I might see in my future career no longer need a pediatric endocrinologist. I want to sleep through the night. I want to go to the beach without wondering how much sand will inch its way into my two medical devices or the sites where they are attached to my body. I want to be able to live my life in a way that is not at all based around where I'll obtain my health insurance.
But at the same time... I am incredibly strong and driven. And that strength and drive did not arise from an easy life. It arose from a struggle- it arises daily from a struggle. I am intrinsically motivated to work to make my own life easier and to make the lives of children and adolescents with diabetes easier. I would not have that dream if I did not have diabetes- or if I did, it would not be as motivated or powerful. I guarantee it. Challenges bring strength, if you let them. But I CAN NOT execute my dreams if I am unhealthy. I CAN NOT care for others if I, myself, am not taken care of. And that's why I love the idea of researchers working to make my life better NOW. Because what I'm doing now? Well... it's important. It's good. And because there is no cure now- and because I'm adult enough to know that when the time comes, I want to be healthy enough to actually benefit from one- I KNOW that I need to praise anyone who supports my LIFE WITH DIABETES. Because for now, that's what my life is. And it's a wonderful life! It has value. It has purpose.
I am not a parent. I hope that I will be one day, but right now, I am not. It is ignorant for me to suggest that I can understand the emotions involved in caring for my own child when they suffer from a disease like type 1 diabetes. But I've been the child. And here is my response:
I know it must be hard for a mother to give her child shots when the child doesn't want to get them. I know it must be hard for a dad to force his son to drink juice when he just finished off his dinner. I know it must be hard to sleep too little, worry too much, and feel like you have no outlet for the stress this difficult life brings. I know this because I've watched my mom and dad do it. I've seen them upset when I've suffered. And because of that... I understand the outrage of the parents in the forum. That forum is their release. That forum is their place to vent. But here is what they need to remember: that forum is online. It is accessible. And it is not, under any circumstance, a place for hatred, name calling, or uninformed posting. Why? Because it is probably read by others- people without a diabetic child who stumble upon it and are curious. And do you know what those people see? Rudeness. They don't understand the frustration, because they haven't felt it first hand. And who wants to give to a cause of rude people? Very few. So... remember that the internet is public, my friends. Post wisely. Post kindly. Post smart.
Back to a point that got lost... I've been the child. Now, I am an adult. Now, I am the one who gives myself shots, even though it hurts- and even though I can choose not to, because who is forcing me? I still do it, because I am strong. Now, I am the one who forces juice down my throat when I feel like another swallow will cause me to lose it. I inflict these things on myself. It is not easy. It hurts. IT SUCKS. But I do it. Because I am strong. I do not mean to say that I don't have others supporting me- I do. But at the end of the day, it is me against this disease. Because I'm not under constant supervision. I have to be self-sufficient. I change the sites, even when I'm scared. I push in the huge CGM needle, even when I know it hurts sometimes. I push the buttons on my pump site inserter, even though I'm all too familiar with the stinging burn that comes afterwards all too often. Now, I feel the low and treat it, even though my head is swimming, my limbs feel like they can't be lifted, and I'm not sure I can get myself from my couch to the juice in the fridge. I feel the high and treat it, even though my brain is fuzzy and my mouth feels like cotton. I do all of this while living a wildly successful life. But I do it. And I will be the one doing it until there is a cure.
...I am strong. Not because I want to be- not because I'm a hero. But because this is my life. So excuse me, for asking for anything and everything to make it easier while I wait for a cure. And excuse me, for feeling desperate for support from an organization like JDRF. Kids grow up. I grew up. And I still have diabetes. And I still need as much help and encouragement and HOPE as I can get. PLEASE REMEMBER THIS!!!!!!! At the end of the day, it is the diabetic that deals with the disease for life. (I do not mean this disrespectfully at all- I mean it honestly. My parents are great- and they took wonderful care of me. But I need a life of my own, apart from them, and that means self-management. And this is the reality that will fall onto all of the children whose parents are posting on the CWD forums.)
And... that's all I have to say.
Tuesday, January 18, 2011
Time for a vacation...
I have worn an insulin pump for every single day of my life since the fall of 2000, aside from one unfortunate 20 hour period in the spring of 2009, when my pump stopped functioning out of the blue (I also had no long-lasting insulin or doctors to write my long-lasting insulin prescriptions and suggest reasonable dosages... major planning fail on my part. I ended up giving myself hourly shots of humalog, and it was not a fun day.) and I had to wait for a replacement to land on my doorstep.
When I started pumping, it was life-altering. For the first nine months of living with diabetes, I had been restrained. Restrained because I needed to eat on a schedule. Restrained because I needed to take my shots (let's be honest... be given shots) on a schedule. Restrained because that meant that my mom or dad was always close by. Insulin wasn't nearly as user friendly, and my blood sugars were pretty erratic. It was hard. I started pumping in the sixth grade, just in time to go on my middle school's sixth grade trip to Land Between the Lakes. Had it not been for pumping, I'm not sure I would've been able to attend. The LBL trip was thrilling: for the first time since my diagnosis, I was kind of on my own. With the supervision of my teachers, I got to sleep over with all of my friends at the LBL cabins for two nights, go canoeing, listen to scary stories, and learn forest survival skills... it was my dream come true. And it was all because of pumping. If I'd been on shots- dependent on my mom or dad to hook me up with some insulin every few hours- I wouldn't have been able to do it. And if I had, it wouldn't have been the same. But the pump let me go. And for that...well, I have always loved the pump.
As I've grown up, the pump and I have also had our issues. I was allergic to the tape/adhesive used on/with Minimed softsets, which left my skin itching like mad, peeling off, and oozing strange fluids (I know that's gross, sorry) (luckily the quickset now offers different tape- hoorah!). I had a lot of pain with the softsets as well, leaving me incredibly anxious about site changes. I've had sites that, upon removing because of blood in the tubing, spewed blood all over the place. My pumping experience has been, as all of yours probably also has been, flawed. But... I've still kept pumping. Even in my worst hours of D-management, the pump has remained attached to me.
The past few weeks, I've been having some dry-skin issues. Because I'm also wearing the dexcom now, I've got a lot less "real estate" for pumping (and I don't have a lot to begin with, because my torso is incredibly short). Even my trusty butt sites (TMI... but it's true, they are trusty and on my butt) have been bugging me. My sites aren't infected, but when I remove them, I'm really struggling with the skin around them being dry. And that makes putting in new sites really hard, uncomfortable, itchy, etc.
I think my body is tired. I've been on this pump-road for over ten years. I estimate that I've done about 1,460 sites in that amount of time (one for every 2.5 ish days, to account for sites that lasted less than their full 3). That is a lot. I love pumping, I really do. From the very beginning, it has given me flexibility and freedom. It has given me options.
However... I need a break. It is time for a vacation! I have never truly considered stopping pumping for a bit until today. I was talking to Kyle about rafting over diet cokes at a restaurant, and I immediately told him that I didn't think I'd want to do something like that- because I wouldn't want to risk something weird happening with the pump. I realize that it is waterproof to a point, but still. What if the tubing got caught on a branch and the pump soared through the air into oblivion? I could have much more fun and much more peace of mind going shopping, thank you very much. (And no, I don't need a lecture on how I can do anything with diabetes... this is just my personal preference... and my fear of rapid waters my also be an influencing factor here.) But still... the story got me thinking. Could I take a break? Why not? I used to be afraid of MDI, because doctors told me that I would have less tight "control." But I'm sorry... control is mostly about effort. And I'm all about effort these days. Plus, I've heard plenty of pump vacay success stories here on the DOC.
I'm looking forward to calling my doctor tomorrow and setting up an appointment with a CDE to get re-affiliated with MDI. I have never taken a super long lasting insulin like Lantus or Levemir, and quite frankly, I am curious to experience one. With the dexcom, which I plan to stay attached to, I am not afraid at all of this little experiment. I also want to have MDI skillz and resources, so that in the case of another pump failure, I am not left to my own devices, injecting Humalog every hour like a mad woman.
I'm really excited about a pump break, and I'm really excited to be "unattached" for a bit. The idea feels liberating... exciting! I know that some of you have taken pump breaks recently, so help me out! Any tips? Anything I should watch for?
And as a side note... I suck at blogging regularly. As much as I wish I could dedicate myself to doing it on a consistent basis, it just isn't a priority. Moreover, I don't want to blog about nothing. But, while my motivation to blog may be less than frequent, that doesn't mean I'm not still lurking and thinking about life with type 1 diabetes!
When I started pumping, it was life-altering. For the first nine months of living with diabetes, I had been restrained. Restrained because I needed to eat on a schedule. Restrained because I needed to take my shots (let's be honest... be given shots) on a schedule. Restrained because that meant that my mom or dad was always close by. Insulin wasn't nearly as user friendly, and my blood sugars were pretty erratic. It was hard. I started pumping in the sixth grade, just in time to go on my middle school's sixth grade trip to Land Between the Lakes. Had it not been for pumping, I'm not sure I would've been able to attend. The LBL trip was thrilling: for the first time since my diagnosis, I was kind of on my own. With the supervision of my teachers, I got to sleep over with all of my friends at the LBL cabins for two nights, go canoeing, listen to scary stories, and learn forest survival skills... it was my dream come true. And it was all because of pumping. If I'd been on shots- dependent on my mom or dad to hook me up with some insulin every few hours- I wouldn't have been able to do it. And if I had, it wouldn't have been the same. But the pump let me go. And for that...well, I have always loved the pump.
As I've grown up, the pump and I have also had our issues. I was allergic to the tape/adhesive used on/with Minimed softsets, which left my skin itching like mad, peeling off, and oozing strange fluids (I know that's gross, sorry) (luckily the quickset now offers different tape- hoorah!). I had a lot of pain with the softsets as well, leaving me incredibly anxious about site changes. I've had sites that, upon removing because of blood in the tubing, spewed blood all over the place. My pumping experience has been, as all of yours probably also has been, flawed. But... I've still kept pumping. Even in my worst hours of D-management, the pump has remained attached to me.
The past few weeks, I've been having some dry-skin issues. Because I'm also wearing the dexcom now, I've got a lot less "real estate" for pumping (and I don't have a lot to begin with, because my torso is incredibly short). Even my trusty butt sites (TMI... but it's true, they are trusty and on my butt) have been bugging me. My sites aren't infected, but when I remove them, I'm really struggling with the skin around them being dry. And that makes putting in new sites really hard, uncomfortable, itchy, etc.
I think my body is tired. I've been on this pump-road for over ten years. I estimate that I've done about 1,460 sites in that amount of time (one for every 2.5 ish days, to account for sites that lasted less than their full 3). That is a lot. I love pumping, I really do. From the very beginning, it has given me flexibility and freedom. It has given me options.
However... I need a break. It is time for a vacation! I have never truly considered stopping pumping for a bit until today. I was talking to Kyle about rafting over diet cokes at a restaurant, and I immediately told him that I didn't think I'd want to do something like that- because I wouldn't want to risk something weird happening with the pump. I realize that it is waterproof to a point, but still. What if the tubing got caught on a branch and the pump soared through the air into oblivion? I could have much more fun and much more peace of mind going shopping, thank you very much. (And no, I don't need a lecture on how I can do anything with diabetes... this is just my personal preference... and my fear of rapid waters my also be an influencing factor here.) But still... the story got me thinking. Could I take a break? Why not? I used to be afraid of MDI, because doctors told me that I would have less tight "control." But I'm sorry... control is mostly about effort. And I'm all about effort these days. Plus, I've heard plenty of pump vacay success stories here on the DOC.
I'm looking forward to calling my doctor tomorrow and setting up an appointment with a CDE to get re-affiliated with MDI. I have never taken a super long lasting insulin like Lantus or Levemir, and quite frankly, I am curious to experience one. With the dexcom, which I plan to stay attached to, I am not afraid at all of this little experiment. I also want to have MDI skillz and resources, so that in the case of another pump failure, I am not left to my own devices, injecting Humalog every hour like a mad woman.
I'm really excited about a pump break, and I'm really excited to be "unattached" for a bit. The idea feels liberating... exciting! I know that some of you have taken pump breaks recently, so help me out! Any tips? Anything I should watch for?
And as a side note... I suck at blogging regularly. As much as I wish I could dedicate myself to doing it on a consistent basis, it just isn't a priority. Moreover, I don't want to blog about nothing. But, while my motivation to blog may be less than frequent, that doesn't mean I'm not still lurking and thinking about life with type 1 diabetes!
Tuesday, December 7, 2010
BURNOUT
You know what I'm talking about.
It's the sinking feeling that we all get every once and awhile (and always more often that we'd like) when we realize that we haven't been making our best effort. We've become accustomed to post-prandials in the 250's for a few weeks, and now we're shrugging them off. We've started relying on our ability to "feel" our blood sugars, or we've stopped actually checking bg's aside from when the CGMS attached to our hip DEMANDS a real blood sugar. Maybe it is worse (thank God it is not this time). Maybe we've stopped checking all together for a bit. Maybe we've become beaten down by everything else that life has thrown at us, and we've just forgotten to pay attention to this disease. Of course, the other side of this is that we probably think we'll be fine, regardless of our minimal efforts lately. Because this is OUR disease. Because we know our bodies. Because we always are. Ahhh burnout. If you don't believe it is a side effect of diabetes, you're wrong. If you pretend you haven't felt it, you are lucky. And if you're dealing with it right now, oh buddy, I am with you!
It is dead week here at Indiana University. Finals are next week (officially... most of mine are this week, which is weird). I've spent the last few weeks absolutely swamped with STUFF to do. Tests, papers, lab reports, assignments, and then there's that thing where you actually have to physically get out of bed and GO to class...
All of my friends are feeling school burnout. I just. don't. care. about. this. semester. anymore. I am a senior, I'm inches away from graduating, and I'm already accepted into medical school. I'm set! It is a wonderful feeling. But, it also makes me want to curl up on my couch with my house-mates, bake Christmas cookies, watch movies, cross-stitch dish towels... basically, I want to do anything but school work. And also, apparently, anything but micromanage my diabetes. I'm still checking, carb-counting, etc... but I'm not micromanaging. I'm not spending time every night thinking about what I can do differently tomorrow to be more successful. And I should be! I KNOW that micromanaging is how I deal successfully with diabetes. I know that when I make time for it in my day... everything else still gets done and falls into place.
But... (there is always a but!) when I'm busy, I feel like I don't have time to micromanage my life... let alone a disease that requires a significant amount of brain power each day. No! I can't devote that brain power to diabetes! I need it for my microbiology final tomorrow night! I need it for my inorganic chemistry quiz this afternoon! All of the work piles up... and all I want to do is ABSOLUTELY NOTHING!!!! This is true for school sometimes, and it is true for diabetes sometimes... and it is BAD.
I realize that I'm burnt out. I realize that I'm slacking off. And now I'm ready to jump back on top of my diabetes. The semester is winding down, and it's time to refocus my attention where it really needs to be so that I am successful. I know that my level of awesome-ness is high enough to do great things professionally ... and in school ... and in my social life, and relationship life, and family life... AND do great things with my health at the same time. It's just about re-finding that balance.
So... stay tuned. I am going to try to post more (because when I'm blogging about diabetes, I'm thinking about diabetes!) and tweet more. And I'm going to flatten out my less than attractive Dexcom graphs before I lose my motivation. Ready, go!
It's the sinking feeling that we all get every once and awhile (and always more often that we'd like) when we realize that we haven't been making our best effort. We've become accustomed to post-prandials in the 250's for a few weeks, and now we're shrugging them off. We've started relying on our ability to "feel" our blood sugars, or we've stopped actually checking bg's aside from when the CGMS attached to our hip DEMANDS a real blood sugar. Maybe it is worse (thank God it is not this time). Maybe we've stopped checking all together for a bit. Maybe we've become beaten down by everything else that life has thrown at us, and we've just forgotten to pay attention to this disease. Of course, the other side of this is that we probably think we'll be fine, regardless of our minimal efforts lately. Because this is OUR disease. Because we know our bodies. Because we always are. Ahhh burnout. If you don't believe it is a side effect of diabetes, you're wrong. If you pretend you haven't felt it, you are lucky. And if you're dealing with it right now, oh buddy, I am with you!
It is dead week here at Indiana University. Finals are next week (officially... most of mine are this week, which is weird). I've spent the last few weeks absolutely swamped with STUFF to do. Tests, papers, lab reports, assignments, and then there's that thing where you actually have to physically get out of bed and GO to class...
All of my friends are feeling school burnout. I just. don't. care. about. this. semester. anymore. I am a senior, I'm inches away from graduating, and I'm already accepted into medical school. I'm set! It is a wonderful feeling. But, it also makes me want to curl up on my couch with my house-mates, bake Christmas cookies, watch movies, cross-stitch dish towels... basically, I want to do anything but school work. And also, apparently, anything but micromanage my diabetes. I'm still checking, carb-counting, etc... but I'm not micromanaging. I'm not spending time every night thinking about what I can do differently tomorrow to be more successful. And I should be! I KNOW that micromanaging is how I deal successfully with diabetes. I know that when I make time for it in my day... everything else still gets done and falls into place.
But... (there is always a but!) when I'm busy, I feel like I don't have time to micromanage my life... let alone a disease that requires a significant amount of brain power each day. No! I can't devote that brain power to diabetes! I need it for my microbiology final tomorrow night! I need it for my inorganic chemistry quiz this afternoon! All of the work piles up... and all I want to do is ABSOLUTELY NOTHING!!!! This is true for school sometimes, and it is true for diabetes sometimes... and it is BAD.
I realize that I'm burnt out. I realize that I'm slacking off. And now I'm ready to jump back on top of my diabetes. The semester is winding down, and it's time to refocus my attention where it really needs to be so that I am successful. I know that my level of awesome-ness is high enough to do great things professionally ... and in school ... and in my social life, and relationship life, and family life... AND do great things with my health at the same time. It's just about re-finding that balance.
So... stay tuned. I am going to try to post more (because when I'm blogging about diabetes, I'm thinking about diabetes!) and tweet more. And I'm going to flatten out my less than attractive Dexcom graphs before I lose my motivation. Ready, go!
Monday, November 29, 2010
Civil War? Why not make it a Revolution.
I've been watching responses to the Chicago Tribune's Diabetes Civil War Post pop up for a few days.
If you haven't read the article yet, you should. Just google it (I tried to post a link, but it is not showing up). I think it reflects a lot of different viewpoints about the "types" of diabetes and the appropriateness of the names of our disorders. It also exhibits a display of incredibly inappropriate disrespect... and it makes me sad to think that a fellow Type 1 would so openly say inconsiderate things about individuals with Type 2 on a diabetes support site.
I have a few thoughts about the article:
Types of Diabetes have received their names because of their similar symptoms. Diabetes mellitus originates from words meaning "honey siphon," essentially explaining that the body was siphoning out sugar through the urine. It was coined long ago, before we understood the intricacies of the disease- that there were different causes for the symptoms of thirst, excessive urination, and wasting away that had historically been associated with this type of illness. It made sense. Consider, even, the condition Diabetes Insipidus. Ever heard of that? Probably not, because it has little to do with our disease. The symptoms of the disease include excessive thirst and the excretion of large amounts of urine. But, it has nothing to do with insulin or the pancreas. It has to do with a deficiency in arginine vasopressin, or antidiuretic hormone. Similar symptoms. Entirely different disease.
I'm not sure it is fair to say that T1 and T2 D are quite so different. Similar symptoms? Yes. Different causes? Yes. Somewhat different routes of treatment? Yes. But... same general concept (blood glucose levels are out of range, because something in the body is dysfunctional).
I guess I'm trying to say that, historically, I totally get why these diseases were both named diabetes.
With that said, it is essential (both for the health and sanity of PWD and the ability of both types to get much needed funding for a cure) that those in power understand the basic differences between the two.
I also want to say this: from a research prospective, I can understand why there is a slightly larger focus on T2. (I should preface this by saying that yes, I find this disheartening, but that as a science-y gal, I get it.) Type 2 research has a lot to do with receptors. Those receptors don't necessarily want to let insulin do it's thing... but in most cases, they still exist. Type 1 research (and I mean research for a cure at the cellular level- none of this artificial pancreas business) is looking at an entirely different beast: regeneration of cells that have been destroyed. Which one sounds more daunting to you? I think that the community needs to realize that this is possibly one of the reasons that there is more research on Type 2. Is that a good thing? No. But it is a fact. Plus, I think it is reasonable to suggest that much of the research being done on Type 2 may lead to a greater understanding of Type 1. The system being analyzed is still glucose regulation... so it is plausible that insights from research geared towards Type 2 could still greatly benefit Type 1 in the long run. The reverse could definitely be true as well (T1 research granting a greater understanding to T2 research), but in all honesty, I don't see where this funding will come from, because...
I also get it from a public health prospective. There are way more people with Type 2 diabetes than with Type 1. It may not be fair, but it is definitely logical that a community should direct research towards diseases that have an impact on the largest percentage of individuals. And until we are willing to put pictures of kids with Type 1 suffering on commercials like St. Jude does with cancer patients... well, I don't see much of an option for getting extraneous funding from the general public for care and research. PWD and parents of PWD have an incredible amount of dignity when it comes to this disease. That is something that I respect.
As the minority, it is rational for Type 1's to be outraged. I routinely am. I want a cure, at the cellular level, desperately. I want a life without attachments to devices, without food requirements, without daily needs that I can't always meet for myself. I want to die of something other than complications from this disease. I want to be able to schedule my life around what I want, instead of when it is smartest to leave my parents' insurance plan. Of course I want those things. But at the end of the day... I get it. A name change may seem like a good change, but I also think it will be a confusing change. If we change the name of type 1, what will that mean for well-recognized organizations like JDRF and the ADA? Won't that hurt funding opportunities? Perhaps most selfishly, diabetes is a core part of my identity (by my choice). It is the explanation for much of what I do... and hope for... and work towards each day! Losing that identity, or changing it, seems like a confusing thing. Like a name change. Like a lost identity.
I respect the opinions in this article. I understand the outrage. I get the logic behind a name change. But at the end of the day, I don't really see the point. If awareness of T2 raises awareness about diabetes in general (which it does, since the vast majority of the public doesn't understand the difference between the two)... is being occasionally confused with the connotations of T2 (as correct or incorrect as they may be) truly a terrible thing? This Type 1 diabetic is unconvinced. I'd rather see a focus on respect and education about the differences, an elimination of terms like "bad type," and the realization that any research on diabetes is potentially helpful for both types... because they are, while intrinsically different, still quite related.
I'd rather see a Revolution than a Civil War... one of education and understanding, instead of a name change that could potentially lead to less funding and awareness in the long run.
If you haven't read the article yet, you should. Just google it (I tried to post a link, but it is not showing up). I think it reflects a lot of different viewpoints about the "types" of diabetes and the appropriateness of the names of our disorders. It also exhibits a display of incredibly inappropriate disrespect... and it makes me sad to think that a fellow Type 1 would so openly say inconsiderate things about individuals with Type 2 on a diabetes support site.
I have a few thoughts about the article:
Types of Diabetes have received their names because of their similar symptoms. Diabetes mellitus originates from words meaning "honey siphon," essentially explaining that the body was siphoning out sugar through the urine. It was coined long ago, before we understood the intricacies of the disease- that there were different causes for the symptoms of thirst, excessive urination, and wasting away that had historically been associated with this type of illness. It made sense. Consider, even, the condition Diabetes Insipidus. Ever heard of that? Probably not, because it has little to do with our disease. The symptoms of the disease include excessive thirst and the excretion of large amounts of urine. But, it has nothing to do with insulin or the pancreas. It has to do with a deficiency in arginine vasopressin, or antidiuretic hormone. Similar symptoms. Entirely different disease.
I'm not sure it is fair to say that T1 and T2 D are quite so different. Similar symptoms? Yes. Different causes? Yes. Somewhat different routes of treatment? Yes. But... same general concept (blood glucose levels are out of range, because something in the body is dysfunctional).
I guess I'm trying to say that, historically, I totally get why these diseases were both named diabetes.
With that said, it is essential (both for the health and sanity of PWD and the ability of both types to get much needed funding for a cure) that those in power understand the basic differences between the two.
I also want to say this: from a research prospective, I can understand why there is a slightly larger focus on T2. (I should preface this by saying that yes, I find this disheartening, but that as a science-y gal, I get it.) Type 2 research has a lot to do with receptors. Those receptors don't necessarily want to let insulin do it's thing... but in most cases, they still exist. Type 1 research (and I mean research for a cure at the cellular level- none of this artificial pancreas business) is looking at an entirely different beast: regeneration of cells that have been destroyed. Which one sounds more daunting to you? I think that the community needs to realize that this is possibly one of the reasons that there is more research on Type 2. Is that a good thing? No. But it is a fact. Plus, I think it is reasonable to suggest that much of the research being done on Type 2 may lead to a greater understanding of Type 1. The system being analyzed is still glucose regulation... so it is plausible that insights from research geared towards Type 2 could still greatly benefit Type 1 in the long run. The reverse could definitely be true as well (T1 research granting a greater understanding to T2 research), but in all honesty, I don't see where this funding will come from, because...
I also get it from a public health prospective. There are way more people with Type 2 diabetes than with Type 1. It may not be fair, but it is definitely logical that a community should direct research towards diseases that have an impact on the largest percentage of individuals. And until we are willing to put pictures of kids with Type 1 suffering on commercials like St. Jude does with cancer patients... well, I don't see much of an option for getting extraneous funding from the general public for care and research. PWD and parents of PWD have an incredible amount of dignity when it comes to this disease. That is something that I respect.
As the minority, it is rational for Type 1's to be outraged. I routinely am. I want a cure, at the cellular level, desperately. I want a life without attachments to devices, without food requirements, without daily needs that I can't always meet for myself. I want to die of something other than complications from this disease. I want to be able to schedule my life around what I want, instead of when it is smartest to leave my parents' insurance plan. Of course I want those things. But at the end of the day... I get it. A name change may seem like a good change, but I also think it will be a confusing change. If we change the name of type 1, what will that mean for well-recognized organizations like JDRF and the ADA? Won't that hurt funding opportunities? Perhaps most selfishly, diabetes is a core part of my identity (by my choice). It is the explanation for much of what I do... and hope for... and work towards each day! Losing that identity, or changing it, seems like a confusing thing. Like a name change. Like a lost identity.
I respect the opinions in this article. I understand the outrage. I get the logic behind a name change. But at the end of the day, I don't really see the point. If awareness of T2 raises awareness about diabetes in general (which it does, since the vast majority of the public doesn't understand the difference between the two)... is being occasionally confused with the connotations of T2 (as correct or incorrect as they may be) truly a terrible thing? This Type 1 diabetic is unconvinced. I'd rather see a focus on respect and education about the differences, an elimination of terms like "bad type," and the realization that any research on diabetes is potentially helpful for both types... because they are, while intrinsically different, still quite related.
I'd rather see a Revolution than a Civil War... one of education and understanding, instead of a name change that could potentially lead to less funding and awareness in the long run.
Monday, November 15, 2010
Learning about the Pancreas: Part II
It is one thing for the average individual to be confused about the intricacies of diabetes.
It is another thing for the President to release a statement saying that Type 1 must be controlled by "insulin or other medications."
But you'd think an endocrinology professor would get it right.
Today we covered that diabetes slide. We talked about how type 2 was on the rise. We talked about what each type meant (kind of). And we talked about treatment for type 1 (no touch on type 2 treatment, though, which I also found strange). Apparently, "insulin or other medications" must be used to deal with type 1. What does that mean? Why is that "or" there??!?!?!
You'd better believe that three diabetics in the front row were making some awesome "WTF?!?!" faces. We kept our mouths shut for the most part, because he'd said he didn't want to go into much detail... and because at the end of the day, I want an A in this class. As much as I believe in D-Awareness, I also know that professor's don't like being called out. And I realize that doing so can affect my relationship with him... and whether or not my potentially A- grade gets bumped to an A... and that's not a grade boost I'm in the mood to compromise.
I'll be sending him a respectful email after the semester ends with suggestions on how to improve this segment of the course, though.
I really did expect more...
It is another thing for the President to release a statement saying that Type 1 must be controlled by "insulin or other medications."
But you'd think an endocrinology professor would get it right.
Today we covered that diabetes slide. We talked about how type 2 was on the rise. We talked about what each type meant (kind of). And we talked about treatment for type 1 (no touch on type 2 treatment, though, which I also found strange). Apparently, "insulin or other medications" must be used to deal with type 1. What does that mean? Why is that "or" there??!?!?!
You'd better believe that three diabetics in the front row were making some awesome "WTF?!?!" faces. We kept our mouths shut for the most part, because he'd said he didn't want to go into much detail... and because at the end of the day, I want an A in this class. As much as I believe in D-Awareness, I also know that professor's don't like being called out. And I realize that doing so can affect my relationship with him... and whether or not my potentially A- grade gets bumped to an A... and that's not a grade boost I'm in the mood to compromise.
I'll be sending him a respectful email after the semester ends with suggestions on how to improve this segment of the course, though.
I really did expect more...
Sunday, November 14, 2010
World Diabetes Day
Today is World Diabetes Day!
The purpose of this day is to spread awareness and support for diabetes throughout the world. This is no easy task, but the Diabetes Community has done amazing things this month, and I am hopeful that we have made a difference.
I am so grateful for the awareness that has been spread already, and I am filled with hope that this awareness will lead to understanding and better care for those fighting with diabetes every single day.
If you are reading and you are not diabetic yourself, this is what I want you to remember today. Yes, today is World Diabetes Day. Today is the day that you pay attention to my disease. But I pay attention every day, every hour, and every minute. I check my blood sugar 7-15 times a day, depending on how things are going. I wear a pump and CGM at all times, and I change those sites every 3 and 7 days respectively (or more when they stop functioning ahead of time). I count carbs every time I consider eating a snack or a meal. I think about fiber, protein, sugar, and fat content. I do the math for the insulin I need when I am high or hungry- and I'm not even going to begin to discuss the complexities of this. It is not a simple ratio. I do the math for the carbs I need when I am low. I make sacrifices for my health daily. I make an extraordinary effort daily- not just today.
But today, it is your turn to pay attention. Hold your diabetic friends tightly today. Tell them that you are proud. Because their work to survive is extraordinary- not just today, but every day.
The purpose of this day is to spread awareness and support for diabetes throughout the world. This is no easy task, but the Diabetes Community has done amazing things this month, and I am hopeful that we have made a difference.
I am so grateful for the awareness that has been spread already, and I am filled with hope that this awareness will lead to understanding and better care for those fighting with diabetes every single day.
If you are reading and you are not diabetic yourself, this is what I want you to remember today. Yes, today is World Diabetes Day. Today is the day that you pay attention to my disease. But I pay attention every day, every hour, and every minute. I check my blood sugar 7-15 times a day, depending on how things are going. I wear a pump and CGM at all times, and I change those sites every 3 and 7 days respectively (or more when they stop functioning ahead of time). I count carbs every time I consider eating a snack or a meal. I think about fiber, protein, sugar, and fat content. I do the math for the insulin I need when I am high or hungry- and I'm not even going to begin to discuss the complexities of this. It is not a simple ratio. I do the math for the carbs I need when I am low. I make sacrifices for my health daily. I make an extraordinary effort daily- not just today.
But today, it is your turn to pay attention. Hold your diabetic friends tightly today. Tell them that you are proud. Because their work to survive is extraordinary- not just today, but every day.
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