This week has been really difficult for me. Not only am I constantly thinking about and worrying about my blood sugar, what I’m eating, how much insulin I need, or whether or not I have time to exercise, I’ve also been stressed to the max with my job. And to top it all off, even though I called Dexcom to order more sensors almost a month ago, I finished my last sensor this week and am still waiting for new ones to be delivered. It really feels like everything is going wrong, or that I’m doing everything wrong, and I’m trying really hard not to get discouraged. Running helps, but with work as crazy as it has been, I’m finding it harder to make time for that.
What I really want, and what I truly think I need, is a vacation. A whole week off where I don’t need to think about work, or grocery shopping or cleaning my apartment or counting carbs or remembering to give myself insulin and I can just relax. Preferably on a beach. I’m so lucky to have Sean, because I’d feel twice as overwhelmed if he wasn’t always there to calm me down.
I need to try to stay positive. While that’s easier said than done, I realized today that I can only do my best. I’m not perfect, and even though I might mess up, I know 100% that I’m doing better than I was a year ago. I know that my husband, my parents, my doctors and my friends are proud of my progress and that they’re all behind me while I figure out how to manage everything. I’m not going to see results overnight. Diabetes control doesn’t work like that. I have to make smart and healthy choices to stay ahead and continue to improve.
In the meantime, I’m going to stare at this picture I took from the last time I was in Cancun, almost 5 years ago. I will keep staring at it and imagine I’m still there.
I started my journey at the beginning of this year. My first appointment with my new, fantastic endocrinologist was on January 6th, 2014. I had heard wonderful things about Dr. Peters from other doctors, diabetics and parents of diabetics. So after some online research I prayed that she was still taking on new patients and made an appointment. Just walking into her office made me feel better. It doesn’t feel like a regular waiting room. There’s nothing extraordinarily different about this one. It’s actually smaller than most waiting rooms and has the same pamphlets, generic artwork and family photos you’d see in any doctor’s waiting room, but everybody who works there is just so positive and wonderful I couldn’t help but feel comforted. She has the friendliest nurses and is the nicest, most comforting doctor I have ever met with. As is my nature I completely broke down and just started crying buckets during our initial meeting. She assured me that cases like mine are her specialty and that she will safely bring my numbers down and help me feel better, because after all, that’s why I was there in the first place. I was sick of feeling sick and completely over waking up every morning with my sugars over 400. I was ready for a change.
We’d take baby steps, Dr. Peters told me. The first job I had to master was checking my blood three times a day and giving myself a correction before each meal. I didn’t have to count carbs, I didn’t have to drastically change my diet, I didn’t have to start wearing my Continuous Glucose Monitor, I didn’t even have to lower my basal rate that much……yet. I would be doing all those things soon; however, for the next month my only job was to gather data for Dr. Peters. I haven’t had an actual logbook in at least 10 years, but I was able to use my insulin pump to log my blood sugars that whole month. I felt hopeful and capable of staying on track.
At my next appointment we discovered that my sugars are consistently between 300 and 400, with just correction boluses and a high basal rate. I was frustrated, but I knew it would be a long and difficult journey to see my numbers where I want them to be. I started meeting with Meg, a wonderful and dedicated dietician. Together, we came up with meals and snacks that are not only easy to make, but absolutely delicious. She answered all my texts and emails. How many carbs are in an acai bowl? How nutritious are those diabetic shakes really? How many carbs do I need to eat everyday? Do I need to give myself a full bolus if I eat a meal after I workout? I discovered that avocados are ‘free foods’ and I don’t need to give myself any insulin for them- which is incredible because I could eat them for breakfast, lunch and dinner for the rest of my life. She is teaching me how to calculate the carbs in the foods that I eat, and she is showing me quality foods that don’t leave me feeling guilty for enjoying.
Since then, my blood sugars are consistently hovering between 250 and 350…for now. I’m working really hard to do whatever Dr. Peters and Meg tell me to do. They still shoot up to 400+, but those readings are becoming less common.
A new month brings a sense of new beginnings. A blank slate. I’m going back to the basics and ready to re-learn everything I was taught regarding type 1 diabetes 12 years ago- when I began a lifetime relationship with my Paradigm MiniMed insulin pump. I started using an insulin pump because I had an amazing opportunity to travel to Europe with family friends. But in order to go I had to be comfortable with an insulin pump which would give me more freedom than twice daily insulin injections at 14 years old did. I’ve had the pump for the past 12 years, but once again it seems completely new to me. While I was in control over a decade ago, I have in the last 8 or 9 years become a victim of my pump. All through college and my post grad life I didn’t check my blood as often as a T1D should. In fact there were periods of time that I would go weeks without once pricking my finger. And then I’d feel bad about it and start checking religiously for about a week. I never gave myself meal boluses and relied only on my obscenely high basal rate and occasional correction boluses. I’d run out of insulin in my pump and often go about a day or two before changing it. I forgot how to count carbs. I even forgot what foods to avoid. Instead of gaining the dreaded Freshman 15, I lost about 20 pounds. But I can’t say I’m surprised. After eating pizza, bagels, ice cream and pasta every night in the dining hall for 4 years and not getting any insulin for it, it’s no wonder all my clothes were falling off me and I had to start shopping in the children’s department. I didn’t realize what I was doing and didn’t even recognize the link between my weight loss and state of denial until I read an article about what is commonly known as ‘the black diet’, when diabetics purposely refrain from taking insulin just to lose weight. I don’t think I’ve fully processed that moment. Even after I read that article and realized what I was doing to my body I didn’t change. Sure, there were times I’d vow that I’d check my blood 6 times a day and count all the carbs I ate for each meal and eat healthy, quality foods. And I’d start out living up to the promises I made myself, but like clockwork, within a month I’d fall easily back into my old habits.
I don’t know what’s different now. Maybe it’s because I’m closer to 30 than I am to 20. Maybe it’s because I got married last year and it’s not just about me anymore. Maybe it’s because I’m feeling more like a grown up. Maybe it’s because eventually I want to have kids and I’ve seen Steel Magnolias (spoiler alert….don’t see Steel Magnolias). Maybe it’s because I’ve told myself for years how serious T1D management is and now I’m finally ready to do something about it. Whatever the case, I’m working closely with my fabulous endo who has seen cases like mine hundreds of times and who truly cares about her patients. I’m meeting with her and an amazing dietician who has completely changed my perception of quality diabetic meals once a month and I’m going to do everything I can to take back control. I’ll probably mess up, but this time I won’t let it stop me.