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Friday, April 24, 2015

Talking pregnancy and diabetes, aka Dear DOC

Dear DOC,


Today's entry is feeling heavy-hearted but necessary...

I am as of now 27. Years old that is, and not a BG value ;)

And I really want to have a baby (there is a more than good chance I will try to conceive in the next year) Also, my last A1C was 8.6%. Up almost two point from the last 6.8% I had.. This afternoon, I have had a craft beer (7% ABV) + 1 Bud Lite so please bear with me. I recognize that my alcohol use is having detrimental effects on my BG control and I am no longer afraid to state that. Sometimes, it feels good to have a few drinks and forget about diabetes. Sometimes, it's OK. But certainly not when you're trying to prove to yourself that you can maintain long-term stable and "good" BGs (along with, of course, complete abstinence from things like alcohol, etc.) Don't worry - I am physically and mentally capable of not using alcohol or any other drugs, that has been established (I am familiar with addiction and I am familiar with bad habits, and thankfully this is the latter). Although bad habits can be hard to break. Recently, I had to admit to myself that the reason for this particular "bad habit" is a strong desire to neglect my Diabetes management (please don't judge), because life has just been too damn overwhelming. Couple that with a desire to reproduce (and not seeing/knowing clearly what all of that is going to look like and the self-doubt of - "can I do this, do I deserve this, bla bla bla") has left me feeling a little messy in my head to say the least. 27. Its weird fucking age. A part of me still feels 17. Another part sees my 30-year old sister-in-law (who became a mom this year) and I feel like I am being pulled into two opposite directions - work-hard, play-hard grad student/ postdoc vs. responsible, "well-balanced" (whatever that means) adult/soon-to-be mother..

In my "defense" (not that I need to "defend" myself to anyone, except myself perhaps) I have been on a crazy 7+ year journey with not only Type 1 Diabetes, but living abroad, shaping/growing a marriage, obtaining my Ph.D., becoming a mom to three puppies (and a couple of cats), getting a post-grad job, maintaining post-grad job, thinking about future, (oh, yeah - and the diabetes management, cause of course!)

Things change, that's how it rolls - I know that. A year ago today I was not thinking about having children. I was ecstatic about landing a job, busy writing my damn thesis, and not at all concerned with reproduction. And things have changed a lot since then.. I know that in one week, month, year, whatever, things may be very different. The thing NOW though is that I'm terrified: terrified of pregnancy, complications, my own "inadequacies". (Sidenote: although I know some of you guys on FB/IRL/both/whatever, having this blog be semi-anonymous  - as in at lest my employers won't know it's mine - allows me to not even hesitate to express my true emotions and  deepest of secrets - it has become my therapy and for that I'm grateful.) Back to the point: today, I re-read Kerri's early posts before she TTC('d), etc. I was really happy to feel that others go through this too - as in the doubt and fear and lack of accountability. Am I ready to become more accountable? Am I ready to face my fears and be accountable for the highs? I think so. Clearly, I am ready to admit to you, dear DOC,that I have been struggling in some ways and that I want things to change.

I did read Ginger's Diabetes Burnout book last month, and it was very helpful- I highly recommend it. The combination of the whole "I didn't do perfectly this week, so fuck it all" along with the sentiment's expressed on Kerri's blog about accountability for more than a week or two have really struck a chord with me. I need to go easier on myself a little and not feel like a total failure for lack of (the elusive) "perfect" control.

The truth is that I know that I'm perfectly capable of diligently managing D into submission. I have had A1Cs in the low sixes so I know I can do it! The scary past is hearing the friends/sister-in-law's comment of "Hey - let's be pregnant together!" Sounds so exciting, right? - but there's diabetes for me, and they don't have that hanging over their heads!! So when I think about the realities of not only being pregnant, but having to hear about close ones' "normal" pregnancies, I frankly feel like throwing up ;( However, I know that they will be supportive and understanding if I open up about the difficulties of pregnancy with T1 (and although I'm sure I will, that's a challenge in itself for me, on top of everything, because in my life with diabetes, as I was diagnosed in my very late teens, I have always felt like proving to everyone that I can do anything, and diabetes "doesn't affect anything", "I can do anything")...

TRUTH: Diabetes affects EVERYTHING.
BUT: I CAN do anything :)

Sorry for the rant, as I said it was necessary and I feel better now - love ya'll ;)

-MM

P.S. Stay tuned <3

Thursday, April 2, 2015

after treatment.... a look back (aka the power of insulin)

Every April it's my birthday, and also every April I get nostalgic/nauseated thinking about when I checked myself into MGH back in 2008, two days after my 20th birthday, to start treating (once and for all) my type I diabetes.

As I mentioned in my last post, my A1C was "over 18" at that time. I had spent over a year walking (zombying) around Boston, putting on the regular face of a very skinny undergrad who happened to have to pee 2-5 times an hour. I remember when the depression set in (can you blame me?) and I remember the severity of the denial - the food binges at Whole Foods, the endless bottles of gatorade/powerade/younameit as I stood behind the CVS Rx counter pretending to be a friendly and efficient pharmacy tech. {In case you aren't familiar with this blog, stop feeling sorry for me now! Today, I am more than OK!} Nevertheless, every April I can't help but look back to some degree. For some reason, it's hitting me harder this year, 7 years after the fact (7-yr itch I guess).

I think the reason I was able to hold on for that long was the slow progression. One of the main reasons I didn't treat right away was that  oftentimes I would check my BG and it would be in the 90s (without any insulin whatsoever), although it would often be 300+ after meals) So - it was caught early and progressed slowly (did I mention that I really didn't like needles back then - of course, I am now apathetic to them).

That day. I went to lab. I peed. I was trying to do lab work. I peed. I had the most awful disgusting deep cough you could imagine that wasn't going away. And a headache. My adviser suggested I go to health services. I obliged. My bg was "high", my ketones were "through the roof", (should I even talk about my cholesterol, triglycerides, etc. & oh! and my weight of 90-something pounds!) my pcp pleaded with me on the phone to go to the hospital. I obliged.

Standing outside (in the rain) waiting for the taxi (I told HS btw that I was going to "walk there" and they were like "No, We are calling you a taxi!") to go the the ER. Making the phone calls to my mom and boyfriend seemed surreal. "I'm going to the hospital and getting insulin because I'm really sick and I'm done fucking around." I said. Or something to that effect. I pretty sure I described most of the hospital experiences themselves (all two fucking days of them) in my older posts back in 2012.

There was paperwork. There were nurses and doctors. There was a silly student who said - "oh, birth control and diabetes - you must have blood clots and that's why your legs feel crampy! " There was an attending who promptly corrected him (as in "she's in dka so the leg cramping is likely from that, not the birth control [ps. thank god I was on birth control back then"]) In the end, the defining moments were: 1. receiving insulin; 2. administering my own insulin; 3. getting out.

Here's on the getting out part;
The trees were clearer, the sun was brighter, the depression was nonexistent. Non-existent. I was alive again. I walked to CVS to fill my scripts. It was a little strange because I had just transitioned from working as a pharm tech at that one to going to a private Rx to tech, so I knew those who filled my scripts (in fact, the days I was hospitalized were supposed to be my last two days of work there and wow! what a way to exit and then come to fill a bunch on insulin scripts to prove I wasn't just calling out sick).

Looking back, I obviously wish I treated sooner. A lot sooner. But I can't blame myself forever. All I can do is try to give back by raising awareness, making connections, doing the best I can today, and slowly building my career so I can have a lab of my own (which I will undoubtedly end up using for Diabetes research to an extent, regardless of what the grant money's for ;)

On that note - don't worry if I'm out for a while (grants don't write themselves you know  <3

The person, the numbers

Hey there -just a random story today -

Back when I was first diagnosed and struggling to accept the fact, a pharmacist I worked with said to me:

"You? Type 1 Diabetes? Cake! You can do it. If anyone can do it it's you because you're so smart! Seriously - you're lucky; you can do this."

I have to admit I had no idea what he was talking about back then. At the time I was in denial and refusing to treat, even refusing to learn about treatment - and here he was - assuming that because I was a biochemistry student I should be "all over it" (in more ways than one). That's the thing about the emotional impact of a chronic disease diagnosis - it doesn't matter if you're educated, it matters whether or not you're willing to accept it and deal with it. I know there are plenty of people who don't study biology and were more than willing to accept (even be relieved at) a diagnosis and motivated to learn how to best treat. But not me. I spent a year and a half stuck in the mentality that there was no fucking way I was diabetic, walking around with n A1C of "over 18" and lying to myself. No, dear pharmacist, it didn't matter then how "smart" I was (according to you anyway).

I don't know why I am so bitter about that memory. Probably because once in a great while I can't help but think of how pathetic I felt that whole year+ and how I may live to see the consequences. I hope if anyone out there knows someone or is that someone who was in my situation, they will seek treatment sooner.

Because it's not so bad. And he was right - I can do it. I can count carbs in my head (cake), I can keep numerous variables in my head, I can adjust rapidly, and when I/m really diligent and everything comes together, I am in fact full capable of reigning diabetes into staying in the low to mid 100s with no lows (almost) indefinitely. Although, I am human still - and there is the emotional element. No matter ho much of  a diabetes beast I can be, I can be in a rut all the same. Still the same person - whether the A1C is 6.2, 8.6, or "over 18".