Thursday, May 18, 2017

What Brings Me Down: None and All of It

Most days if someone would ask me how I feel about diabetes, I would say it’s fine, no big deal.  Everyone is dealing with something, and diabetes happens to be where my goat is tied.

But some days it is too much.  The nonstop worry, guilt, stress, fear, and questioning overwhelm you.  You need a break that will never come.  You feel inadequate and unable to master this disease and thus your own fate.  You wish you were cursed with anything else but this.

A few years ago I sat in on a workshop about de-escalation and learned one of the basics was to acknowledge what the person in crisis was feeling.  It makes total sense.

Unfortunately as diabetics we deny ourselves this all the time—the acknowledgement that it is a lot to handle.  It isn’t cancer, it isn’t a terminal diagnosis, and it’s manageable.  We want to minimize the stress and fretting of our loved ones, so we carry on and try to normalize it.  At least I do.  I don’t want to bring anyone down, as if my vulnerability is their burden.

But living with this condition is significant.  It’s always there.  It dominates my thoughts around every meal and every workout and every drive and every date and every time out with friends. 

It’s hard, and we should give each other that much.  Which is why I really appreciate Thursday’s topic and posts relating to Mental Health Month and coping.

On the worst days, some of the things that bring me down are thoughts (if irrational) like this:
  •         Having to deal with this when none of my friends do is the worst thing in the entire world
  •        I am alone and no one understands
  •        I am failing at BS control, and the resulting complications and/or death will be my fault
  •         Diabetes has made me an inferior person

Dark stuff, right?  What I do to conquer these feelings and move on is at first acknowledge them.  I accept that it is okay to feel them and confirm that I am facing a challenging situation.  In other words, I revel in self-pity.

After that phase has concluded I try to do things that make me happy and calm.  This can be very hard to do at times because I’m having so much fun with the self-pity phase, but I know it works every time so it’s just a matter of getting out and doing things such as:
  •         Taking a walk

Walks are nice.  Always.
  •         Playing with my cat (or any animal that is readily available)

Someone super hates her Christmas accessories, which only serves to make it more endearing.
  •         Making a delicious but somewhat healthy meal that makes me feel like I’m back on track

Curry would be super healthy but for the can of coconut cream that has basically a week's worth of calories. YUM!
  •         Seeing family or talking with friends

Bonus: hanging with loved ones AND a furry animal!
  •         Writing or journaling about what’s going on
  •     Going online to listen, learn from, and share with the wonderful diabetes community there

Diabetes won't give you a break, but you certainly deserve one.  Go for it!!

Tuesday, May 16, 2017

The Cost of a Chronic Illness—We Were Born with this Bill

The clerk at the pharmacy looks down apologetically.  “Hmm, looks like it’ll be (some egregious amount of dollars).  Is that okay?”

“Sure,” I say and swipe my credit card, thinking about how the three-month supply of medication just took away my disposable income for the current month and possibly beyond.

This scenario used to happen consistently when I went to pick up insulin and/or the other things involved with diabetes MDI (multiple daily injections) like test strips, pen needles, lancets, etc..  Despite the ridiculousness of the question posed I usually wasn’t irritated by it, instead seeing it as a sort of reassurance that it wasn’t normal to be paying this much at the pharmacy and to feel it as a considerable cost in my budget. 

My reflex every time, though I suppressed it, was to say, “No, it’s actually not okay.  But I don’t see much of a choice.”

Exciting things have been happening within the diabetes community lately relating to advocacy for insulin affordability.  At the same time, prices have been going up, and the political climate regarding access to care in the U.S. is by the best measures tumultuous. 

What I will say in the interest of brevity is this: every time I pay this bill, even the times when I truly couldn’t afford it and didn’t get to my car before I started crying, I felt lucky that I was still able to get the medication I needed to stay alive.  I know there are people around the world who can’t, knowing we all deserve to. 

“Life is a pre-existing condition.  Why won’t you cover it?”

Monday, May 15, 2017

Diabetes and the Unexpected: Ground Rules

This is the first post starting off Diabetes Blog Week.  Check out a bunch of fabulous posts on this topic here!  

The prompt says it best: “Diabetes can sometimes seem to play by a rulebook that makes no sense, tossing out unexpected challenges at random.”

There is no comprehensive playbook.  It’s like every other job: a lot of it you learn on the fly, and it’s not all covered in the manual.

Like an employee manual though there are a few guidelines to not forget.  This year, having reached a decade birthday and my 17th year with diabetes, I’m learning the hard way that it’s good to not forget about the basics.  Ie check your blood sugar before dosing insulin.  Take exercise into account. Don't let yesterday's frustrations about high blood sugar affect the way you carb count today. Make sure your car has at least a quarter tank of gas during a bitterly cold winter.

That last lesson was painful.  I was reminded in January that I had become too comfortable with my routine and too slack with the rules, and a long walk in the freezing cold with much cursing ensued.  I made the same error in judgment months later, this time relating to diabetes.

A few weeks ago I had to wait up with a low for the first time in my life.  It certainly wasn’t the first time I’d experienced a low at night, and while they are rare, I usually just wake up and find my way to the candy dish.  On this night I had accidentally overshot my insulin by ten units, and it was the first time I had to stay awake hours to make sure everything leveled out, coincidentally on a night when I just wanted to go to bed early. 

It wasn’t because my glucose monitor malfunctioned (that I know of, at least), that my medication went berserk, or that the moon did its thing where it plays with blood sugar.  The insulin worked as it was supposed to—the problem was just with the person using it.

I didn’t test my blood sugar before I gave myself those ten units while out with friends for a beer and a slice.  I assumed my blood sugar would still be riding high from the watery spaghetti they served at a charity supper earlier.  I didn’t take into account that the insulin I took for that was still running in the background, and I had run a 10k that morning so my body could still be in workout mode. 

Stupid mistakes, I know.  When you’re constantly adapting to moving parts, knowing 1+1 doesn’t always equal 2, and having lived with a condition like this for so long you start to believe you’re pretty practiced at steering this ship in wild waters.  So you go loosey-goosey with the basic rules like a grammar student who, having learned the ins and outs of punctuation, assumes he’s an expert then throws caution to the wind and starts chucking commas all over the place for artistic effect.

I got home after the pizza soiree and immediately checked my BS.  It was 110.  Crap.  That meant a bunch of insulin was coming on board to do its job and there was no job to do.

It was my fault, but I was frustrated.  I was tired of the unpredictability, of the highs and lows, of doing simple math that commonly seemed to come up with the wrong answer.  So I bathed in self-pity and the next day decided to make peace with it.  There were things I could change about my perception of diabetes and thus my experience, starting with respect for the basics, and most importantly taking a lighter mental approach and learning to roll with the punches that were most certainly going to keep coming my way. 

You can’t be Type A about it.  I mean maybe you can, maybe that works swimmingly for some people, but I’ve found it’s easier to get by when you expect the unexpected and let it go.  There are two rules of diabetes: respect the ground rules, and know there are no real rules. There you have it: an old cliché, paraphrasing from Fight Club, and a Frozen reference in the same paragraph.

Another nerd note to round this all out—when I looked up “unexpected” in an online thesaurus it listed “wonderful” and “amazing” as synonyms.  Other words related to "unexpected" also denoted more positivity than unpleasantness, which I was surprised by.

But I shouldn’t be.  Nothing should surprise me anymore. J