2.

My 2-year-return-to-insulin-shots-anniversary came and went a few weeks ago.  The anticlimactic day was all the validation I needed to know that this was the right choice for me.  I no longer count down the days, weeks, or months on shots; they are my new normal until I switch things up again or diabetes is cured.

People probably wonder why I still harp on my defective insulin pump saga, and the truth of the matter is that one can talk as much or as little about trauma as one sees fit.  Medical trauma is particularly cruel; our already-limited “control” further fades away as our cells cry out for insulin.  I continue to harp on this because the wounds are still fresh, however many years after the triage.  Yet the bandages of an engaged healthcare team have eased the pain, and I finally feel better.

Two years ago I feared that I would die of ketoacidosis while sleeping on my couch.  I worried that the graduate school experience I had always dreamed of might slip between my fingertips.  Or worse, that the mental desperation would become too much- that in my attempts to be heard my voice would eventually fade away.

Multiple daily injections (MDI) are not always pretty, but they are a guarantee that insulin is getting into the body.  MDI is literally and figuratively another shot at life.  (More to follow, but not everyone has this guarantee currently; they deserve a chance, too.)

Two years later and I have successfully completed my Master’s degree.

I flew to California twice to participate in Stanford Medicine X.

I didn’t die on my couch.

And I was too busy living to remember that it was my 2-year Shotoversary.

Insulin makes it happen.

graduation-tulips

 

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Tequila Shots?!

Okay, Lantus shots.  Almost as much fun, right?

Many thanks to Jeremy of 70-130.com for his insightful piece on various insulin pump and insulin injections perspectives.  I found it therapeutic to reflect on my journey from shots to pumps and back to shots again.  You can read Jeremy’s blog profiling some #doc viewpoints here.

 

 

 

 

Milestones.

This week will be my final class before graduating with my Master’s degree at the end of December.  The saying about a weight being lifted is true.  As I handed in my final paper last week and my classmates hoorayed, happy to see one of their own crossing the finish line, I instantly felt relief.

Unless you live under a #doc Twitter rock, you know that I was on an emotional rollercoaster last week.  I second-guessed whether I would get my final paper done in time.  Mostly, though, that doubt was due to the anxiety of moving forward in life, of leaving behind the structure, love, and discipline that grad school has blessed me with over the past two years.

As much as I have complained about homework on the weekends, truth be told, I will miss the academic environment very much.  There is a definable purpose there, a working towards something greater than oneself, a joy of learning amongst peers and professors who are just as passionate about healthcare and making the world a better place.

Grad school becomes a part of one’s identity, and I am scared out of my mind to not cling to that role soon.  My go-to introduction spiel at cocktail parties has been, “I’m Ally.  I work fulltime at _____ and I go to grad school at night at _____ and have I mentioned how freakin’ busy I am all the darn time?!!”  As fulfilling as these different components of my life are, it is now time to put what I have learned to good use and to explore new opportunities- after taking a much-needed vacation.

My identity as a graduate student may be shifting, but I do not necessarily have to be lost.  Perhaps I have already been found, and that is what is so scary- those moments of truth where you reconcile who you are, with who you have been, with who you want to be.

Complicating such notions is the fact that today marks my one year shot-o-versary, or the anniversary of returning to a multiple daily injections regimen after a decade of insulin pumping.  I have beaten a dead horse over this, but in case you are new to Very Light, No Sugar: Insulin pumps are great.  Sadly, I experienced product defects with mine and watched my health slowly slip away as a result.  The pros of using injections for me, personally, outweighed the cons, so here I am.  Do what works for you.

My current apathy about the shots milestone surprises me.  In many ways I expected to be just as proud about the shots as I am about my impending Master’s.  But I’m just… not.  Shots are my new normal.  Some day that may change (diabetes cure, please!), but for now, this is what I am working with.

And to be honest, I think that apathy is a good thing.  It means that I have made peace with some of the previous bitterness, that I have chosen to chalk up the pump company’s ignoring of my email pleas as being due to an overloaded pump rep.’s inbox, even though I know in my heart that was never the case.

I now experience the freedom of insulin getting into my body every time I inject, and those #JerkFaces also known as ketones do not hang around much anymore.  I have proven to myself that I am stronger than I ever believed, and that it is good that we have many options in our diabetes management tool boxes.

Every day, I have access to life-sustaining medication, something I will never take for granted again.  Others are not as fortunate, and I am attuned to their suffering because my faulty insulin pump taught me what it feels like to lack insulin.  It is a brutal, desperate torment.  Only insulin can fix it.  And while I feel blessed to have escaped my insulin-delivery mishaps, I will always remember and pledge to help those who do not have access to insulin.

I recall emailing my doctors a week into our shots trial and implying, “Hey, I tried.  Time to call it quits and return to the pump?”  And I remember my dismay at their gentle urging to stick it out one more week, one more month.

Today- one more year- I am happy that I listened.  The difficult days are still here.  But the good days are back, too.  Any day not spent battling ketones on the couch is a day that I must be thankful for, and I am.  I just need to work on expressing that more often.

So here it goes:

I am thankful to have enjoyed the opportunity of receiving a graduate-level education.  During the days of my insulin pump saga, when the ketones were syrupy-thick in my blood and the couch was my home, grad school was the bright light that I could focus on.  I read and read and read and repeatedly told myself that one day I would feel better and have my degree.

Today, I am happy to be here to see that internal mantra come to fruition.  Thank you to everyone who has rooted for me along the way.  My gratitude is best expressed by leaving you with the prayer said on my long drive to Boston before difficult medical appointments:

“In every circumstance and in all things

I have learned the secret of being well fed

and of going hungry,

of living in abundance and of being in need.

I can do all things in Him who strengthens me.

Still, it was kind of you to share in my distress.”

-Phillipians 4:12-14

 

November: 166,650.

WDD 166,650

Diabetes Awareness Month is finally here!  I’ve stocked up on blue apparel and drafted, re-drafted, deleted, expanded, and re-visited my Facebook status updates, tweets, and so on for World Diabetes Day on November 14.  Being new to the diabetes blogosphere/social media arena, I feel the importance of November, and specifically November 14, more so than I may have in the past.  This is our day and our month. I’m clearly biased here, but I do not believe that diabetes gets its fair share of attention in society and in the media. Take a gander at my diabetes rant if you want my heated feelings on the matter.

I am truly happy for other organizations and causes that garner lots of fanfare during their designated months and days. Seeing the State House lit up in pink for breast cancer awareness month in October as a simple gesture of solidarity for the cause always puts a smile on my face.  My siblings’ delight in dumping ice water all over me for the ALS Ice Bucket Challenge is a fond memory for our family, and it is also a reminder of those very brave individuals who battle an insidious disease every day.

As human beings, we all suffer. Lots of us have health conditions; others, financial troubles; some, relationship issues; many, a mix of a multitude of things.  Connecting as human beings to support one another in our moments of pain and in our moments of triumph against such pain is all part of the human connection.  It is time to make that connection happen for diabetes, and the diabetic online community is certainly capable of moving mountains to do this.

There are various creative diabetes awareness efforts going on right now. I am all for anything that supports diabetes in a positive way, and I truly enjoy participating in various efforts when time permits me to do so.  However, we are also a bit fragmented as a group- not because we want to be, but because the options are too vast and our passions for advocacy too wide and multifaceted.  This is not necessarily a bad thing.  It speaks volumes about us as an intuitive, determined community.  We are always salivating over new and improved ideas for advocacy.

Rather than making things more complicated and diluting the already-expansive efforts to raise awareness, I’m going to put a simplified twist on an old diabetes advocacy message. We have all seen those posters outlining how many injections, pump site changes, finger pricks, etc. that a diabetic has endured over his or her lifetime.  Those posters always knock the wind out of me- no matter how old the person holding up the sign may be.  There is a universal truth to these visual aids: One shot is one too many. If we cure diabetes, there will never be another “first shot” of insulin for so many out there whose islet cells may one day rebel.  Sadly, as we all know, the shots are sometimes the “easiest” part when it comes to diabetes.  Again, #1ShotIs1TooMany.

We can live in a world without diabetes.  It is a matter of hard work, advocacy, financing, and research.  As the doc, we already know the ropes when it comes to informing others about our daily lives with diabetes.  But those who do not live it firsthand- who do not wake up at 3:14 am to change failed pump sites, who do not feel the burn of injecting into scar tissue, who do not wipe their child’s tears during a bad low blood sugar- have perhaps not been exposed to the reality of diabetes.

My tactic is simple: “Shock and awe” is good, occasionally. From a marketing perspective, tease your social media followers a bit.  Engage them by throwing out the line and seeing if they will bite.  I plan on posting my picture with the blue diabetes awareness circle etched in using the World Diabetes Day app.  In Paint or a similar program, I will then write in blue the number of needle pokes I have endured over 23 years as a type 1 diabetic.

As an anxious person, there have been times in my life where I would perform blood glucose tests upwards of 25 times per day, so my number of pokes is quite large, and it is most likely an underestimate. To figure out my number, I scribbled crazy mathematical break-downs to include “hundreds of shots in this timeframe, then switching to the pump during this year, then testing more or less, etc.”  The final number- 166,650– is my very best educated guesstimate.  What are your numbers? We are all so much more than the daily pokes and prods, but they have also permanently marked us as strong individuals. Let’s celebrate this concept with others, and let’s vow to find a cure so that the next newly-diagnosed person is not sentenced to years of replicating our needle tallies.

When people chomp at the worm on the end of the hook, I will clue them in as to what diabetes is all about. I will explain how it is not caused by cupcakes, how much it pains me to see the worry on my friends’ faces on the bad days, and the other ins and outs of taming a sadistic autoimmune beast every day.  Then I will tell them about the good stuff: the #doc, #dsma, the doctors and nurses who have refused to give up, the fact that it is not too late to work towards a cure.

When it comes to advocacy this month, do what works for you; support the message that resonates with your own diabetes struggle. If you hear a diabetes joke at the local ice cream shop, politely inform the misguided comedian that his material is outdated based on modern science.  Foster a conversation about diabetes with someone who may be misinterpreting what it means.  Wear blue.  And wear your heart on your sleeve while doing so.