This is hard...

As people with diabetes, we all have sort of an "nontraditional" relationship with food. Everything we eat must be measured, calculated, and compensated for. But there comes a time in some of our lives where we have to take a closer look and see if that relationship can be called healthy.

I have a sordid mental health history, as some readers may recall. I have anxiety, depression, and Borderline Personality Disorder. I see a psychiatrist regularly, and I see my therapist weekly. I'm a delight, let me tell you. But we are getting off track here.

It was about a year ago that my therapist noticed some odd behaviors around food, the most obvious being that I had stopped eating it as often as I could manage. In a nutshell, I only ate dinner most days. My therapist sent me to see a nutritionist. At first I was resistant because the only experience I had with a nutritionist was way back in 1997 when I was diagnosed, and it wasn't the best experience. I wanted to find a nutritionist who understood diabetes and would understand that sometimes I was making the logical choice by not eating when my blood sugar was high. I wanted to find someone who knew how weird the dynamic with food can be when you throw in diabetes. Naturally, I went to the nutritionist in my endocrinology office.

"Well if you're looking to drop the weight, Weight Watchers is a pretty good option," she said by way of greeting. The woman did not even ask me why I wanted to speak with a nutritionist. I'll admit, I am on the heftier side of the spectrum, but that was not what I expected at all. I accomplished nothing I had set out to do. I couldn't tell this judgmental woman that I was having trouble eating, not feeling hungry, and not caring one bit. I just couldn't.

I returned to my therapist feeling somewhat distraught. I didn't think I had a problem to begin with, but to not even be heard was something else entirely. My therapist then told me I had to go see a nutritionist she knew and trusted, and guaranteed I wouldn't end up feeling the same way.

So I set out again to see a nutritionist. I live in the Atlanta suburbs and I had to drive to a nearby town during the morning rush. What normally would have taken thirty minutes dragged on to an hour and a half. It was gray and rainy that morning.

My therapist was right; this office was much different. It didn't feel clinical, but it also wasn't overly homey. I met the nutritionist, and we sat on a couch to talk. We talked about my food habits, my diet, what I like to eat, my body image, and I'm sure there was more. She did take my weight for records, and I was given the option to not know the number. I signed a release of information so she could share her findings with my therapist.

In my next weekly session with my therapist, we talked about the visit. Wanting one more opinion, she sent me to see another therapist for a consult. Another day, another suburb, and another release of information later, I was back with my original therapist. 

An eating disorder. That's what they decided. All three of them had the same reaction and the same diagnosis. A restrictive eating disorder.

Horse shit. I have diabetes; I have to know about the foods I'm eating. I just don't feel hungry. I don't eat unless I'm hungry. None of this is pathological.

Well, nobody was buying my story. My therapist pulled my mother into the mix somewhere along the way. It was decided that I would work with the nutritionist and my therapist to get my eating back on track. I met with the nutritionist every other week for a few months. I kept a food (and blood sugar) log. She helped me make some meal plans. She called my boss and insisted that on longer shifts I be allowed to stop for a snack (that one was humiliating). She had me eating every four hours while I was awake. It felt like a lot. It was hard and I pushed back so hard on everything.

I wish the story could end here, with me eating regular meals and snacks. But life isn't exactly linear, you know? A few weeks ago my therapist asked me how my eating had been. Ashamedly, I had to look away. Suddenly the weave of her upholstered couch was fascinating. I knew I was no longer doing what I should be doing.

I'm not even sure where things went off the rails. I stopped seeing the nutritionist over the summer. I had to cancel one appointment, and then I never made another one. No longer keeping a food log, I wasn't accountable to anyone for my eating. I let snacks slide. Over time I decided lunch was for losers. Then I stopped breakfasts again.

My therapist insisted that I go see the nutritionist again. I refused. She told me I had two weeks to get my shit in order. Two weeks came and went, and I still don't have my shit together. The last time I went to the nutritionist, she and my therapist thought that doing a treatment program in Nevada (?) was the next step. It is a step I am fighting hard and part of the reason I don't want to go back. The other reason is that I don't like being accountable for what I eat.

Today my therapist dropped the A-bomb on me: anorexia. I don't meet the clinical requirements for that, but it still is something I never thought I'd hear about myself.

That's where the story ends for now. I know I have a lot of work ahead of me, and it's hard. It's really, really hard. Updates to come!

For anyone who bothered to read all the way to the end, thank you. Your support means the world to me. Drop me a comment below so I know I'm not shouting into the void. 

D Blog Week 2017: Diabetes and the Unexpected

Diabetes brings with it a ton of unexpected challenges. For example, take the humble banana. A simple food that, simply put, drives me bananas. One day I can eat the banana and take the right amount of insulin for it, yet my blood sugar will nose dive. The next day I'll eat a comparable banana and take an identical bolus and end up in the stratosphere. This is one of a million examples of unexpected challenges that people without diabetes will never truly understand.

The worst is when things to unexpectedly wrong and there's a possibility you could have prevented it. It's frustrating because something went wrong and because it's partly your own damn fault. Like the one time I decided to rely only on my CGM during a night out to maximize room in my tiny, fancy purse. Of course my Dexcom decided to give me the ??? of doom right when I needed it the most.

For my next example I'll give you a short (but true) story. Even when I thought I had everything planned out perfectly, things still went south. It was a few falls ago and I was going to a Georgia Tech football game (Go Jackets). It was a hot day in Atlanta and I had packed extra pump supplies, just in case. I sweated off the infusion set I had applied only the day before. Right there at the tailgate, I inserted a new set just as the pep band was rounding the corner to our tent and hoped desperately that I wouldn't have to head back to the car for my emergencies-only backup set. Just as we were heading into the game my tubing wrapped around something and nearly pulled all the way out. I was able to save it, but only just. Unexpectedly I had to locate the first aid station and hope they had some medical tape or a Band-Aid.

The upside to all this unexpected nonsense is that I get less worked up over unexpected happenings that are out of my control. Also, I'm more prepared than a Girl Scout in most situations. Usually if someone needs an emergency Sweet Tart, I'll have some in the bottom of my purse. They might be linty, but I have them. Diabetes has trained me to be prepared for the unexpected. 

Back to MDI

I love my insulin pump. I love the control it gives me. I love the freedom from the many pokes I'd otherwise have to endure daily. I took a break from my pump a little over a year ago and had mixed feelings about it. And here I am, about to embark on another pump hiatus.

Why? If I'm singing the praises of my pump, then why, why am I giving it up? Well part of me needs another break from being tethered all the time. The other part is really not up to me.

Ever since my suicide attempt last year, I've had a slew of professionals (and my mother) telling me I needed to give up my pump. They consider it to be dangerous and potentially triggering. It's dangerous to have several hundred units of insulin attached to my body, just waiting to be used against me. It's triggering because it's a constant reminder not only of my diabetes, but of how I have lethal means if my mood dipped that low again.

Do I agree with the plan to get me back on pens and away from my pump? Not entirely. When I tried to kill myself with insulin I used a syringe to inject 100 units of Novolog. The max dose for an insulin pen is 60 units. I already know that 100 units isn't going to kill me. I'm going to need multiple injections, so why does it matter if it's 60 or 100 units? I can still get the job done with an insulin pen. Another thing: diabetes doesn't go away just because I don't have to look at my pump! I think about diabetes all the time. It doesn't matter if I'm on a pump or MDI.

I have an endocrinology appointment on Tuesday. My endo is generally of the opinion that a pump is best for me, so we will see how things go this time around.

Given how low my moods have been recently, I'm willing to accept any help I can get. I appreciate the thought that switching to MDI might help.

What do you think? How would you keep a suicidal diabetic safe from themselves and their insulin? 

In Case of Overdose...

I've been out of the hospital for exactly a month now.

I was admitted around 5 AM on September 30th for an intentional insulin overdose.

 I took my total daily dose in one go, waited 30 minutes, and was about to inject another day's worth when I freaked out and did the only thing that made sense: asked Twitter what to do. I didn't know if it was something I could fix by chugging a lot of juice and monitoring it on my own. When I thought I'd gotten over the worst of it (blood sugar was 90), I got a call from my university's police department. Someone had anonymously reported from my Twitter that I was suicidal and in danger. I talked to the woman on the phone, declined help, and hung up. Five minutes later there were two cars from the city police sitting outside my parents' house at 3:30 in the morning. The police wouldn't go away until I let the paramedics check me over. Their meter read my blood sugar at 30, but the paramedics didn't quite believe it because I was coherent. After a recheck came back at 33, they believed it.

Fast forward half an hour. Three policemen and two paramedics are in my house, and there's a fire truck outside for some reason. The police dispatched to my house have had training in speaking to suicidal individuals, and are going on the word of the paramedics that I should really be going to the Emergency Room. By this point my parents are awake and the police are working to convince my mother to at least get me checked in the ER. So we went to the ER. I was drinking juice the whole way there.

When I checked into the ER around 5 AM, my blood sugar was 73, but quickly plummeted to around 40. I was given a Coke and IV glucose. The orders were written that I Was supposed to have my blood glucose levels checked every hour. Every hour they stuck my finger and gave me a can of coke every time I was below 90. The cans of Coke they give out in the hospital are 7.5 ounces. By my (and my bored caretaker's) best estimate, I had around one liter of Coke.

Finally, about 12 hours after my admission, my BG was >90 for two hours in a row. By this time, though, the nice doctors in the ER had transferred me upstairs and filed a 1013 on me (in the state of Georgia, a 1013 hold is basically a psych hold because I was considered a danger to myself). I was going to be stuck in the hospital for 48 hours to experience one of my worst fears: not having control over my diabetes management.

After ensuring my BG was stable above 90, the doctors did not want to give me any insulin at all, but gave me dinner, which I refused because they wouldn't give me insulin. A few hours after celebrating a BG of 110, they were looking for room in the ICU because they don't do insulin  drips on the main  floor and my BG was >450. Giving IV doses of Regular insulin eventually brought me under 450 (and kept me out of the ICU).

My usual dose of Lantus, when I'm on it, is 60 units. It's fairly large, I know. The doctors on staff did not want to give me more than 5 units that first night, and I fought my way up to 30 the next day. To this day I have no idea what the hell they did for my mealtime doses. They seemed like random numbers to me. In any case, I tried to avoid the carbs and pretend I wasn't hungry. After my initial lows, I didn't drop under 200 until I went home.

For some reason, health care folks seem to think my insulin pump is a problem. I went through this same thing last year when I was being treated or suicidal ideation. It's like they think I'd use my pump to give myself a ton of insulin? It'd be so much easier to use a syringe or a pen, in my opinion. Maybe they think it's a trigger? In any case, the doctors at the hospital (both the general doctor and the psych doctor) did not want me to have my pump back, but wanted me to go back on pens for a while. After discussing it with my parents, we talked to my doctor as a team and convinced him that using my pump is ultimately what's best for my health.

One of the most infuriating things about this whole ordeal is that the entire time I was in the hospital, they would not let me call my endocrinologist. At the same time they wouldn't trust what I said about my own treatment, which is fair given the reason I was in there in the first place. When I went to my endocrinology visit the next week I was told that the hospital I was in was the worst for diabetes care.

 At any rate, please don't worry about me. I'm at home with my supportive family. I have friends to talk to. I have a new therapist and she seems like a good fit. It's going to take some time, but I'm slowly getting over this hurdle and getting ready for the next.

It's taken me a month to get this blog post out because suicide is something that's hard to talk about. My hope is that by talking about it, I can help reduce some of the stigma around talking about it.

Dblog Week Day 5: Let's Get Physical Wild Card

A diabetic walks into a CrossFit gym, and...

It sounds like a punchline waiting to happen, but it also sounds like a regular Thursday night for me. For Christmas my parents got me personal training sessions, and I've been going pretty regularly since then. I'm still the flubbiest person in the gym, but it's important to try. In order to try, I've got to make sure my diabetes has itself in line.

I have to make sure my blood sugar is between 100-250. Any higher and I feel like crap. Any lower and I spend my workout time paranoid about going low. If I'm under 100, I pop a tab or two and trust that things will be fine. If I'm over 250, well, I might not go. This has only happened once. I keep an eye on my blood sugar during the day and aggressively correct my highs. It's always easier for me to eat something than to wait for insulin to work.

During my workouts I mostly put diabetes out of my mind. There is a shelf inside the door at the gym where I leave my stuff, and that stuff always includes my cell phone (serving as my Dex receiver) and a bottle of glucose tabs. My trainer knows I'm diabetic and doesn't say anything if I take a minute to check my Dexcom.

Now the bad part. If I go low during a session, I pop a few glucose tabs and keep going. I very rarely feel my lows, so I can just keep going, keep pushing through it. I know it's not the right thing to do, but I only have 1 training session per week and I don't want to waste 15 minutes waiting to come up. So I don't wait. I might get a little sloppy in my movements, but I rarely have to actually stop.

I'm really bad at the gym. I'm so bad that I don't feel comfortable doing weights without someone to watch over me and make sure I don't hurt myself. So I don't do much at the gym when it's not training day. My favorite type of exercise is no exercise, but the exercise I hate the least is dancing. I dance alone in my bedroom to very loud music.

It's hard to keep myself motivated to move. It's hard to keep myself motivated to do a lot of things. The only thing that keeps me moving is a desire to not look like a marshmallow. What? Have you ever played Wii Fit? If your BMI indicates you're overweight your Mii will look like a marshmallow. Both virtually and in real life, I don't want to be a marshmallow. It's vain, it's shallow, but it's true. 

Dblog Week Day 4: The Healthcare Experience

I want to start of today's post by saying how much I love my endo's office. By and large, they have their shit together. I know exactly what to expect when I go in and they rarely deviate from the script. I love that. If I get my eye doctor to send over a summary of my last exam, they will have it in their system and my doctor will know how my eyes are doing. Again: I love my endo's office. I do.

This post isn't supposed to be a love letter though. It's supposed to be a summary of things I would like to change about my healthcare experience.

My initial thought is that I wish everyone could just learn the basics about diabetes to avoid pissing me off. I know that this isn't going to happen; it would be unrealistic. If they have to know about diabetes, then they have to know about other conditions, and it snowballs into a huge mental Rolodex that our healthcare providers are expected to know off the top of their heads.

Realistically I would like to see better communication between HCPs. Mostly I want to see my other doctors listen to what my endo says. She's good; she will write notes to other doctors on what to do in terms of my diabetes. She's not telling them how to do their jobs, rather she's telling them how to make their work fit in with what she's already doing for me. They just don't listen.

Dblog Week Day 3: Language and Diabetes

I'm a person with diabetes, but I'm also a diabetic. I'm a person with depression, but I'm also depressed. I check my blood sugar, but sometimes I test it.

Words matter. What you say to others and how you present your ideas matter. I understand the concept of using person-first language when dealing with the chronically ill; sometimes we just want to be seen as people, not as diseases. I agree with treating people with respect, and for most of the diabetes folks online that means calling them a person with diabetes (PWD) instead of a diabetic. Symbolically they are saying that diabetes doesn't define them; they are more than a diagnosis. I understand the position they are taking, and I will fully support them by calling them by PWD if that is what they want.

I am a diabetic. I am a PWD. In regards to this issue, I don't care what people call me. I respond to diabetic, PWD, hey bitch, and most of what people want to call me. Personally, I have a thick skin and I don't feel more or less defined by diabetes if someone calls me a diabetic.

---EDIT---

I do not suffer from diabetes, even when it's making my life super hard. I live with diabetes. I endure diabetes. I battle diabetes. No matter what, I refuse to be known as someone who suffers from diabetes. Diabetic, PWD, whatever, but I am not a diabetes sufferer. 

Dblog Week Day 2: The Other Half of Diabetes

When you have to endure a mental illness along with diabetes, you spend a lot of time wondering if the two are connected in any way. Obviously there are days where diabetes is just an annoying pain in the ass and affects my outlook, but is this monster of a disease at least part of the reason my brain is broken? There is a huge correlation between having diabetes and having depression. Because my depression has been presenting with suicidal ideation, I have spent more time than I'm comfortable with contemplating whether or not life is worth living with a body that requires not only round-the-clock glucose monitoring, but also 8 pills daily to keep me functional. On my bad days, it's a no, then it becomes a struggle to talk myself down from the proverbial ledge.

Interestingly enough, I still can't decide if my diabetes and mental health are totally linked. Most of the time my diabetes doesn't bother me on a conscious level. Even when I have days where I can't get my blood sugar into target range, I'm mostly able to brush it off. That's the best part of running a Twitter devoted to diabetes jokes: it forces me to look at this disease and everything surrounding it in a totally different light. It really helps my outlook when I feel like crap and try to come up with something silly to say about it.

Dblog Week Day 1: Message Monday

Who am I? What the hell am I doing here? Why am I writing this?

I'm here for a myriad of reasons. My online persona started on Twitter where I just wanted to make jokes. Through Twitter and the greater DOC in general, I realized that I have a few opinions and things to share that take more than 140 characters.

When I first started blogging, it was because I was really bad at diabetes. I had just gotten a new endo and I was just starting to take care of myself; my a1c was 8.5, down from 12. I felt like I represented a group that wasn't out there: the imperfect diabetic. Really, there is no "perfect" diabetic, but at the time I felt like I didn't measure up. I was reading posts about people who were dissatisfied with their sub-7.0 a1c when I was struggling to get my 8.5. It felt stifling that nobody recognized what was going on for people like me, so I started blogging. The support I received was overwhelming.

Given my beginnings, I have a hard time maintaining the original message. I was disappointed with my last a1c, which was 6.6. I'm now a part of the mass I never thought I'd belong to.

Now I blog infrequently. I only blog when I have something to say, an opinion to give that might not already be out there. There are tons of great diabetes blogs out there that usually write things a lot better than I ever could. Sometimes when I write here it's because I want to share a message or a thought not only with my diabetes friends, but with my non-D family and friends.

So, dear friends, that is why I'm here. 

The Post I Didn't Want to Write

I didn't want to write this post. I really didn't, and I'm worrying about pressing "publish" on it this time. I've written it several times over in the last few months. I just feel like I can't get back to regular diabetes blogging without letting this skeleton out of my closet.

I know this is a diabetes blog, but I have talked here about my depression before. (You can check the "labels" section in my sidebar.) I've always said that the easiest way to reduce stigma around something is to get people to talk openly about it. So I need to talk about some personal things now. I need people to understand. I'll be sharing this blog post with everyone I know online and in person, so excuse me if parts are a little vague. Feel free to shoot me a message if you have questions.

Some background: I have had depression for a long time. I'm 26 and at least half of my life has been covered by this dark cloud. The first time I had to see a counselor for depression, I was 13 years old. I fought against taking antidepressants until I was 19 and couldn't cope on my own anymore.

This past fall (2015) was a particularly bad one for some reason. My brain decided that it wasn't enough to just be depressed. I'd always had the occasional suicidal thought, but my brain needed to ramp things up. I couldn't stop thinking about killing myself. Everything became a plan to end it all. To top it all off, I'm usually attached to enough insulin to get that job done.

One morning was particularly bad for some reason, so I called into work and told them I wouldn't be in. Then I called my psychiatrist and told her what was going on. She told me I needed to come into her office, so that's exactly what I did.

I ended up spending time as an inpatient at a psychiatric hospital. After the inpatient stay I transferred to an outpatient program where we (the patients) spent time working on things like mindfulness, reflection, and various ways to cope with out maladaptive behaviors, be they drinking, drugging, cutting, or just being flat out depressed. I met a lot of cool people and was working hard at this program, but I was not getting any better. I ended up needing to spend more time on the inpatient unit because I was still very suicidal and the staff felt it was in my best interest to not be at home. Additionally, my psychiatrist thought it was a good time for me to take a break from my pump because he was afraid I was going to use it to hurt myself. I did write about taking a brief pump break, but I don't really remember doing it. Why?

Electroconvulsive Therapy. ECT. Even in psych hospitals it carries a bit of taboo. I was mentally in a dark place with no options left. I'd tried many, many drug therapies to no avail. I'd spent weeks in treatment at a psych hospital. Nothing was helping me and I was constantly suicidal, so I agreed to undergo ECT treatment.

Over four weeks I had a total of 12 treatments. It didn't hurt and I don't remember much of it. The main side effect of ECT is memory loss around the time of treatments. I don't remember most of December or early January except that I was pumpless and hopeless, yet optimistic this treatment would work. Did it work for me? Mostly. The visceral need to be dead is gone, and that is a huge relief to me. ECT did pretty much nothing for my mood. I'm still working with doctors to find a good pharmaceutical aid for that one. I'm seeing a therapist. I know that eventually something has got to work. It has to, and I'm not giving up until I find what works for me.

Thank you for reading this far. It seriously has taken me months to decide to hit the "publish" button on this.

Diabetes Goals: 2016

2016 already? Time does fly. I'm not normally one for setting goals, but I've done this for the past two years, so why not? Also, I know it's almost January 3, but whatever.

• Keep my A1C at or below 6.5 all year. I spent all of 2015 at 6.5 and 6.4, so I think I can do it again this year. It feels so good to have your endo actually tell you good job on your A1C. 
• Use as much insulin as I need and not feel bad about it. Somewhere along the way it got implanted in my head (by a certain CDE I visited) that using more insulin is some sort of failing. As I've already established, I'm fairly insulin resistant. I exercise, and I've taken Metformin (to no avail). I'm still insulin resistant and it's not my fault. I didn't do anything to cause it, and not using as much insulin as I need just because I don't want to see a high number of units on my pump is just stupid. 
• At least try decreasing the high line on my CGM. Right now it's set to 170. I'd like to at least try it at 160 and see how it goes. 
• Have more good days than bad, diabetes-wise. Sometimes there's absolutely nothing you can do about the random nature of diabetes, but I'd like to do my best to control the beast.
• Make people laugh about diabetes-related things. I'd like to continue my lighthearted shenanigans on Twitter. 

That's all. I like to keep my goals manageable and reasonable. The only thing I might add is to make myself blog more, because I got really bad at it last year, but I don't want to push my luck with too many goals. ;)

Back to MDI

For the past two months I've been back on Multiple Daily Injections (MDI), and I'd like to talk about the reasons. I had finally hit the stage I never  thought I would: total device burnout. I love my pump. He's a purple Medtronic 723 named Henry. I use him in conjunction with a Dexcom G5. I never, ever in my life (until recently) thought I would voluntarily give him up. So what changed?

Henry and I just hit our 13 year anniversary. Okay, it hasn't been the same Henry the whole time, but I've still been on an insulin pump for 13 years. That's half of my life. For 13 years I never took a voluntary break. The longest I was without a pump was 3 days when I completely wrecked my pump at camp. There were two other times I went without, but they were both less than 2 days each. In 13 years I had at most 7 days away from my pump, total. Other than that I was attached almost constantly to the thing for literally half of my life. Thirteen Years. I was starting to feel a little bit tethered. 

In the months leading up to our anniversary I was looking for reasons to not just throw the stupid thing into a lake somewhere. I have variable basal rates that Lantus can't address. Tons of people would kill to have the luxury of an insulin pump. It's awesome that I don't have to stab myself with a needle every time I want to eat. I'm really bad at the carb game sometimes, and I don't have to inject myself again when I guess wrong. My blood sugar likes to play by its own rules most of the time, and I don't have to inject myself yet again when my numbers are doing their own thing. 

All of the above were swirling around in my head, and then I had a thought occur to me (and it sounded suspiciously like my mother). "Nobody is saying you can never go back." I started to weigh the options in front of me. What did I stand to gain by going back to MDI? My skin, for one. My hips and stomach look like a battlefield. For another, I wouldn't have something logging my every carb and unit. My endo would only know if I recorded it for her, and nobody ever said I had to. The biggest thing was my physical freedom. For 13 years I've picked out my bottoms carefully to make sure they could hold the weight of my pump. If I didn't have a pump, that wouldn't be a problem. 

I called my endo to see about getting some pens. I had worked out my Lantus dose a few months prior when I destroyed my pump at camp. I knew I wanted to use pens because I was given a pen of Humalog and one of Lantus when I messed up my pump at camp because they had a few laying around. My endo was super confused as to why on earth I would ever want to give up my pump. My A1Cs were pretty good (6.4) with the pump, so there was really no reason to change. I listed my reasons. After a little back and forth, she agreed that it was ultimately my choice, and she wrote a 90 day prescription for pens and pen needles. 

Almost 2 months in, and I'd forgotten how much I hated MDI. This is hilarious to anyone who knows how hard I resisted getting a pump in the first place, but I think that's a different story for a different time. As I said before, I'm not always the best at the carb game and frequently have to correct a few hours after a meal. It's not my insulin:carb ratio being wrong; it's just me (sometimes) being really bad at counting carbs coupled with me being quite insulin resistant. 

Speaking of being insulin resistant, my Lantus dose is pretty huge. It's 60 units huge. No matter where I inject or how long I hold the needle in my skin after injection, some always comes back out. The amount that comes back out varies, and I don't know how much this is messing me up throughout the next day.

As it turns out, not logging everything can have its downsides. Like forgetting if I actually took a correction dose, and if I did, when I did it. There's some guessing that can be done, but sometimes I just can't be sure I actually took a correction or not. My memory is pretty bad. 

The people around me aren't fond of watching me stick a needle into myself. This isn't a huge deal for me, because my health comes above their comfort, in my opinion. I'm not a total asshole though, so it does weigh on me. For what it's worth, I don't care at all what strangers think of my injections. I really, really don't. 

I'm fairly insulin resistant and carb sensitive, so I end up injecting frequently. I mean, I have to take insulin for carrots. There are very few foods that won't mess with my numbers. The sheer volume of injections is annoying. 

I'd forgotten about the bruising that can accompany injections. Now my skin isn't dotted with old infusion sites. Instead it's mottled with bruises from many shots. Even in the beginning when I was a good girl and changed my pen tip with every injection, I still got the bruises. 

I'm not a wasteful person at all. I reuse just about everything I can, and try to not waste anything if I can avoid it. This adds annoyance when I get down to the end of a pen. Let's say I have to inject 15 units for dinner, but I only have 10 left in the pen. Do I waste the 10, or inject 10 and then another 5 from another pen? It's frustrating, but I can't stand to waste, so I will usually inject 10 plus 5. 

Remember earlier when I mentioned my variable basal rates? Yeah, that really has come into play. Because I'm still wearing the Dexcom, I can see exactly what happens when I try to use Lantus for my basal. I'll go to bed around 120, then dip down to around 70/75 around 3 AM, and be up to 250 by 9 AM. Then I'll spend a good chunk of my day trying to get my numbers back to where I'm used to seeing them- under 130 most of the time. This is the biggest reason I want to go back to my pump. It's not the number of injections I have to take, it's not the bruises, it's not the inconvenience. It's the fact that  I can't manage my basal needs with Lantus, and then it takes me hours to get back to a reasonable level. Because of this, Dexcom is now estimating my A1C to be 7.1, up from 6.4. 

All in all, I'm not okay with the way my care has suffered since switching back to MDI. I'm frustrated with the higher numbers I'm experiencing and I'm probably going to be back on my pump by New Year. 

Yes, the Crossfit Thing, Again.

It's been a little over 24 hours since the infamous Coke=Diabetes Tweet was sent from the official account of Crossfit. There have been numerous articles written about this fiasco, and I originally had no interest in writing one of my own. I spend a good bit of time on the internet, like most 20-somethings, so I've developed a thick skin for this type of ignorant joke. I was content to just let it go by; there were already articulate people fighting the battle with Crossfit on Twitter and Facebook. Then things started getting crazy. Instead of apologizing, maybe back pedaling, Crossfit not only stood by its tweet, but then opened its figurative mouth and spouted a lot of things that made it clear that the person tweeting for Crossfit does not understand diabetes. That's fine. Most people don't understand diabetes until they're forced to (and yes, it just highlights how far we have to go in raising awareness). The issue comes in the fact that they are not willing to let go of their misconceptions.


Before I get into the meat of this post, I want to express how strong the Diabetic Online Community (DOC) is. Generally, we stick together. We support one another, we chat, we fund raise, and we kick ass. Generally. When these jokes (obviously geared to the type 2 crowd) come out, the first issue always presented is "not type one! Nope, not me! I was diagnosed as a child and I only ate organic unicorn meat before I was diagnosed; I was perfectly healthy!" and the typical response is "oh, of course we didn't mean you! We know you guys are totally innocent!" So, I'm not going to touch that one. We are aware that type one and LADA (slow-onset type 1) are autoimmune conditions that we don't know how to prevent. We know.

My problem with the obvious "not me" gut reaction of type ones is that we are throwing our T2 brethren under the bus. I'm of the opinion that we have the more socially acceptable diabetes because it's generally accepted that we didn't do anything to cause our diabetes. But we need to stick with our T2 friends. I know there are quite a few T1 folks who resent the T2s because they feel T2 is easily preventable. I've already written about why I fight these misconceptions, but seriously, nobody asks for diabetes. Nobody deserves diabetes.

Some facts from the CDC:

As of their 2014 report, and estimated 29.1 million people in the United States have diabetes, and 95% of those cases are type 2. Out of all T2 cases, an estimated 80 percent of  them occur in overweight or obese individuals (those with a BMI of 25 or higher).

Okay, so dismissing the 1,455,000 T1s and the 5,529,000 "thin" T2s in the US, we are left with 27,645,000 overweight or obese type 2 diabetics. That's a lot of overweight T2s, I know. It shouldn't be surprising, given that being overweight is one risk factor in developing type 2 diabetes.  Newsflash: regular, full-sugar soda is a beverage that is relatively high in calories. Consuming an excess of calories causes the body to store the extra calories as fat, adding weight.

I am not denying that drinking cola can contribute to gaining weight, which can contribute to developing type 2 diabetes.

Given that 66.8% of Americans are overweight, and 35.7% are obese, I would honestly expect to have more type 2 Americans if weight were the biggest contributing factor. If HALF of all obese (BMI of 30 or greater) Americans had type 2 diabetes, there would be over 57 million type 2 Americans. It seems pretty clear to me that weight is only one contributing factor in the onset of type 2 diabetes.

Do you remember being taught about the fire triangle in elementary school? Fire needs three things to survive: heat, oxygen, and fuel. If you don't have all three you don't get fire. Weight is only one side of the proverbial triangle. But diabetes doesn't actually have a neat little triangle of causality. We're not really sure what shape it is because there are so many factors that influence T2: ancestry, age, sex, birth weight, and more. Blaming diabetes on obesity is overly simplifying a complex issue.

Ultimately, the big fuss surrounding the Tweet is really about fat shaming. For a fitness Twitter account though, that's business as usual. Because, you know, these elite fitness types work so hard for their bodies, and everyone who doesn't is just wrong. And if you're one of those wrong people, you could totally benefit from their fitness regime and supplements. You could fix yourself, you know. you could save  yourself from diabetes, because as long as you work out and don't drink soda, you can't get diabetes. Tell that to the 5 million T2 diabetics who are at an acceptable weight.

Another large component of developing T2 diabetes is ancestry. 13.2% of black Americans have diabetes, compared to 7.2% of whites. But we can't post a meme about having diabetes because you're black, because that would be uncouth, right? It totally wouldn't be cool to blame diabetes on something that an individual can't control.

Tl;dr If you say "drinking Coke will make you fat and give you diabetes," you sound like this:

Dblog week day 5: Foods on Friday

Okay, I'm going to start of by admitting that food and I don't have the best relationship. I don't advise eating like me. Some days I don't eat unless I go low, some days I don't eat, and most days I don't eat what a human should. Instead of listing off things I eat on a daily basis, I'm just going to give an overview of the foods I do eat when I eat them.

Breakfast: I hate typical breakfast foods. Most of them are filled with a gazillion carbs and lots of sugar. I also don't like eggs, which are a breakfast staple for many. That being said, I love cereal. My biggest weakness is Froot Loops. I have to bolus 30 minutes before eating them if I don't want to see a huge BG spike. If I wake up in the morning and I'm on the low side, I will fill a bowl with Froot Loops and chow down. My other favorite food for breakfast is a peanut butter sandwich. I know, I know, it's not a typical breakfast food, but whatever.

Lunch: Lunch is my meal most likely to be skipped. What I eat for lunch depends on what I had for breakfast. I eat a lot of sandwiches for lunch. Peanut butter is my go-to, but sometimes I switch it up and have some cheese or faux deli meat (I'm a vegetarian). There's usually a Diet Coke at lunch time whether or not there's an actual lunch.

Dinner: Dinner is the one I almost always eat, mostly because my boyfriend also has to eat and it seems like the thing to do. Dinner is highly variable in what I eat, but pasta and Mexican foods are my favorite to eat. This is the meal where my vegetarianism comes into play. My boyfriend loves meat, and we usually end up making our own versions of the same dish most nights. For example, I'll make a veggie burger and he'll make a burger. It creates more dishes, but fewer arguments.

Snacks: Hummus is the best thing ever. Seriously. It's also very versatile. You can dip so many things in hummus: veggies, pita, a spoon... anything! Sometimes I'll eat hummus on an everything bagel thin for a meal. Mostly this section is about my love for hummus. Tip: take plain hummus and mix is with buffalo sauce for hummus with a delicious kick. It's so freaking good.

Again, I don't advocate eating the way I do, or the way I don't, however you look at it. I know it's not exactly healthy, but the blog prompt said there's no judgments on this, so I'm presenting it just the way I am! 

Dblog Week Day 4: Changes

I was diagnosed in late 1997, almost 18 years ago. A lot of things have changed with my diabetes management since then. The technology, the theories, and so on. I've changed too. Obviously I'm not 7 anymore. Let's take a stroll down memory lane...

I remember getting my first glucometer, the OneTouch basic, when I was diagnosed. I thought it was huge, and I almost wish I still had one hanging around to see if it really was as big as my little mind remembers it being. For those of you who never got to experience the OT Basic, it took a large, pendulous drop of blood to cover a circle in the middle of the test strip. It came with a Penlet lancing device that I swear used paper clips as lancets. It never occurred to me that testing would ever happen any other way. After the OT Basic, I got the Profile, then was in for a big change when  Imoved to the OneTouch Ultra. Everything about it was so small! The lancer was smaller, the meter was smaller, the strips were tiny and the sample size was nothing compared to what I was used to. It was the first meter I ever used that had strips that sucked up my blood. That was so cool. Since then, things have continued to get smaller and easier. Now I even have a CGM that can tell me my BG any time.

When I was diagnosed. I was on older insulins that meant I had to eat the same amount of carbs at same time, every single day. I had to get up at 6 to get ready for school, so that meant I had to get up at 6 on weekends to eat the same number of carbs. I was not the favorite sleepover guest. My dad made me the same gross 45 carb shake for breakfast every day. It had peanut butter and eggs in it to keep my BG stable. I remember that very clearly. I also remember being a hungry kid and not being able to eat because it wasn't snack time, and sometimes 15 carbs just didn't cut it. I've never been a big meat or cheese eater, so a lot of the time I was just hungry. Whenever I complained about being hungry my mom would tell me to go have a glass of water.

In 1997 I was started on insulin vials and syringes. Those insulins could be mixed in the syringe so I only had to take one shot at breakfast and dinner instead of two. I remember being really excited when I got to use pens for the first time. It may have been because my hands were smaller, but they felt heavy, and I was terrified I was going to drop them while they were stuck in my body. I went back to syringes because of that. Eventually, after a year of nagging by my mother and doctor, I started on the insulin pump. Even the pump was different in 2002. There was no bolus wizard, so I still used my trusty calculator keychain to figure out my doses. The biggest thing about the pump was that it gave me more freedom. If I wasn't hungry, I didn't have to eat. If I was hungry, I could bolus. It was like freaking magic.

In 1997, I hated diabetes. Okay, that hasn't changed a bit. I still hate diabetes. I deal with that hate differently now. I used to throw hissy fits and refuse to take my shots. In my teen years I didn't want to be different from my peers, and I hated diabetes for making me so different. I tried my hardest to ignore diabetes. I did the minimum it took to stay out of the hospital. As I got older I got used to the doctors telling me that I was doing a really bad job of managing. I didn't care. Diabetes made me different, and diabetes was going to kill me. I was used the that idea. My a1c was 12 for the longest time. Even when I wanted to get better I didn't know how because I was so out of practice. Eventually I adopted a better attitude. I got a better doctor by chance, and now I wouldn't give her up. Now I'm active in the DOC, on Twitter, and sometimes I blog. I joke about diabetes, but not in the usual cupcakes=diabetes way.

So much has changed since 1997. Things I didn't even think of (like CGM) are now a part of my daily life. I can't imagine how different diabetes management will be in another 18 years. Part of me really hopes it will be cured. The other part of me is just accepting that I'll probably just have a few more gadgets to play with. Only time will tell.

Dblog Week Day 3: Clean it Out

I'm not in the mood for anything heavy today, so I'm not going to be cleaning out my emotional closet. As a matter of fact, my literal diabetes closet is actually in order. My purse... well, it's not. I'm not a super girly girl; I don't have a lot of purses. I mostly just carry around the one. It's become a catch-all for a variety of things. Take a look:

There's makeup, not that use it much. I have some gum, my test kit, lip balm, a pencil, a bottle opener I got in Seattle and subsequently forgot about, a AAA battery, the cotton ball from the last time I had blood drawn, an empty Humalog bottle, and, oh yeah, a shit ton of used test strips. The stack of test strips is what makes this post really about diabetes. This post has made me realize that I really should clear that crap out more often. I didn't even realize I had the cotton from my last blood draw. Grooooooss! 

Dblog week 2: Keep it to Yourself

When I joined the diabetes internet, I did so with the purpose of being open. I was not a "perfect" diabetic then, and I'm still not. I did not want to gloss over the negative aspects of diabetes. I refuse to do so. I've always been very open (maybe too open) about diabetes. I share pictures of beautiful CGM graphs when I have them, but I also make sure to show glimpses of the bad days, too. There are very few areas of my life that I'm not broadcasting, but there are a few. Allow me to gloss over them:

I'm not going to give you super detailed information about myself. Very few of you know my last name, and it's going to stay that way. I'm not telling you where I go to school. I'm not going to tell you how much I weigh, and I'm not going to give you my address. I think you understand what I"m saying here.

I try my hardest to not post about other people. This includes my friends, family, boyfriend, and medical professionals. I don't mention any of these people by name because they probably don't want me to. They didn't sign up for Blogger/Twitter just because I did.

I don't like to talk about exactly how much money I have to spend on diabetes. It's depressing. I believe I have answered a few tweets asking about insulin prices with my insurance, but I must have been in a generous mood. I don't like talking about the financial burden of diabetes.

To sum it up: I have loose lips on the internet, but some things are just out of bounds. 

D Blog Week Day 1: I can!

It's taken me a while to sit down and really write this post. I've had diabetes for a while now, so it's not that I'm a stranger to doing things while diabetic, or I couldn't think of anything cool I've done. My problem was the exact opposite: I have too many cool stories of things I've done in spite of or because of diabetes. I got to do the coolest summer abroad in Greece during 2011 (seriously, I got to play with bones). I've graduated college. Diabetes has helped me overcome some of my social anxiety. There's so much stuff that I have done with diabetes that would make a really good story, so maybe I'll save them for another time. Perhaps my post will seem mundane in comparison to others, because I decided to write about something so simple.

Despite diabetes, I've managed to fall in love.

Maybe that doesn't seem like a big deal, because in the grand scheme of things diabetes isn't that huge. It isn't going to turn me into a raging monster (except when I have high BG). Diabetes is not going to stop people from caring about me. Unfortunately I spent years believing that I would never find love while diabetes was in the picture.

I usually don't bring up things like this, so it's a little difficult to say. When I hit the age where boys were no longer a disgusting alien race, it occurred to me (not for the first time) that not everybody has diabetes, and dealing with diabetes isn't fun. Why would a perfectly good boy want to waste time waiting for me to check my blood sugar when he could be eating already with another girl? Why would a boy want to go out with me when there's a chance that my diabetes will do something stupid and I'll have to cancel when other girls wouldn't? I knew how much of a burden diabetes was to me, but that was the hand I was dealt. Why would another person willingly subject themselves to being around that all the time?

Like most girls, I joked around in high school and had a few boyfriends here and there. It wasn't until I hit my senior year of high school that I realized that diabetes didn't have to be a relationship changer. My best friend in the whole entire universe put up with my diabetes. She understood that sometimes we had to hang out and watch TV for a bit until my BG was in line. A boyfriend is supposed to be like a best friend, just a little bit different, right? If my bestie accepted the diabetes with grace, any good guy should be able to do the same, right? I could even consider myself fortunate that I had a built-in, non-negotiable test that my potential suitors had to pass.

Now I'm going to get mushy and nostalgic.

I met my current boyfriend in 2009 while doing marching band together. We were friendly, and we  talked a little bit here and there. We weren't super close. I started having problems with some depression medications I was taking in 2011 and I posted something vague about it on Facebook. Being the awesome guy he his, he messaged me to talk about it. Eventually he asked me out. He knew I had diabetes before we started dating, but I was still shy about it on the first date.

 At the time of the first date I was drowning in diabetes and trying super duper hard to manage it. Nothing was working, and I had one of the worst endocrinologists on the planet (for real, he was fired by his practice). I was back to manually logging numbers in an effort to make myself check more. So I explained my huge purse and unsightly notebook while I was poking my finger at lunch.

We've been together almost four years now. We live together with a dog and a cat. I can unequivocally say I'm in love with this guy. He makes me happy. The best part is that I have someone outside my family (BFFs are family) that I can bitch to about diabetes. It's taken some training, but he knows the lingo and all of my routines. We can laugh together about the strange places test strips end up living.

For anyone out there left wondering: yes, you absolutely can find someone who will love you, diabetes and all.

Downplaying the D-beastie

"I took insulin. I'll just grab some water to go."

"It's nothing a glass of juice won't fix!"

"Really, it's not a big deal."


I catch myself saying these things all the time. Really, it's understandable. I have things I want to do (plans with friends, a party, whatever), and I really don't want diabetes to get in the way by being its annoying self. The biggest problem is that diabetes just wants to ruin my day sometimes.

I'm going to a beer tasting with my friends, but my BG is really high because my site went bad overnight. Diabetes and I are fighting, and my friends are about to end up in the middle of it. I'd better diffuse this situation. I'm not spilling ketones, so I do an injection, change my set, and head out the door because it's not a big deal

Do you see how easy it is to downplay diabetes like this? The truth is, this beer tasting is outside, during the summer, in Atlanta. The truth is that all I want with a high BG is a tall glass of water instead of beer. The truth is, I'm irritable right now, and I'm feeling dehydrated. The truth is... it is a big deal to me.

I was raised to not use diabetes as an excuse for anything, and I don't. I'm also the person that doesn't want to get in the way; I like to go with the flow. I don't want to be "that diabetic" with the problems, so I never let it show that it bothers me.

I was thinking about my downplaying habits in relation to personal advocacy. What is it saying about the severity and seriousness of diabetes if I'm always saying it's not a big deal? Are people going to take my fundraising and awareness campaigns seriously if I'm able to do things with a high or low blood sugar?

Moving forward, I'd like to change the way I handle it when diabetes acts up. If it's beer time, and I'm high without ketones, I'll likely still go out. I'll explain why I'm holding back on the beers. I'll tell my friends I'm going to be a little cranky for a while, because diabetes is a part of me, and I'm kind of a big deal. 

Foot Update!!

A friendly warning: there is a picture of my stitched foot in this post. 

I had my foot surgery a few weeks ago. When I got home from the surgery, my dog wouldn't leave me alone for a few days. Everything went fine with the surgery, and they put me in a sexy, sexy post-surgical boot. A few days after surgery, my foot was quite swollen, and my toes looked like Vienna sausages.

The pain meds were... an experience. I was prescribed Vicodin, which I thought I had taken before. Well, I have never taken Vicodin before, and it makes me really, really nauseated. I mean, to the point of almost vomiting in my boyfriends car (thankfully I didn't). That being said, taking Vicodin and an anti-emetic every four hours did nothing to the accuracy of my CGM numbers. So at least it had that going for it.

In addition to the lovely drugs, my doctor prescribed this neat little machine for me. It circulates really cool water around my sore foot and squeezes on my other leg to prevent DVT. I really only used it for the first few days after surgery, and now it's sitting in my living room. I really do need to call the guy to return it.





I went back to the podiatrist yesterday, almost three weeks post-op. I was told that my foot looks good and is healing quickly. Yay foot! The doctor took my stitches out, manipulated my foot for a bit, and then bandaged it back up.I haven't been allowed to get my foot wet since the surgery, so that means it hasn't been washed since before the surgery. That's why my doctor's initials are s till on my foot. Also, the smell! I won't even get started on that....

I still have some swelling and bruising in my foot, as well as some pain and stiffness. You know what, though? I'll take it for now. I have at least another week in the sexy gray boot before I can start slipping back into my dancing shoes. Right now I'm still walking like a slow poke, but I should be back to normal-ish soon.