I Should've Kicked You With My Sprained Foot.

I hurt my foot. I am, without a doubt, one of the clumsiest people on the planet. I hurt myself without even trying. My foot's been bothering myself for a while now, so I went to my Primary Care doctor. When I got there, I was told that I'd be seeing a different doctor because mine was out today. Okay, fine, whatever.

After a general check of my weight, blood pressure, and pulse rate, the doctor came in to see me. I've never met this guy in my life, so I didn't know what to expect. I looked him up on my phone while I was waiting. He is a certified family practitioner, with a specialty in family medicine. Okay. He examined my foot, said I'd be fine, gave me a prescription anti-inflammatory, and told me to get an Ace bandage. He was scrolling through my file on the computer and getting ready to send the Rx to the pharmacy. Then he brought up my diabetes, and that's where things got ugly.

"Oh, I see you're a type 1 diabetic. How's your diabetes?" he sounded conversational, so I told him I was managing. Usually doctors leave it at that. Nope. "What's your A1C?" Eight-point- "that's not managing! That is terrible! You're on a pump, there is absolutely no reason you should have an A1C above 7. What? Are you not checking your sugars? Not bolusing? Sneaking candy?" That's when I used my stern voice to tell him I test a minimum of 6 times per day, correct when needed, and bolus for everything. "Well obviously something is not right. Do you actually see an endocrinologist?" Yes. Every three months. Given my circumstances, she is okay with my progress, and- "any endocrinologist worth their salt is not going to be happy with an A1C that high. What is your BG when you wake up? When is it the highest?" Around 100, usually mid-afternoon, but I have a non-constant schedule, so finding patterns is difficult. "Well, if you're high in the afternoons you need to increase your basal rate. Your carb ratios should remain constant through the day, but if you're higher after lunch, you need to increase your basal rate." Okay, whatever. At that point, I was over it, flustered, and taken aback. So I just listened to him talk, nodded, and left as soon as I could.

I'm still finding my voice when it comes to standing up for myself. I can defend other people all day, but I'm still working on advocating for myself. I didn't want to keep going with this doctor about diabetes, mostly because he seemed to have an overly simplified view of it. He was of the opinion that diabetes is a static, formulaic disease. Input the right number of insulin, and there is ZERO reason you shouldn't get the right numbers.

If I run into this again, I don't know what I'll do. Has anyone else dealt with this? 

Wearing Diabetes on Your Sleeve

Recently I've started wearing my pump sites on my arms to give my abdomen a rest. Also, I fell up the concrete stairs yesterday and my whole tummy is basically a giant bruise. Anyway, having an arm site and wearing short sleeves does lead to a lot of sideways looks, and a couple of comments from people who sit next to me in class.

"What... what is that?" in a hushed voice from the girl in my chemistry class.

"Uh, you've got a... something stuck to your arm. Did you know?" from the girl next to me in my psychology class.

"What the hell did you do to your arm? That looks like it hurt!" from the guy on my other side in psych. This one was my personal favorite.

I take the opportunity to give them a little insight on diabetes. "Oh, it's not a big deal. I have diabetes, and it's for my insulin pump. It's how I get medicine" is usually enough. I try to make them not feel bad or embarrassed for not knowing. So far, so good. 

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. 

A weekend without Henry.

For those not in the loop, Henry is my pump. This weekend I had to go without him. Long story short, Henry crapped out. Over the weekend, naturally.

I've been meaning to address the issue of a backup plan with my endo, but I keep forgetting. Really. I've been pumping for... 12 years now. I've only had to resort to a backup once, and it was only overnight, so I just dealt with it using Humalog. Because all great things happen on the weekend, I had to call into my endo's office to talk to the on-call nurse, who didn't seem happy to hear from me. She ended up prescribing me Lantus. "Now, you remember how to use Lantus, right?" she said hopefully. No. I've never taken Lantus in my life. "WHAT?!? You've never taken Lantus?! What on earth were you taking before you started your pump?" I was taking Humulin N in 2002 when I started pumping.

After that ordeal, my mother drove me to the pharmacy to get my Lantus and a baggy full of syringes (yes, I'm 24 and I still run to my mommy when there's a problem. And boyfriend was busy).

I only had to inject it twice, but that stuff burns. Wowza. Mad props to the people who do this every day. In addition to the Lantus, I had to give multiple shots of Humalog. I'm so used to just pressing some buttons and getting my insulin. Now I have to do math? Ugh. Well, at least now I have a calculator on my phone to help me out and my ratios are fairly easy. 

Monday morning I rushed home from my anatomy/physiology test to get home in time to meet the UPS guy. I almost hugged him, but he mocked my shirt, so I just signed and took the package. 

All in all, I think having a broken pump was good for me. I mean, not the hyperglycemia or the blind panic, obviously. The experience of having to go back to MDI, even temporarily really made me appreciate how awesome it is to have a pump, and it highlighted exactly how much I depend on it. The dependency is a little frightening on its own, but I'm learning to cope with it.  

I'm so thankful for my pump. I love my little Henry. 

Why I Share My Imperfection

My most recent A1C results are in. 8.3. I swear it was going to be so much better than that. I'm actually very disappointed with that number because my day-to-day numbers do not average 200+, even considering the Christmas feast week that would be included in this result. I don't know what's going on, and it upsets me. As a matter of fact, I'm a little ashamed that I can't get things under better control.

If I'm so ashamed of my crappy results, why do I bother to post them on the internet for everyone to read? I do it because I think people like me need to share our stories too. A lot of places on the internet are run by diabetics with sub-7 A1C values who like to pretend that diabetes is easy for them and should be easy for me. For me, diabetes has never been easy, and getting my numbers in line has been a constant struggle since I was 7 years old. Somehow, I hope I'm reaching someone who is roaming the internet looking for people like them, people who are struggling to control this beast, but not seeing the results they'd like.

It's been a long battle for me to even get my A1C down to the 8's. I found an old lab report in my car the other day, dated November of 2012. My A1C was close to 12 at that point. I just... yuck. I mean, yuck. And I've been trying since January of 2013 to actually do something about it. 8.3 is the best I've been able to get. It's very discouraging. Sometimes I feel like giving up because it's never going to get better, but then I realize there is absolutely ZERO chance it's going to get better if I don't try.

I've never been a quitter. I hated playing basketball when I was younger, but I was pretty okay at playing, and I stuck it out to the end of the season. I'm a piccolo player, and if you know anything about piccolos and music, you'll know how much work I've put in to being able to do this 90% of the time:

Why should diabetes be any different? It sucks, and I have to hit a LOT of numbers out of range, but maybe, just maybe, I'll be able to consistently hit it in range consistently someday. 

I've been trying so very hard, and my results are not something I'm super proud of. 8.3. I can't remember the last time I had candy when I wasn't low. I miss desserts and waffles and all those other delicious things that make my body unhappy (this is where I'm happy pizza doesn't mess me up as badly as it seems to mess up a lot of people). I still eat these things, but I know the consequences, and that prevents me from eating them frequently.

So, in short, I share my diabetes imperfections in hopes that I can somehow help people in my situation feel less alone. Or maybe if there is someone out there who needs the kick in the pants to start taking better care of yourself, know that it's possible. Also know that the struggles is real, and just because you're doing everything right doesn't mean the numbers will reflect it. 

From the trenches, reporting from the endo's office

Somebody once wrote: Hell is the impossibility of reason. That's what this place feels like. Hell. I hate it, and it's only been an hour. 

Okay, I took a slight liberty there. But I was at the endocrinologist's office today, and I couldn't help but draw the comparisons. The first step: Separate me from things I find comforting.

They took my pump and I feel naked. #endovisit
— Pancreassassin (@Pancreassassin) February 5, 2014

Of course, I did get it back, but it's the principle that is dirty. The left me sit to rot in boredom. Sure, I had a heap of textbooks that I could read, but they really wanted me to suffer like that? I did use the tools at my disposal to keep my mind sharp: text books and a feeble LTE connection. I needed to make sure those on the outside knew of my suffering.

I'm tired of waiting and I've only been in solitary confinement for 15 minutes. #endovisit
— Pancreassassin (@Pancreassassin) February 5, 2014

30 minutes in solitary. I think they're trying to break me. #endovisit
— Pancreassassin (@Pancreassassin) February 5, 2014

I was onto their trickery.

It's mental warfare. They want me to be so depraved of human contact that I will spill all my secrets. They can't break me! #endovisit
— Pancreassassin (@Pancreassassin) February 5, 2014

And then finally... it got worse. So much worse.

Been here long enough that the Muzak is repeating. #endovisit
— Pancreassassin (@Pancreassassin) February 5, 2014

This is an office run by sadists. They want me to be off of my mental game so I will spill my diabetes secrets. They want me to admit to eating four cookies on December 15th. D'oh! My mind is still mushy from the abuse.

Diabetes Art Day 2014

My family moved states three months after my diagnosis. My mother figured I was having a hard time with everything, and took me to see a child therapist. She pulled out a bucket of McDonald's scented markers (really) and told me to draw a picture of how diabetes made me feel. At this point, I just stared at her for a few minutes until she changed tactics. It was a good try with a sound theory, but my primary means of expression has been and probably always will be words. Writing. Emphatic speaking.

I made my entry back in October, but I never really explained it.

I started saving my insulin bottles after I was really getting into DSMA chats, specifically to create this image. The idea is that everyone in the DOC experiences diabetes differently. We are bound by our carb-counting ways, by medication and misunderstandings. In that regard we are the same. To me, diabetes management means one thing. For you, it probably means something a little different. For someone who is not diabetic, but is really trying to understand diabetes, they have to take in each shade of experience and blend them together to get the full picture. My management is red, and yours might be blue, but diabetes is altogether a spectrum that can't really be measured through one experience or one color.

And that, my friends, is the idea behind this image.