sugar

To-Do List.

1.) Get cured of diabetes.  Preferrably, like, tomorrow.

2.) Until number 1 happens, drink lots of coffee.

3.) Attempt shorter blog posts so that we all don’t need reading glasses when surfing the web.

4.) Get through the next month of school and then tackle a few issues.  There are not enough support options for diabetics in my local area, and that doesn’t sit well with me.  The good news is that a few people can get the ball rolling and change that.  I plan to be one of those people.

5.) Focus on helping others more. I have been so preoccupied with my own health that I need to maintain perspective that others suffer just as much, if not more. And maybe from things other than diabetes.

6.) Keeping number 5 in mind, stop feeling guilty about it.  Accept that maybe it did need to be all about me for a few days because, well, I needed your help with the pump stuff, and you all delivered and then some.

7.) Buy cookies for nurse, pump rep, and doctor before appointment next week.  Because heck yes, I’m going to walk into a diabetes clinic with baked goods coated in sprinkles. And heck yes, I’m going to feed the people taking their lunch breaks to troubleshoot problems with me because they are the epitome of what it means to show kindness and consideration in health care delivery.

 

Good day, folks.

 

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Very Light, with Sugar?!

It’s been a while, but it happened again.  And it possibly occurred twice this week.  No, I didn’t eat cheese and crackers for dinner; that happened thrice, not twice.  I kid you not- there was sugar in my coffee on two possible occasions.

The first incident was Thursday evening on my way to grad class after work.  My routine did not stray from the norm: leave work with five minutes to spare, race to class by pretending that I drive a Ferrari instead of a very dinged up Nissan, and stop at the drive-thru for coffee before screeching into campus.  I honestly think the cream was bad; I drink this coffee twice a week for class nights and it never tastes like this.  But it was… sweet.  And alas, so was my blood glucose that evening.  I hovered at 220 mg/dL, not ideal considering that class is three hours long and I prefer to go into it without the furrowed brow look of an anxious diabetic.

I sipped the coffee cautiously.  Caffeine is the grad student version of crack cocaine.  Sure, consuming boatloads of coffee each day probably isn’t the healthiest option ever, but neither is snoring in an eight-person class.  I need that caffeine, if simply for the placebo effect of feeling that I am awake and ready to participate in the discussion.

With each sip my taste buds perked up a bit.  Maybe the coffee shop girl misunderstood me and put in a flavor shot instead of the one shot of cream I requested?  But what if it’s just that the cream is a little sour (not a big deal if it keeps me awake for class) and I end up bolusing for carbs that in reality do not exist in the coffee?  What if I have to leave class early?  It’s such a small class; I can’t just slip out unnoticed.  My mind was set on “rapid-fire mode,” shooting off a million and one scenarios of diabetic “what ifs.”

In the classroom I compromised with myself.  That last sip was sweet, Ally.  It’s really not worth the problems for a little caffeine.  Buy a Diet Pepsi at the break and get on with your night.  In a stubborn preschooler sort of way, I was annoyed.  I WANT THE DAMN COFFEE!!!  But my mind’s internal lecture won by rationality in that moment.  Deep breath, moving on…

***

I wish so badly that mainstream society could spend a few moments inside of our minds when they are like that.  Each person has his or her own personal problems.  I have diabetes, but I am blessed to have a secure job that pays the bills each month.  Some people may not be so lucky in that regard.  I do not mean to downplay others’ struggles here.  But I do intend to showcase just how much of a mental battle diabetes poses.  Such a simple gesture- sipping on a coffee that perhaps has a spoonful of sugar in it, or perhaps not?- is a diabetic guessing game that can have dire consequences.  The average human being consumes coffee loaded with sugar quite frequently without any further thought than to enjoy the savory flavor.  As diabetics, our options are limited: Take too much insulin, and hypoglycemia appears.  Take too little insulin, and your blood sugar skyrockets, leaving you with a gigantic headache while grappling with a graduate level psychology course that is already a lot of material to digest without any added wrenches thrown into the mix.

I opted for the easiest way out: do not take any more insulin and throw out the coffee.  Figuratively, I do this quite often in life.  It is easier to turn down the sugary shot of alcohol when friends buy a round of drinks for the table than it is to chase high blood sugars all evening.  I am not much of a risk-taker when it comes to calculating insulin doses; I would rather stick to what works, or mostly works.  That is just my way, and who is to say if it is right or wrong?  Chances are it is neither.

***

On Saturday, I ordered my usual small iced coffee, took a large swig, and immediately spit it back through the straw.  Sugar!!!  This time it was definitive.  You would have thought that I swallowed rat poison by my reaction.  I waved frantically at the drive up window until a bored high school aged employee asked what was wrong.  I restated my order and he begrudgingly went off to make a new coffee.  Take two, mission accomplished.

***

I can’t wait for the day when we are cured and we do not have to be intimidated by an accidental addition of sugar in our coffee.  Until then, I will continue my emphatic “very light, no sugar” order at the local coffee shops.  I also pledge to stop and think from time to time of how lucky I am to be able to take a deep breath and to refill my lungs, organs of mine that work well, with fresh air.  Those with cystic fibrosis or lung cancer may not know that feeling anymore.  If any non-diabetics stumble upon this post and read this, I hope that tomorrow when they drink their coffee they take a moment to remember what a blessing it is to enjoy food and drink each day without a second thought.  Life is not always easy, for any of us, for various reasons.  Let’s try to be a bit more understanding of each other.  Walk a mile in one another’s shoes- rather, enjoy a very light, no sugar coffee on me…

True Life: I’m afraid of spiders and insulin, in that order.

Without fail, every summer night when I go outside to get in my car, a few yellow spiders are hanging out on the hood and roof.  When I approach, they look at me as if I am interrupting their block party.  After catapulting myself into the driver’s seat a la Angelina Jolie in Tomb Raider, I give myself the “spider pep talk.”

“Ally, you are better than this.  It’s one moment in time.  Try to forget about them and get on with your life.”

If only the “take your insulin” pep talk was that easy…

Every type 1 diabetic understands the rocky relationship that we entertain with insulin.  We can’t live without it, but sometimes living with it makes the act of living really, really difficult.  Like the times when it almost kills us at 3:34 am with a blood glucose reading of 45 mg/dL when we inadvertently over-calculate the spike effect of pizza for dinner by bolusing heavily.  Or the times when we hit a bad pump site at insertion and the cannula kinks and suddenly we want to drink water out of a fire hydrant like dogs do in 1960s cartoons.  Those times, and any other times that insulin doesn’t work perfectly.  Which is almost every time.  Because. insulin. does. not. replace. a. normally. functioning. pancreas!!!!  As we have all heard many times before, insulin sustains life, but it is not a cure for diabetes.

I will delve further into my own struggles with insulin as we progress in our blogger-bloggee courtship, but for now just know this: I sincerely appreciate the discovery of insulin and how much diabetes technology has changed over the course of my 23 out of 26 years of life spent as a type 1 diabetic.  Every time I go to Joslin Diabetes Center in Boston, I look at the murals on the walls in the lower level of the building which depict some of the history of insulin, and I am so thankful to be a diabetic “now” as opposed to “then.”  But I also fear and respect this life-saving commodity for the abusive lover that it sometimes is to all of us.  I have a tendency to “under-bolus” because of the trauma that over-bolusing has caused in the past.  Whew- the hardest step is admitting that you have a problem, right?

We are stuck in an ongoing oxymoron of sorts.  We can’t take too little insulin or our sugar will be high; we can’t take too much insulin or our sugar will be low.  And many of us grew up with the dreaded lecture from (insert whoever is applicable for you) ____________ (doctor, parent, school nurse, etc.) if we did not perform flawless algebra to compute the correct “insulin to carb to exercise to stress to illness to social life” ratios every time we took insulin.

But you know what?  Once I admitted that the problem was there, a doctor looked me in the eye and told me that it was okay.  Hers was not a lecture of blame.  She told me that I could forgive myself, that I did not have to spend the rest of my days in self-imposed “diabetic timeout.”  She told me that it was normal to be frustrated, that trying to play the role of a perfect pancreas every day was “not a good look” because it was essentially bullying myself, giving myself that loathsome lecture that I never really deserved in the first place.  But why give yourself that negative commentary when you fully understand that diabetes is not so cut and dry?  You are not an outsider to the disease, so do not treat yourself like you are.

I understand that I have the tools to do this, to improve and maintain my health. Not carrying “survivor’s guilt” of sorts is difficult for all of us who put in 110% effort every day only to have diabetes knock us on our asses with a herculean effort when we least expect it.  What truly matters is that we have already entered the boxing ring.  We have given ourselves the “insulin pep talk.”  We have calculated the carbs in the 5 crackers that we snacked on and pressed a few buttons on our insulin pumps to account for them.  And if we forgot to do so, or if we mistakenly took half a unit of Humalog less than what we should have taken to achieve an ideal blood sugar goal, so be it.  We have tomorrow, and the next day, and the next day.

And we keep showing up at the boxing ring ready for a fight, which is more than most people can say…

Coffee helps diabetic eyesight? Count me in.

According to the Journal of Agricultural and Food Chemistry, drinking coffee may help protect diabetic eyes from retinopathy.  See the article here: http://www.battlediabetes.com/news/diet-and-nutrition/coffee-could-prevent-retinal-damange-in-people-with-diabetes.

And how do we take our coffee, everyone?  Oh, that’s right- very light, no sugar.  😉

Microsoft Word’s “Lost and Found” Bin

According to the record in Microsoft Word, I edited what would later become the bones of this blog post almost exactly one year ago.  It was a project for Faustman Lab at Massachusetts General Hospital for a Facebook forum titled “Share Your Story” to raise awareness for type 1 diabetes research at the Lab.  Crazy grad school hecticness must have gotten in the way, or for once in my life I may have been a little shy- I’m not sure, really.  But for some reason, I did not share my post a year ago. 

Today I feel differently.  Part of writing this blog is to be vulnerable- to take the chance that people might brush off my story, that some might laugh, that no one will care.  Something tells me that there are other diabetics out there who “get it,” though, and that hopefully this will resonate with some of you. 

 

It was a simple question, really.  “Come on, Ally, you’re going to have a bigger piece of cake than that, right?!!”

I had just met Kate a few minutes earlier upon arriving at a birthday party for our mutual friend, Sean.  Kate clearly meant well, but she had no idea what she was really asking.  She was unaware that I had been eyeballing the frosting from across the room as if it was some sort of monster lurking in our presence while I calculated the sugar content and the havoc a few bites could wreak on my body.

Kate had no idea that my blood sugar had been double and triple the normal levels all week thanks to a head cold and the usual pump problems of bad insertion sites due to scar tissue build-up; no idea that it had been hard to focus at work but I had no remaining sick time coverage; no idea how much a “ketones hangover” can put the aftermath of any college fraternity party to shame; no idea how guilty I felt after snapping at a well-intentioned coworker who happened to cross my path in the midst of a diabetes-induced temper tantrum, which included flinging a few pens at the walls of my cubicle as they closed in on me; no idea that I would spend my Friday evening unlike almost all of my twenty-something year old peers: setting alarm clocks during the night to deal with the anticipation of a blood sugar crash; and no idea that the next day my pump would kink while traveling and I would have to find an abandoned shopping plaza for some privacy to change my pump site and shoot up insulin.

She had no idea that after all of that- about 15 hours in the life of a type 1 diabetic- many nights I go to bed thinking, You should have done more!; no idea that society, even close friends, seem to imply that it is your fault when your control lapses.  Just avoid candy bars and life should be easy, right?

 

My good friend, Jessica, knew what that larger piece of cake might entail for me, and quickly intercepted any further questioning from Kate with a stern, “No, just no,” shaking her head.

Kate, a bit bewildered, thought better than to pursue the topic and shrugged it off.

Most days, I would pounce on the opportunity to discuss type 1 diabetes with those willing to listen.  I probably would have displayed my blood glucose meter, explained how diabetes has affected my life and the lives of my loved ones, with careful emphasis on how much technology has changed things for the better during the course of my twenty-two years with this disease.  Then I would have described how people like Dr. Faustman and her team at the Faustman Lab have been a reason to keep waging the good fight against diabetes, and how they top my long prayer list each morning and evening.  I could go on to describe people of all backgrounds, those who traveled from Seattle or Mexico or right down the street in Newton, Massachusetts, who I have witnessed over the course of hundreds of endocrinology appointments, all coming to the Boston area for the common goal of improving the health of their family members at the best hospitals in the world.

Alas, tonight was supposed to be a relaxing occasion, a time to enjoy nice company and to forget the stressors of the week, whatever they had been.  Yes, I could have gotten on my “diabetes soapbox,” but I opted not to for the sake of Sean’s birthday.  Instead, I scooped up a forkful of my tiny sliver of cake, pressed a few buttons on my insulin pump, and took a bite, savoring the sweet chocolate flavor.

Everyone has his or her cross to bear.  I do not blame Kate for asking an innocent question that happened to touch upon my cross during a rather difficult day.  I truly hope that she has the freedom to live her life without ever having to contemplate why a large piece of cake might be a negative thing; it should not have to be!  I am confident that one day my future children and grandchildren will enjoy that same freedom and can go back for seconds, without a care in the world, whenever birthday cake is served.

 

With sincere thanks to Faustman Lab for all that you do,

Ally