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 17^th 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

The Vacuum Epiphany

For 30 years of my life I’ve loathed vacuuming. 

Technically I shouldn’t count the years before I could walk, talk, or you know, understand the concept of vacuuming, but the hatred I harbored in the comprehending years more than made up for it. 

I don’t know what it was that spawned so much disdain.  ( I’m a clean person, I swear.)  Maybe it started because it was one of my almost daily chores as a child, though that certainly didn’t ruin dishwashing for me.  Maybe it was the years I spent as a waitress at a local restaurant where it took at least 15 minutes to vacuum up the fries and chew spittle at night.  For most of my life I’ve attributed my hatred of vacuuming to an inherent aversion to either floor chores or physical exercise itself.

So I avoided it.  At the last townhouse I lived with a roommate—hold your dinners people if you vulnerable to queasiness—I vacuumed probably three times in two years.  It disgusted to me sit on the floor, look at it, or even think about it, but I wouldn’t bother to vacuum. 

For one, it seemed pointless.  It never seemed to get clean, and like all the other vacuums in my life, I believed the one available at the time was more likely to start on fire than suck up the dirt and grossness.

At my new apartment though where I was finally reunited with my cat I realized I had to do the unthinkable: buy, and potentially use, a vacuum.  The cat fur was rolling through the place like tumbleweeds in the Wild West before the end of the first week.

So I bought a vacuum.  And realized everything I’d believed about vacuuming in the previous decades had been wrong.

I found I enjoyed it.

It was easy, and best of all, the results were clear.  The carpet looked as if it’d been fluffed, but best of all I could see all it had picked up.  At work I thought about it, even looked forward to it.

And realized that all along what I had hated wasn’t the practice or concept of it.  The equipment I had been using was consistently ineffective; choosing the right tool made all the difference.

I should’ve known that, because it’s clear in diabetes care that choice in supplies matters significantly.  I feel I’ve never recovered from my insurance company’s decision to stop carrying a small portable meter and rarely take the new one with me as a result.  The #AccessMatters / #MyPumpMyChoice debate this spring hit home because even though I don’t use a pump, I completely understand how access to the right tools for each individual determines attitude and practice towards proper care.

It’s not just a piece of equipment.  It’s an experience, reinforcement or recreation of a mindset.  

Tools, it seems, change everything.

On the Malice of Bugs

When I took a walk today tiny gnats swarmed in clouds around me.  They stayed with me for a good clip of my route as if magnetized to my face.  
 

Annoyed, I tried my best to ignore them, but I soon got amply frustrated.  It seemed as if they were trying to ruin the outing, holding me back as well as they could with their muted buzzing and dangerously close proximity to my eyes.  I imagined they were deriving amusement from it all.

Which, of course, is ridiculous. 

Though my knowledge of biology is shaky, I doubt the the bugs were actively attempting to foil my walk. 

I thought on the way home that I needed a mental reset; I was thinking of things in an unhealthy way.  Not only were the bugs not “out to get me,” but wasn’t it just plausible that the converse was true, that the bugs were swarming me because they wanted to join in and accompany me on my walk?

Feeling beaten down is always a choice.  Stress and frustrations from dealing with diabetes easily brings us to a place where negativity seems the most real, but we have to clean our lenses to see things for what they are.