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.

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.

Living Life With the Double D's (NOT another boob post)

I posted back in March about the other D in my life: depression. Then I wrote that things were okay, and they were. But okay slowly drifted into less than okay, which led to a change of medications. These new meds aren't really doing their job, and I'm fairly certain that at the end of their probationary trial period they will be replaced with another.

Strangely, it hasn't impacted my diabetes. Like, at all. In fact, I dropped my A1C by 1.2 points between February and May. Usually when depression hits me hard, my diabetes care suffers. The thing is, it's super easy for me to get down about my medical conditions. I'll likely be diabetic forever. My belly has little white scars all over it from years of needles. I have strange bits of machinery hanging off of me. I'll be on thyroid meds forever, and my brain can't function very well without pharmaceutical assistance. You get the point. It's incredibly easy to let my health (or lack thereof) get me down.

I've heard many times that challenges we have in life are what make us stronger people. I never really thought that was really applicable to me until I realized that diabetes is actually the thing that keeps me going some days. Some days it's hard to make myself do anything. By "anything" I mean even simple things like get out of bed, shower, and take the dog out. On days like that it is easiest to just fall into my standard routine. For some reason, I have to know my BG number first thing in the morning. Yes, I have a CGM now, but I still need to poke my finger and hear the beep of the meter to make it real. Glancing at the CGM screen is easier and usually just as accurate, but like I said, I fall into my standard routine when I need to. Then I eat the same thing I eat almost every day: something covered in peanut butter. It might be easier to grab something faster and sugarier than that, but I still don't want to mess up my BG.

I have no idea why, in the midst of caring about nothing, I care about my diabetes so much. In that moment, though, I'll take anything I can to keep my head above the water. So I get up, I check my BG and eat peanut butter, and take the dog out.

No matter what, I always care about the DOC. Usually, they care about me too. I know I've really dropped the ball on blogging lately. I kept tweeting, though. It's just that the last few months have been really, really bad with my depression. I'm not going to lie. It sucks, and every aspect of my life has been suffering (except the diabetes). I'm starting to feel a little better, I think. It's a good thing, too. I'm going to have so much crap to post about with the holiday adventures coming up, and my next endocrinology appointment coming up on December 1st!

So, stay tuned, readers, because there might be something posted one of these days.

The Other D in My Life

Since this blog's inception, I have known that I needed to write this post. I believe that talking about issues (like diabetes) can help spread accurate information and help to reduce stigma. Not only do I struggle with the stigma of being diabetic, but also the stigma of having depression. I also have anxiety, but that can be its own post.

The first reaction to hearing of my depression is usually disbelief. The next reaction is that it's not so bad. Life is great. The conversation usually goes something like this: "No! You don't seem depressed. You just need to cheer up and see the positives in life."

The common assumption seems to be that depression is a personal weakness. I'm not strong enough to deal with the realities of life. Another assumption is that I choose to be depressed. Why I would choose depression is completely beyond me.

I don't seem depressed to outsiders. That's a big problem with these "invisible" diseases. You can't see the pain I'm in because I've left my infusion set in too long, just like you can't see  what's going on inside my head. That doesn't make it any less real to me.

I received my official diagnosis in 2010, and I started medication shortly after. I wish I could say that everything got better and it's all sunshine and rainbows now, but it's not. I started taking medications in 2010, and I haven't stopped. They have been working (mostly). These days, my depression is manageable. I can deal with it, and push through the fog. Sometimes I have to work a little harder to see the sunshine, it's true. The point of medications is not to make me happy; the point is to bring me back to even, so I have the same opportunity to be happy as everyone else.

Does depression affect my diabetes? You bet your behind it does. On the bad days, the days when it's hard to get out of bed, I force myself to do the things I need to do to stay healthy. I know everyone has bad days, so this isn't unique to someone with depression. Some days I need to remind myself to take it one blood test, and one bolus at a time.

In general, my body is extremely sensitive to stress. Having depression/anxiety issues does not help with that. The stress induced by my chemistry lab made my blood sugar rise 200 points during the first two labs, and then I got smart and increased my basal rate during lab. Performances, (watching) sporting events, and the most random sources of stress make my BG soar.

I know there are more people out there like me. I know there are other diabetics, maybe some reading this blog right now, who also have to deal with depression. If you aren't comfortable speaking about your depression, that's fine, not everyone is. I do hope that by putting this out there I can spread a little bit of information, or reduce the fear around the D-word. Maybe I can allow someone out there to know they aren't alone, that they aren't the only one trying to slay more than one dragon.

If you think you have depression, you need to find someone to talk to. The first steps are the hardest, but in the end you'll be thankful you took them.