Dating with a Pump?

Has anyone ever felt awkward or out of place in the dating world due to your pump or CGM? Has anyone ever had a really bad or embarrassing experience with it? Does being type 1 come up on first dates or do you keep that inside as long as you can? How do you tell someone you are interested in that you have diabetes? These are all questions we will face at one time or another, well unless you are a nun or a priest then I guess you won’t ever date. But does having diabetes and or a pump have an impact on your dating life? I would love to get feedback on this.

Some of the diabetes equipment can seem bulky and noticeable at times, but I know several patients who keep it all so well hidden, if they don’t tell you they have diabetes you would never know. To me diabetes is not embarrassing. I am not afraid to talk about it (or blog about it….LOL). I don't even mind when people come up and say what is that thing on your arm, or something along those lines. I have no issues explaining it to anyone and I am super passionate about how great they are it’s hard to not accept it I think. I mean this thing changed my whole life. There is no way I can imagine not having it.

I have dated in the past with all of my machinery on. When I was younger I know I was not sure if and when to tell a guy I was dating about it. I used to worry they would not be attracted to me because of it or something like that. I got to a point in my life, however, where I just tell people right off the bat. To me there is no point in getting involved with someone who can’t handle it. It’s not like it will change or like there is anything I can do about it. It’s not going to go away and the alternative is to become a giant pin cushion with 5 or more shots a day (been there and done that and not going to go back). I mean in my opinion anyone worth having will accept you as you are, pump, CGM and all.

I have dated a few men who were terrified of needles, they were ok with the pump. I had one guy who freaked out about the whole idea of it. Most men don’t seem to care though. When I met my ex husband, before we go married we did talk about having kids and that it may be hard, but otherwise, I am just me. I have had patients who hated their pumps and felt awkward with it on, like it drew too much attention to them. And I had one woman who said it freaked her husband out so much he would no longer touch her, so she came off of it. I was like are you kidding me? That I could not understand, but Hey we are each our own person, free to make our own decisions right? It is not my job to judge anyone.

I think we should all wear the shirt above on every first date we go on from here on out! Normally, I don’t wear a giant sign or have a shirt that says “DIABETIC” but I don’t hide my sensor to just to get someone to like me. I am secure enough in my own skin (diabetes and all) to show people who I am. I am a type 1 diabetic and I have things stuck in me, this is my life and I am ok with it, hope you all are too. I would love to hear your comments and thoughts. Has anyone had a really bad experience on a first date?

Sick Days

Is it just me or does it seem like getting sick when you have Type 1 Diabetes is the worst? My kids get a cold and they bounce back in a day or 2 tops. I get a cold and I fee like death. It starts with feeling blah and ends up with a 27 day coughing my brains out episode that makes me want to do nothing but sit around and vegetate. If I do try to do anything physical the coughing gets worse. I am bored to death and trapped In my house and guess what happens….. that’s right sugars start to go up. I try to carefully to be diligent about taking my insulin, I am honestly barely eating but as soon as I do, it’s a high rise affair. Up up and away goes my sugar. I bolus and bolus again and it seems it won’t come down. For 2-3 days it does this then all of the sudden, boom it crashes.

When we are sick with a cold, the normal rules of diabetes don’t apply. Nothing that normally works seems to be efficient in keeping numbers under control. I am even more diligent about eating low carbs because I know I am not going to be burning much off (you know because I am like curled up in a ball in bed wishing I was dead or at least that I was not sick). Seems like it doesn't matter what I do though, I will still go high. And once I go up it doesn't want to come back down. My steps are maybe 2000 a day if I am lucky. I feel awful and I wish I could go out side and swim or do something, anything but the fever and the chills suck away my will to live. I know we have sick day management, stay on top of sugars, and blah blah blah, trust me the beeping won’t let me escape them. But is there anything to make it go away faster or make it suck less?

In addition to the sugar spikes, you just don't feel good. You are tired and your body hurts and you want to sleep, but guess what, NO SLEEP FOR YOU!!! That’s right, sleep is interrupted by beeping sensors and urges to pee and the incessant need to drink. Maybe it’s just me but the coughing also keeps me from sleeping. A stinking minor cold turns into a 4-5 day vacation to your worse nightmare. On a plus note I guess we get to catch up on Netflix right? Or maybe read that book we started 3 months ago but never got to finish.

What do you all do when you are sick? Does anyone have any trick for the rest of us? Any tips to get over a cold faster or to keep your sugars down in a semi-normal non beeping zone while the virus works its way through the system? Does anyone have some tried and true sick day management they want to share? Hoping you all stay germ free and healthy!!

Insurance Nightmares

For patients with Type 1 diabetes, having good health insurance is a necessity. Sadly it seems that nowadays, more than ever, insurance companies are not out to help their clients but instead they merely want to make money. Every day in my office I see situations that sicken me. Patients who are unable to get the necessary medications and equipment needed to survive with diabetes, let alone to excel in their treatment. This awful Obama care system that was supposed to provide affordable healthcare to all, seems to have actually made things worse for most people, myself included. It seems to me that now less jobs are offering insurance and if they do the prices are astronomical. If you try to buy insurance the deductibles are high and then the fees seem to be higher as well.

The whole point of insurance is to keep us safe right and to cover us when something happens right? So does it seem that the insurance companies and the drug companies seem to feed off of one another and everything just gets more and more expensive.  Seems like more people who once had insurance now can't afford it, no thanks to Obamacare. And if they can afford the insurance, the coverage of medications and insulin pump supplies is too high to afford. How can an insurance company refuse to pay for a medication prescribed by a doctor? How can the insurance companies make deals and pick and choose which medications they will and won’t cover? How is that even legal? So we have to now pay through the nose for coverage that only allows you a few select medications, praying that we can get what we need. Even though in a year it will change anyway based on the new deals the company makes with the drug manufacturers. Explain to me why I am paying $600 a month and still have a $5000 deductible that I have to meet before you will pay for my supplies? I mean you know I will need them to live right? It’s not like I can be safe and not get diabetes, cause you know I already kind of have it….

I honestly don't know which is worse, the fact that these insurance companies and drug companies are allowed to make exclusive deals with one another,  or that they can refuse to pay for any medication that a doctor has ordered. Where is our wonderful government in all of this? How exactly are there no rules to regulate the fees and the selective preferences of the companies? Can’t the government say to these greedy companies- enough or stop, let the patient have what they need!

Are these companies full of greedy rulers who seriously can only see the short end of things. To me this is how their meetings go: “Look by making a contract with company A we can save blank amount of money. When in reality their refusal to provide adequate care ends up costing them more when patients are hospitalized and ending up blind or on dialysis or some other awful complication. I actually got a letter of denial for insulin for a patient, the company said to try metformin. They are not even near the same classification of medication. Hello insurance companies, type 1 diabetes is a condition where body makes zero (0) insulin, metformin does not produce insulin, so it is not a useful medication in Type 1 Diabetes. There are patients how do respond better to one brand of insulin then to another. There are patients who have side-effects to one brand vs another. Honestly, there are some patients who prefer one brand because it is what they have used to stay alive for the last 30 years of their life and they feel safe on it. They are afraid to try something different when what they use works!! The insulin is literally our lifeline people. It prevents us from dying. Now I am sure in your eyes death would possibly be a cheaper alternative to this medication but, seriously……..

As a patient and a provider both, I think we all need to stand up for ourselves, lets do something to make these “for profit” companies get some regulations so we can get the care we need and the care we deserve. The drug and insurance companies are surely not going to cut into their salaries to help us stay alive so it looks like we need to do it on our own! Write to your local leaders and fight for all of us!!

It Was Soda Poisoning

Have you ever see the movie A Christmas Story, the one with Ralphy and the BB gun? Well there is a line in that movie that brought me to todays subject. When his mom finds out he cursed, he gets his mouth washed out with soap and he daydreams of a day when he is blind and comes back home to reveal to his parents that it was “soap poisoning”. Well today we are gong to talk about a diabetics worst fear when eating out, something I like to call soda poisoning. Where you waiter or waitress accidentally gives you a regular soda instead of diet soda, and unbeknownst to you, your sugars starts a rapid climb til your CGM is screaming and the whole world is staring you down. And all because someone else made a mistake and now you are paying for it.

Today I stopped at a local restaurant on the way to my son’s basketball game so I could grab some lunch. I got a sandwich and a drink. I asked for a diet Dr. Pepper, my food was prepared and given to me and off I went. I drove to his game sipping on my diet soda and eating a few of the fries. I looked at my sugar and it was 98. Today was a good day. I figured I would eat once I got there. I went into the building and found his court, sat down to eat. As I took another sip, I though snuck into my head, did this taste a little off? Then to my horror, my sensor starts beeping and I look at my CGM only to see a reading that now say 175mg/dl with an arrow pointing straight up. I lean over to my daughter and I say try this does it taste like diet to you? She drinks a sip and says no mommy this tastes different. My sensor keeps going up and now there are 2 arrows. Now it’s 225, then 240 then up and up it goes til a high of 324 within an hour. I am frantically bolusing and correcting and watching it climb and climb and go higher and there was nothing I could do. What was my conclusion? This was not diet soda.

Now for those of you who are not diabetic you are like so who cares, it’s not that big of a deal. Diet verses regular soda won’t kill you right? Well, to be honest with you, it actually could if you have type 1 diabetes. I mean we make no insulin at all. Dumping pure sugar into your body without any insulin is a bad idea. As I saw this afternoon, my sugar went through the roof from about 1/4 of my soda. The annoying part about it is I did nothing wrong, but because someone was careless and because of their mistake, I could have ended up in the hospital. Normally I just get upset and then let it go, but this time I decided to take action. After my son’s game, I decided to go back to Chick-fil-a and explain to them what happened. They were very apologetic but that doesn’t make me feel better. It doesn’t get my sugar down and it still takes me the 3-4 hours to get it down on my own. I complained not to get free food, or anything but simply to speak up for those of us in the world who have type 1 diabetes and to make sure the staff knows to be careful.

So this is my little rant for today, for those of you who have been where I was today, I feel your pain and it really stinks. Especially those 3-4 hours of misery where you are grumpy and short tempered and thirsty and hungry and have to pee. On a plus note it passes and on another plus it does not happen often. I strongly do recommend whenever possible, try to watch them pour your soda, for your own peace of mind. And yes I get that diet soda tastes different but when it’s from a machine, to me it takes more syrupy then from a can so at times I do question my own taste buds. Thank you for reading and be careful out there!

Good. Better. Best.

Have you ever thought about how good your life is? Have you thought about the good things in your life and how much worse it could be? Do you often analyze your success by comparing yourself to others? Have you ever wondered if things could be better? Have you ever imagined the best possible life for yourself? I feel like I am always analyzing my life and constantly striving to be better. I love my life, I really do, but I often wonder how could it be better? I imagine what the perfect life for me would look like. So, I ask, how do we decide which part (s) of our lives should take priority? I often feel like there is simply not enough time in my life to do all the things I need to get done. So how can I make my health and my diabetes a priority, without letting it rule my entire life. Can I be better and if so, how?

        I have read, seen and heard so many ideas for self improvement. I watched movies and listened to inspirational talks. I sometimes wonder what is enough, how can I find my best self? This world seems to be always trying to drag us down. If you are a religious person, you might say Satan is gaining more and more control in our world. How are we supposed to fight him and find a way to be our best selves? I believe without a doubt that Satan wants us to be miserable. He is like that little 2 year old toddler who didn't get his way and throws a constant tantrum. As the old saying goes misery loves company so Satan tries to make us as unhappy as he is. I think he uses time pressures to do this. The world we live in is overwhelming. There is so much technology, so many things to do and never enough time. We are all focused on stuff, and money, and on doing more and more to have more and to be more. I think this is again a way Satan tries to ruin lives.

        Life is hard. We have so many demands on us for our time and our talents. For me, finding time to be the diabetes guru of the world is impossible. There is just no way for me to ever spend the amount of time I think is required to be a perfect diabetic, on my diabetes. So how can I be better then what I am? How can I be my best? My A1C’s used to always be 6.1-6.3. Now they run 6.5-6.6. Does it bother me? Yes, but can I get back to where I used to be? My weight has also gone up. I am not working out as much as I used to and I feel bleh as a result. But how can I do better when I can't find time to even clean my house?

It seems to me that our health should be a priority, but how many of you can honestly say that it is? We all know how to lose weight right? I mean we take in less than what we burn off in our daily life. Over time weight comes off. It is amazing how we all feel like we can’t lose weight though. We all swear there is something wrong with us. I am different, I am special. I have thought about this a lot lately and honestly I can say for me I simply don’t put forth the effort I need to. I don’t follow through with things. I give up too easily when it doesn’t happen quickly. I know I am not the best me I can be. I seem to lack the self-discipline needed to make my life the best it can be. I let distractions get in the way. Distractions such as TV, the internet, looking into ways to make my life easier and obsessing to find the answer, looking for my “easy” button.

I feel like I am being pulled in a million different directions every day. I have so many demands on me and my time, it is hard to prioritize myself so I don’t take the time to be the best me I can be. Again, is it not true that we can help people more if we are ina good place ourselves? Can’t you help others better when you feel you are taken care of? So I challenge each of you to put yourself first. Take care of you, which means taking care of your diabetes. Your health should be first. This will allow you to be the best version of you that you can be. You eat and exercise and sleep and you take your medicine and monitor your sugars and you do you first! Then you do everyone else. So take this next month and work on putting your health first. Work on becoming the best version of you that you can be, one area of a time, starting with you health (and your diabetes).

Security Alert

Have you ever flown on a plane? Have you ever flown on a plane with your insulin pump or CGM attached to you? I am sure like myself, most of you have right? Well, it used to be a minor hassle, you go through the detector and then they make you rub your pump down and then they swab your hands and then run it through this machine and you were on your merry way. Used to be just a minor hassle.

Well this weekend I went on a trip that required a flight. I got the new DEXCOM G6 and tandem pump and as I was reviewing my information I noticed that it says do not go through those machines where you have to put your hands up overhead and the thing spins around you. Per the DEXCOM papers, they have not been able to test all of the machines to ensure there are no issues, so they recommend avoiding them. This weekend was my first time flying with these new devices

As I approached the security area I tell the guard that I can’t go through the machine due to medical equipment. I show him my pump and I am told to stand to the side while he finds out what to do. After what seems like 100 years, this woman comes up to me and says what are you waiting for? I told her I can’t go through the machine due to my medical device. She says so you are opting out? I said well I was told not to use those types of machines. She got snotty with me and said then you are opting out. She walked away, then came back in a few minutes and told me to follow her.

I follow her to this area and am told since I opted out they had to do a full body pat down and she explains what that means, basically that she will run her hands all over my body, including chest, legs (inner and outer thigh), buttocks and everywhere else. She says is this ok with you? I felt like saying do I have aa choice? She asks if I need to go behind a curtain for this. I decline and hold my arms out as told while she does her thing. It was quite uncomfortable. But I survived. Then she makes me take my pump into my hands while she flags another person down to come swab my hands. I am also required to touch my CGM but through my shirt (which makes not logical sense to me).

Finally I am told I can gather my belongings and and I am free to head ty gate.  As I gather everything up, I look over and see another type 1 patient going through the same spiel. I smile at her and say don’t you love being diabetic at the airport? She smiles back and agrees then as she sees my pump she says ooh which one is that, before i can answer we were met with a glare from her pattering guard so she smiles and says good luck while I walked away.

I understand security is important but seriously has anyone every pretended to be a diabetic and used an insulin pump as a bomb? Is this like a thing that people do? Why do they have to scrutinize us so closely? I mean TSA precheck people doesn’t go through that stupid machine. And they surely don’t get the full pat down. Makes you feel even more self conscious than normal. I guess I could have ignored the warnings by DEXCOM and just gone through the machine with hopes that my pump and CGM don’t spontaneously combust but that was not a chance I was willing to take. I could not be without my CGM in a hotel by myself for 5 days.

So how about all of you? What are the biggest issues you have had to face when traveling or going to some type of secure event?

Still Waiting........

Patience is a virtue they say. Sometimes the best things in life are those things you want so badly, yet they seem to take forever to arrive. I have been told often that sometimes we simply have to wait patiently for things to come, but if we are honest with one another, waiting sucks. I am a doer not a waiter I used to think. If I want something bad enough and work at it hard enough, then I will achieve it. I decided to go for my master’s degree and I did. I decided to go back to church and I did. I decided to have kids and I did. The old me used to believe that working hard with the goal in mind will get me what I want. The new me, however, knows this is not always true. Sometimes, we simply have to wait for things.

When I was diagnosed at age 9, I was told by so many people, that a cure was just around the corner. I was told they are so close, within 5 years type 1 diabetes will be a thing of the past. I used to long for that day to be rid of this disease, this label, this lifestyle. Well here I am 33 years later and I am still waiting. That 5 years has now become 33 years and still no cure. Research has blossomed and they have come up with a ton of ways to manage your diabetes. I am very thankful for these devices, they do make it easier, but none of them are a cure. Even this upcoming “artificial pancreas” will not be a cure. It will not take away the constant need for glucose monitoring and the constant need for extraneous insulin infusions and blouses when I eat. Management of diabetes is not a cure.

How are we supposed to keep hoping and keep waiting for the day a cure has arrived? How do we keep our chins up and an our spirits high when we are stuck with this disease that could decrease our life expectancy by years if we don’t manage it well? Why has it been so many years and so many advances later and yet we are not closer to a cure then we were 33 years ago. If I dwell on these thoughts for too long, it gets depressing. I know people are out there thinking, you are alive and you can survive and you can manage your diabetes. It makes it seem like this is an easy disease to have and deal with. Well those of us who are blessed with this disease know the ugly truth, it is not easy.

If you believe in God, like I do, I can see this disease as a challenge to make me stronger. To help me grow and become a better person. It has for sure changed my life in too many ways to count. Do I want a cure? You bet, am I willing to wait (yes I know I don’t really have a choice), but yes, I can wait for the day type 1 diabetes is a thing of the past. It may not be in my lifetime, but I believe it will be one day. Until then, the waiting makes me stronger. The waiting makes me want it more and when the day does come, I will be so very grateful.

Never Enough

Have you ever felt like no matter what you do, you are never enough? Not enough for your family for your job, for yourself, for her health? One of my favorite movies “Mom’s Night Out” has this great scene towards the end where the main character says that she feels like she is just not enough. And one of the other characters responds, not enough for who? The main character Allison then replies not enough for her mom or her husband, for God, for her kids, not enough for anyone. To which her friend replies, “Not enough for you”. This statement is profound. I mean how true is this? We always think we are not enough for others. But this is our opinions of ourselves. The friend then states that we need to stop spending so much time beating ourselves up for what we see as shortcomings and instead, learn that wherever we are in our journey, we are enough.

I love this thought. I mean I know how true this is. I know I am my own worst critic. I have such a hard time accepting compliments and taking credit for what I accomplish. In another one of his talks President Uchtdorf points out that no matter how amazing her food is, his wife always finds something she could have done differently to make it better. I am guilty of this, especially in regards to my diabetes. My overall control is good. I have had my A1C’s in the 6-6.6 range for like 20 years. The only time it was over 7 in my entire adult life was during my divorce but still I see failures every day. I hate seeing an unflattened line on my CMG tracing. I hit 200 almost every day at some point. Rarely do I make it into the 300’s but it happens from time to time. Overall my averages are around 135-140 most of the time but to me this is not good enough. I want perfection, even though I know perfection is unobtainable (see previous posts).

SO how do we let go of drive to be perfect? How do we relax and let ourselves have bad days once in a while without beating ourselves up relentlessly. How can we learn to be imperfect and flawed? How can be let go of the need and wish to be 100 all of the time? How do we learn to be ok where we are, and to give ourselves a break to keep on working hard and take each day as a new beginning to do better then the day before. To go with the ups and downs of both life and our sugars? When will good enough be enough?

I find it so infuriating when someone critiques my diabetes. When friends and or strangers comment
“are you supposed to eat that” or “I though you had diabetes”. It makes me want to smack them and say I can eat whatever I want. I mean in reality we more or less can I know from experience certain types of food don’t sit well with me so I avoid them. I do this only because i do not feel well when i eat them. Chinese food for me is the worst. I have low sugars after eating it then 4 hours later i am like 400. It is so annoying I chose to simply not eat it. As I am getting older, I am noticing other foods I am starting to struggle with. And maybe I will begin to make more changes to my diet. But I don’t need someone to reprimand me for eating what I eat. I have lived with this disease for 33 years people. Please tell me how the one time you saw or read or heard about the diabetic friend or relative has made you the expert on my disease. You know, the one I live with every day, the one I eat, sleep, and breath…

Will we ever feel like our control is good enough? Will we ever accept our broken bodies and being whole and good. Can a person who has Type 1 diabetes ever see them self as being enough? I truly hope that one day my answer to this question will be YES!! One day I will accept my flawed and imperfect self as being good enough for everything!

Peace, Be Still

I was reading my scriptures this week preparing my lesson for my Sunday school class (I teach 6-7 year olds). While reading I came upon a verse in Mark 4:39 “And he arose, and rebuked the wind, and said unto the sea, Peace, be still. And the wind ceased, and there was a great calm’. This saying “peace, be still”, I have heard over and over again and for some reason it really jumped out at me this time. I have been dealing with some stress lately and quite a bit of anxiety. Maybe this is why this scripture really spoke to me this week.

From my experience dealing with patients and also from my own personal experience, it seems most people with Type 1 Diabetes suffer from one or both of the following, anxiety and depression. I never really knew I had anxiety until a few years ago when my husband announced he was unhappy and was leaving. This sent me into a total tailspin and this anxiety I never realized I had become a dominant force in my life. I had daily panic attacks. I would feel shaky and have chills and be unable to do anything. I couldn’t eat, and if I did I felt sick to my stomach. It felt a lot like a hypoglycemic episode, which I now know is actually a symptom for me, feeling anxious can be a low sugar. Makes it hard sometimes to decide if it is anxiety or low sugar.

I have never really gone through much depression, however, I have had to battle anxiety at times. Whenever I feel like things are spinning out of control and I can’t fix them, I become anxious. I have come to realize that this reaction stems from when I was diagnosed with diabetes at age 9. The little 9 year old girl who is still inside of me, whose whole life changed in a day and who no longer had control over her life. This little girl couldn’t cope with it well and so it has been inside of me this whole time, coming out in times of extreme stress and loss of control. I did go through therapy during my divorce and I was able to find a way to work through my panic attacks and anxiety without medication. I am able to do as the scripture says and stop myself, to calm myself and to focus on what I can change or control. What little thing or things can I do to resolve the issue at hand. I am able to still my mind and find peace, then fix those things that I can control and do have power over…

Although I don’t know if all anxiety can be managed without medications, I do know there is a way we can identify what triggers our anxiety and find ways to prevent it from happening. I also believe it is possible for most people to learn, like I did, to resolve their anxiety. I wonder if other patients with Type 1 DM suffer from anxiety, for a similar reason as mine. If others feel this loss of control and have anxiety as a result. From my research, it does seem like anxiety is a result of inappropriate coping, usually from a feeling of being totally overwhelmed and unable to cope. When our conscious mind can no longer make sense of what is happening or figure out a way out of the situation, anxiety sets in. Anxiety can be crippling at times and definitely interferes with going about your daily routines.

My experience from working as a practitioner has shown me that almost everyone who has T1D suffers from anxiety or depression. Most of the time these conditions are not addressed in practice and most patients seem to need help but don’t know where to turn. Mental health issues like anxiety and depression are very common in all areas of chronic illnesses and diabetes is top on the list. Sadly, studies show that if these conditions are untreated, they will result in poorer control of the patient’s diabetes. So, what can we do, as a patient who suffers from one of these two ineffective coping methods? Is there anything we can do, on our own, to help work through some of these issues? I for one believe there is. I had a friend who once told me something very easy. Don’t worry about those things you can’t do anything about. If you can not control it, why stress about it? My mantra for life has become the same for every situation. All we can really control in this life is us, what we say, how we feel, what we think and what we do. So if someone is a jerk to you, can you make them stop being a jerk? Nope. However, you can control how you react to it. You can chose to take a breath and walk away or to be a jerk back (which is strongly advise against), or you can treat them with kindness. Even if they don’t deserve it, they most likely are struggling with something internally and taking it out on you. Learn to let things go, to not take everything so personally and to take the higher road. As you start to do this, you will notice that everything slowly becomes better and easier to handle. Anxiety sucks, but I have no doubt in my mind that we can all figure out how to get through it.

Self-Control

Today I was listening to a talk in the car on my way to work (yes I do this most days to help center myself) and the speaker started talking about self-control. He mentioned that we all need to learn to have more self-control in all aspects of our lives to be happier. Self-control gives us a sense of power, a sense of accomplishment and can drive us to be better and happier. It made me start to think about diabetes (yes I know, everything makes me think about diabetes, LOL). I was thinking about all of the times my sugars do what they want and how at times they seem totally unmanageable. But then, as I listened and thought about self-control, I wondered if and how having more self-control could help my diabetes to be better managed.

Think about all the times you have had a low sugar and how hard it is to control your eating as you try to treat this low sugar. To me it is like I am possessed by the cookie monster and I want to eat everything I can get my hands on. I keep eating until I feel sick at times. That panicky feeling of a low makes me feel like I could never get self-control. There are times however that I am able to get control and to eat the required amount of food, then walk away, and go about my day. So why can I control it some days and others it seems impossible?

Now let’s talk about my sugars, some days I am on point, my sensor tracing is flat lined and I am like yes!! BEST DAY EVER!!! While other days I am like a giant yo-yo with a line that looks like it was drawn by a slinky that can go both up and down the stairs. Again, I wonder, could I have more self-control here and would it make my sugars better from day to day? What could I better control to get my lines flatter more consistently. Could I eat better or be more strict with the timing of all of my boluses? Will this help my diabetes to improve and to be easier to manage?

Then there is exercise. I know for sure I could have more self-control, or I guess rather discipline in this case to be more active and to make better choices on how to spend my free time. I lecture patients all of the time about how important exercise is. I know how great I feel when I do exercise, yet I don’t seem to have the self-control to make myself do it every day or every other day. Why is that? It is actually one other factor that can affect my sugars often with varying outcomes. I know how important exercise is for overall health and I want to be healthy. So why can’t I make myself do better in this area?

So what is self-control? Well according to Merriam Webster, self-control is “restraint exercised over one’s own impulses, emotions, or desires”. I googled self-control and found an article in Psychology Today which further states that “self-control is primarily rooted in the pre-frontal cortex, which is significantly larger in humans then it is in other mammals with similar brains. Thanks to this pre-frontal cortex, we as humans can chose to respond, to plan, evaluate alternative actions and avoid doing things we will later regret. Animals on the other hand respond immediately to every impulse as it arises.” Humans can develop willpower. One of the most famous studies of self-control is known as “the marshmallow test”. This study was when children were given a marshmallow and told if they were able to wait to eat their marshmallow for a certain amount of time, they would be rewarded with 2 marshmallows. The study showed that those who were able to wait, later showed higher academic achievement then those who ate it immediately. Is our willpower and self-control something we are born with and stuck with or is it a behavior that can be learned? Can we teach ourselves to have more willpower and therefore better self-control?

Ok so back to self-control and diabetes, I am almost positive that self-control can be learned and practiced and improved upon. I have been reading up on this idea of self-control and I would like to challenge everyone to see if you can find one way this week to try to have a little more self-control in regards to your diabetes. Can you be more diligent in timing your shots or boluses? Monitor your sugars more? Can you exercise more? Can you eat healthier and limit the amount of carbs in your diet? What can you do to try to have more-self control and to make your diabetes control better? Can self-control help you be a better diabetic? Try it and tell me how it went for you. I am going to take this week to exercise more regularly.

Lead Me, Guide Me, Walk Beside Me

I have been reading a book by Stephen R. Covey called “The 7 Habits of Highly Effective Families”. Mr. Covey has written several books with the “7 Habits of Highly Effective” in the title. He teaches how to better manage your life, your family, and your business, so I have been thinking could these rules and or guidelines help us to better manage our diabetes? I would need to really think about this and decide what the 7 habits are for diabetes, but today I was reading the last chapter. Mr Covey talks about managing verses leading. This line really caught my attention: “the reality is that most families are over-managed and under-led”. I know this sound weird because we are talking about diabetes here not families, right? But I could not stop thinking about this concept of managing versus leading.

Mr. Covey goes on to say that “the more quality leadership that is provided in the family, the less management is needed because people will manage themselves”. The opposite is also true he says “the less leadership is provided, the more management is needed because without a common vision and common value system, you have to control the things and people to keep them in line. This requires external management but stirs up rebellion or it breaks people’s spirit'‘. So what does this have to do with diabetes? Well, my brain came up with this thought: if this concept can be applied in a variety of circumstances, couldn’t it be applied to diabetes management?

I think of the times I have gone in to see my endocrinologist. When he or she has more or less threatened me and tried to make me see that I had to do what they were telling me if I wanted to be ok. That they were the expert and they knew how to manage my diabetes. They knew better then me how to perfect my sugars. The rules are simple: eat well, avoid sweets, don’t cheat, take your medicine, exercise, check your sugars. I used to get so mad, I would think how dare you tell me what to do. You don’t understand, those rules may apply to some people, but not to me. My diabetes is different, I am different. Taking my insulin 15 mins before I eat causes me major issues. It’s easy for you to say what to do doctor, but you don’t have to live this. I would want to rebel and be like I will show you that you are wrong and you do not understand. The doctor was my external manager. I did rebel and I hated their rules and I did not like being told I was “bad” because I had a high reading once in a while. (see previous postings, this disease does not allow for perfection).

I feel like I do the best with my sugars when I take a more relaxed approach. The more I obsess about trying to make my sugars perfect, the more I tend to feel burnt out. If I live my life and do what needs to be done and accept the imperfections and the bad days, I notice I do much better. I do check my sugar (all the time) and I do take my insulin all the time. Some days I am super precise with my carb counting and others I more or less guess based on experience. I do what I need to do but I don’t over manage myself. I don’t constantly berate myself for the days when I go high, when I forget to bolus until an hour later when I am beeping high alert on my sensor. I don’t punish myself if I want to eat something that is considered by doctors as “cheating”. I hate that term by the way, it’s not cheating, people it is called living!!

Back to Mr. Covey, so is there a way to apply his 7 habits of Highly effectiveness to diabetes? In my humble opinion, it is better for me to have some of my own control, to take responsibility for my diabetes myself. It helps to have someone to turn to with questions to “lead” me but not micromanage me. I know from experience, that micromanaging for me, does make me rebel. I also know that having a non-judgmental person who I can talk to and share my experiences and who is willing to work with me and consider what I am saying, is the key to my success. Having a doctor on your side saying yes that is normal and you are doing a good job. I think that is what we all need. We need to know that we are ok, that we are good and that we are doing the best we can each day. Some days are easier then others and some days we may be more into our management than others. But it is ok to have these ups and downs. In fact, it is human to mess up and make mistakes.

I know we can all benefit from being led rather then being managed. Nobody likes to be managed do they? Leadership even sounds so much nicer. Let us all lead one another into a world where life with diabetes is not the end of the world as we know it. Leaders teach those who follow how to do things for themselves. Managers simply tell you what to do and how to do it. So when looking for an endocrinologist, maybe that is what we all need to do, find someone who can lead us and guide us and not manage us. And we can all help to empower and lead one another right here. To walk beside one another and share our experiences rather then to judge and compete for who is doing the best. Lets lead and guide one another as we all walk the path of diabetes together.

Diabetes is Like a Box of Chocolate, You Never Know What Your're Gonna Get

Type 1 Diabetes is challenging. You seriously never know what you are going to get from one day to the next. I have tried to eat the same food every day for a week and my sugars are never the same. I finally think I have figured out how to handle breakfast. I eat the same thing 6 of 7 days a week. I know boring right? Out of those 6 days 2 might have a similar response. The others are all totally different. I used to say I was a control freak. I love order and I love to make things happen. I like hard work and perseverance and mostly, I like to succeed.

Living with T1D has made me reconsider my outlook on life. It took me years to realize no matter how hard i try I will never get complete control of my sugars. There are so very many factors that affect it, some of which are not even known. Food, exercise, hormones, stress, sleep, all have been shown to have a direct effect on blood glucose levels. I don’t know about you but I have no idea which days which hormones are high and low and which days the 2 minute difference in timing of my mealtime bolus will cause a huge shift in my sugars for the next 4 hours. I drove myself insane for many years trying to get control. Then I realized something. Nobody is perfect and our bodies are definitely, imperfect. We have broken pieces and nothing man creates can ever replicate what God has given us.

Does this mean life with diabetes is impossible? Does it mean why bother trying if we can never succeed? I know many patients who say yes to this. To me the answer is a clear absolute no. It simply means we need to adapt and to change our expectations and perspectives. Diabetes may not be totally controllable, but honestly, is anything in this life? Is there any part of your life you are totally in control of? For me the answer to that question is a heck no! I tell my patients this: when you are diagnosed with diabetes you have 2 choices. You can chose to figure out a way to make this disease fit into your life, find a way to make it work for you. Or you can ignore it or fight it and hate it and one day it will come back to bite you in the booty (this can be blindness, renal failure, missing limbs). Sadly the possible side effects are not pretty.

So how do I live with this disease? How do I go day after day struggling for normalcy? Well my answer is simple, I do my best. I adjust myself, and every single day I know I have a new chance to make it better. Some days I succeed others I don't. But I surely celebrate those days I have a great day. I never give up. I never quit. Some days I am frustrated but other days I am rocking it. I accept the good and the bad. I try and try again and again. I accept the bad days and appreciate the good ones. I gave up on perfection, but I refuse to give up on success. Even if it is only 1 day or half a day or a few hours here and there. Looking at my blood sugar tracings, I celebrate when I have a 6 hour 12 hour flat line tracing. On a rare occasion I will have a full 24 hour tracing that is good. I try to replicate it and some days it works but others it does not.

Success is always in our own perspectives. How we see the world and how we see ourselves within the world is how we judge our success. Instead of comparing yourselves to others with diabetes, I challenge you each to compare yourself to yourself, from one day or month or year to the next. Stop looking at others. We are all different and will never be the same ever. No 2 people are and therefore, no 2 diabetics are. So do the best you can do for you and accept that some days you may have to settle for a less amazing day the ones around it. Give yourself a break on those bad days and just pledge to do your best. This does not have to be a battle, embrace your diabetes and keep on biting into those chocolates until you find the flavor you like.

Why Me?

Have you ever felt sorry for yourself and asked why me? Why did I get diabetes? Why do I have to do this? What did I ever do to deserve this?” I am sure at some point in all of our lives, we have had a moment where we asked one or all of these questions. Have you ever really thought about it though? I mean what do you think? Do you think you are being punished? Do you wonder if it is a test from God? Do you blame your parents or grandparents or whoever else has it in your family? Do you simply blame it on bad luck or bad genes?

I know throughout my life, I have had all of these thoughts at one time or another. I have felt sorry for myself and thought this is not fair. I did not do anything wrong to deserve this. I never ate too much candy and I was not overweight or lazy. I have 4 brothers and they are all fine why did I get stuck with this?

Honestly, I don’t know that we will ever know the answer to these questions. I mean medically speaking it has a genetic component to it, but the exact causes remain unknown. Scientists theorize various viruses cause an autoimmune response in some people, but the exact reason for that response in some and not others remains unknown.

Do I think we are being punished? Definitely not. I do believe however, that God will not give us more then we can handle. And one day we will know the reason, we just need to be patient and to do the best we can to deal with it each day. We need to find a way to embrace our diabetes rather than hate it. In my experience, doing so makes life a heck of a lot easier. Holding onto hate just attracts negative energy into your life and I don’t think anyone wants to do that.

I believe that instead of asking “why me”, we should instead turn our focus towards a different way of thinking, one that is more positive. Instead of playing the victim play the superhero. Take pride in the fact that yes, you have diabetes but you are rocking it! If something doesn’t work, try to think” ok, I can do better next time”. Instead of thinking “Ugh, I suck at this”. We all learn more by failing and then trying something new right? I mean Thomas Edison did not invent electricity in one try, he had multiple failed attempts before he succeeded at mastering it. And who knows, maybe one day we can each discover something about diabetes the doctors don’t even know. We may come up with the next breakthrough needed to find a cure.

We can’t escape diabetes, so why don’t we instead try to figure it out. Take each day and try try try to find a way to live your life with your diabetes. To still live a full and as normal of a life as everyone else. Honestly everyone has something they are dealing with, we just may not be able to see it. So don’t let your disease run your life. Find a way to make it work in your life, in whatever way works for you.

Be Not Afraid

One of my favorite Bible stories is when Jesus walks across the water, toward the boat holding Peter, and as he approaches, he says “Be of good cheer; it is I, be not afraid”. I love that phrase, be not afraid. It is perfect for so many situations we find ourselves in. Fear sucks, fear is not fun for anyone, and so whenever I am afraid, I think of this quote “be not afraid”.

As a grown woman, and a mother, it often shames me to know I am afraid to be alone. I know that probably sounds weird right? I mean what 40 year old woman is afraid to be alone? Well, a few years ago, I went through a pretty traumatic divorce. I honestly never saw it coming and I was devastated. Over the last 3 years, life has been an adjustment. I have had to take over everything for me and the kids. I get to be both mom and dad. I get to support all of us financially, spiritually, emotionally and mentally. I get to cook and clean and shop and pay bills and fix holes in the wall and clogged drains and broken bikes. I get to practice volleyball and basketball with the kids and make sure we are all exercising and eating well. Then there is my work and homework and I have a never ending supply of charts to do. And I have to be sure we are all receiving the love we all need. Anyway, it has been a huge change and a so many adjustments have been made.

One of the biggest adjustments for me personally, has been the time alone. Those days when the kids go to their dads house and I am here alone. It used to scare me to death. I realized over the last few years, how scary it is to be alone when you have type 1 diabetes. All of those fears run through my head. What if I go low and nobody is here? How long will it take people to realize I am missing? Will anyone check on me? Will I die before I am found? I used to see crazy scenes running through my head of my kids coming back to the house to find me unconscious and close to death. This has also greatly inhibited my travel plans. I more or less refused to go anywhere that I don’t know someone. I wanted to go to the ADA conference in San Diego a few years ago, but I was terrified to go alone. What if I passed out in the hotel room and they did not find me til check out time?

So, how did I cope with and overcome this fear? How do I keep these worst case scenarios from running my life? How do I stay sane when I am here alone? How can I be safe? Well, I have had to go out of my comfort zone and ask my neighbors to keep an eye on me. I have told friends to check in with me as well. To make sure someone gets a response. I have a dad who lives fairly close, and is here a lot during the week so I make sure he knows to check as well. And I have the amazing share ap from DEXCOM that truly has given me a ton of comfort. My 9 year old has it on his ipad. He gets alerted if I am low (strangely the 13 year old who is on her phone constantly, could care less, LOL). But, I love that periodically my 9 year old messages me saying “mommy are you ok, i see you are low”. Just knowing someone is watching out for me. When they are home, they have both been taught to read my sugar, and what to do if they find me unresponsive (which has not happened and I hope never does). They know how to use the glucagon kit and who to call. They know which neighbors they can run to for help.

When i went to San Diego, I had my friend who is a primary care doctor put it on is phone for the week. I would get random messages in the middle of the day saying “EAT now!!”. At first I was like why are you telling me to eat, then I realized, I was dropping. I know it sounds silly, but just knowing someone is watching over me has kept me sane. Taking the time to find friends to join me on bike rides, swimming laps in the pool, on road trips, and or making sure someone knows I am alone and asking them to please keep an eye on me once in a while has really helped me.

So now, instead of keeping myself from enjoying my life due to fear, I just make sure I have someone watching over me when I need it. I used to think it was a sign of weakness to need help but now I know, it is not weak, it is brave to reach our and ask for help. People are usually happy to help, you will be surprised. So I ask you all to do the same. Set up a safety plan for yourself and or your child. Make sure you are never truly alone with your diabetes. Be safe, be smart and live your life!! It opens up a whole new world and such a sense of freedom to “be not afraid”!

To Exercise, or Not to Exercise?

I love to exercise, I really do. I think I am one of those weird people who loves the rush of adrenaline and endorphins that are released when I exercise. I love to feel that burn in my lungs and the ache in my legs as I push myself harder and faster on the bike. I like to challenge myself to see how far I can go. As I have gotten older, my interests have definitely changed. Now I prefer biking, swimming and yoga over my previous cross-fit days. I sometimes feel like I have gotten fat and lazy the last 2 years. I used to be so fit and active and now life as a single mom makes exercise more difficult. I guess if I really think about it I might be a little hard on myself, but I still feel like a slacker.

I gave up cross-fit about 2 years ago. I became so frustrated by the extreme fluctuations in my blood sugars during the various work outs. Some days I would crash and be unable to complete the workout, which angered me. Other times I would spike over 300 and stay there for hours and hours despite constant boluses to bring it down. On competition days, I was a mess. The intensity of the work outs, the adrenaline and the anxiety to compete were all factors that messed me up for the whole day. So after 3 years I said I can’t do this any more. I had an A1C of 7.1%, the first one over 7 the entire time I have been on a pump. I asked my doctor, I researched online how to combat these spikes post work out and all I found was “check your sugar more often and correct if it happens”. So treat it after the fact, well that is an awesome solution, NOT!!!!

Even now in my “lazy” days, I still see this phenomenon, sometimes I go crazy high after working out. Even with biking and yoga. I still try to read about it, I talk to my doctor about it as well. I am told to keep on doing trial and errors to find a way to maintain a steady state. I decided this year to get back into my triathlons. It has been a year since my last one but I need a change. I miss the exercise and training too much. So back on the bike I go and soon to be back in the pool. I have 6 month to get into shape.

For me, swimming tends to drop me, so the 400m swims are ok, but if I do more, I tend to drop, however, the adrenaline of the race and anxiety spike me so I usually come off the swim kind of stable. I can go either way on the biking. Some days it makes me go higher some days it makes me go lower. Then the run usually drops me. It is very tight balancing act, and I only do the sprint distances for these races (400m swim, 10-15 miles bike and 3.1 m run). I really do aspire to do the Olympic distance race at least once but I need to build up to that…..

So how about all of you. Has anyone out there found anything to work for exercise? Do you eat before, suspend your basal? Decrease or increase? Does anyone else go high from working out? Have you found a way to fix that? I think we need more studies for people who do sports. And I know there has to be a way to keep us more glycemically stable. I am not ready to give up yet. I am going to work harder this time to figure out what works for me. Wish me luck everyone and please share your feedback!!

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I love to exercise, I truly do, however, I never know what will happen to my sugar..