Friday, June 15, 2012

Groucho Marx

You know that saying, "I don't want to belong to any club that will accept me as a member?"  It was running through my head last week when I attended a Type 1 group.  A young woman from the JDRF was filling us in on all the super cool stuff that the Foundation had planned for the upcoming year to raise funds for diabetes research and encourage us all to get together and have fun.

All this super cool stuff, and I couldn't get that saying out of my head.  Couldn't get past the fact that I was sitting in the waiting room of a doctor's office surrounded by young adults with Type 1, all of us with a stake in everything this young woman was saying.

How was it that I became a member of this club?

And why couldn't I hold back the tears?

Thursday, June 14, 2012


I went in for a routine physical last week and received a call from Dr. B's office this afternoon with my lab results.  The voice on the other end of the line said to me, urgently, "Dr. B wants you to see an endocrinologist.  You have an A1C of 5.9."

She said this as though it were a bad thing.  I, on the other hand, had to swallow back my excitement before replying, "Thank you, but I'm already under the care of an endocrinologist.  I have diabetes."


So funny how her grave news was my great news.

Wednesday, May 30, 2012

Flat line

Conjures up images of frantic interns and their patients, stretched out in hospital beds or operating tables.

I've been watching Grey's Anatomy :)

There's another type of flat line though.  This one isn't deadly.  Isn't dire in the least.  It's the one stretched across my Dexcom screen.  The one I've been riding for the past couple of days.

I began reading Dr. Joel Fuhrman's Eat to Live over the weekend.  As a vegetarian, I had been eating a decent amount of produce.  But my schedule over the last several weeks had me making sandwiches on the go.  Grabbing cheese and crackers for snacks.  I was good on the carbs and proteins, but the only vegetables were the sprinkling of celery in my black bean soup or the lettuce and tomato garnishing my hummus wrap.

I made an intention to center my meals on greens.  To enjoy salads as a main course with one grain serving on the side and maybe some fruit to round it out.  I felt surprisingly full and upon awakening my Dexcom, delighted at my blood sugar's minimal movement throughout the time I ate and and in the hours following my meals.

M and I savored this super easy, super delicious strawberry blue cheese salad several times over the weekend, and the biscuits we made to accompany this awesome lima bean stew were divine.

Yes, it takes a little more planning and preparation to produce meals brimming with fresh fruits and vegetables.  But that flat line, the one signifying stable energy - life - for me, it's been well worth it.

Tuesday, May 29, 2012

Sweet tooth

I've got a sweet tooth.  And I used to begin feeding it first thing in the morning with a short stack of chocolate chip pancakes.  I remember the day I was diagnosed with Type 1 diabetes, how I thought my diagnosis meant no more sugar for me.  Ever.  And a sense of panic set in.  People, my health was in a precarious state, and I was concerned that a Crave cupcake would never again cross my lips.

Before learning how to manage Type 1 diabetes and understanding what this diagnosis meant and what it didn't, I determinedly eliminated all added sugar from my diet, relegated desserts to special occasions like birthdays or weddings.  And I felt great.  Empowered.  Energetic.  Those desserts that I allowed myself on special occasions even tasted better than I remembered.

Nowadays I'm still going (mostly) without refined sugar.  But it's not because I'm passing on dessert.  I'm learning to tweek favorite recipes and discover new ones, like this basic chocolate cake recipe from Heidi over at 101 cookbooks.  I substituted maple agave for the maple syrup and skipped the frosting.  And Dexcom showed a nice flat line during and after my indulgence.


Tuesday, May 15, 2012

You Can

I met with a Certified Diabetes Educator for the very first time yesterday, and it was the best $40 copay I've ever spent.  D spent two whole hours answering the bulleted list of questions I had arrived with:

  • How do I adjust my insulin for exercise, and Tex Mex?
  • What should my postprandial targets be now and during pregnancy?
  • How do I know it's time to adjust my basal and/or bolus when I'm sick or stressed or my I:C is changing? 
  • My toes have been cramping during yoga.  Is this related to diabetes?  What do I do about it?
  • Where are other viable, discrete pump and CGM sites on my body besides my favorite - my upper glutes?
  • My sugar rises significantly between the time I wake up and the time I have breakfast.  What do I do?
D answered each and every one of these questions.  Then he looked at me and said,, "The goal is to manage diabetes, not to perfect it.  You cannot perfect it."  Or something awfully close to that.  He proceeded to tell me at exactly what point I should be worried about complications.  And only if it was years and years that I was producing readings like that. 

Then he got quiet and asked me, "What's the hardest part about diabetes?"  And I just started crying.  He asked, "Parts?"  And I told him.  I told him that I couldn't enjoy myself anymore when I went out to eat with friends because I was constantly counting and recounting the carbs I ate and wondering if I was going to go high or low.  I told him that I missed being able to go for a run after work without having to plan hours ahead of time or carb up.  I told him that I sometimes felt insecure about the way my pump and CGM looked on me. 

And he just listened.  He didn't encourage me.  He didn't say those two little words, "You can..." followed by variants of being able to do it.  And in just listening, he was telling me, "You can...just talk."  And it was so relieving.  And so painful.  And I continued to cry all the way home.  He gave me permission to feel my feelings.  I didn't have to feel strange for feeling sad.  I didn't have to sit through him saying I have resolve and resources and support and so what do I have to be sad about?  People live full, healthy lives with diabetes.  I'll be fine.

And so the most important thing I learned yesterday was the power of presence.  The importance of not trying to encourage or fix or do any number of things that I think will make the other person feel better.  Sometimes the goal is not to feel better.  It's simply to feel.

Wednesday, May 9, 2012

The Sweet Spot

Driving home the other night, cool air from the A/C swirling gently through my curls and around my neck, the local country station playing one of my favorites, I relaxed into my seat and took a deep breath.

And aaahh.  That feeling I get when I'm right in the right range.  I retrieved my Dexcom from the back pocket of my purse and took a peek.  83.  The only way I can describe the feeling is...drained.  Like there had been fluid from the tips of my toes to the crown of my head, and it had all been drained out, leaving me lighter and emptier.  Calmer.  I feel so calm and peaceful when I'm in that sweet spot.

I relaxed into it for a bit, then was struck by the thought that I wouldn't be here for very much longer.  That my blood sugar would meander slowly, ever so slowly, away from 80.  It had been awhile since dinner, and down was the only direction for my blood sugar to go.  Or, if I snacked before bed, slowly, ever so slowly, up to 90.  Then 100.  Then...

I felt such envy in that moment for people whose body naturally keeps them in this sweet spot.  People who feel this light, this empty, this calm.  All the time.


Saturday, May 5, 2012


Since participating in the JDRF walk in the fall, I'd been receiving monthly emails about Type 1 support group meetings and dinners out.  Each time, I would add the event to Google calendar.  Excitedly anticipate it.  And, one week out, inevitably delete the event when a client requested to see me the same evening.

Last week, though, a change in the script:

Me: How does next week look for you?
Him: Could we meet Thursday night?
Me: Sure.  What time?  Sure.  But we'll need to meet earlier.  How about 5pm?
Him: That should be fine.  I'll ask to leave work early.

All this to say that on Thursday night, I left the Type 1 support group dinner on my calendar and, after my appointment, headed to one of our local Mexican restaurants for good food and good conversation with other Type 1s.

I arrived at the restaurant, spotted a long table of 30-somethings, and walked over.  Tentatively, I asked, "Is this...?"  "Yes.  Have a seat!"  I sat down next to a certified diabetes educator, D, and quickly learned that an appointment with him would unlock the secret to consuming Mexican food and exercising to my heart's desire without the unpleasantness of a low.  I accepted his card gratefully and made a mental note to call him next week.

Across the table from me were two women having a discussion about their pumps, which they had placed on the table between them.  They were fiddling with these devices and swapping tips.  Right across the table from me.

A couple seats over was a young woman who had been diagnosed last year, just like me, at nearly the same age.  We found out very quickly that we actually worked in the same office building!

I felt so pumped leaving dinner.  D was right when he told me to keep coming back.  That I needed this group.  I felt known.  I felt like I found a place I belonged.

Tuesday, May 1, 2012

D is for Darn Right!

For me, one of the most challenging aspects of managing diabetes is estimating carbohydrates in restaurant food.  I've become super conscientious about measuring and weighing foods when I prepare them at home so my carb count can be precise and I can reduce the risk of lows and highs - although nothing was minimizing my highs over the past few days while I was sick!  My insulin:carb ratio went from 1:14 to nearly 1:7! the midst of all this, M and I decided to have his cohort over to our place for dinner.  For deep dish pizza.  Now, there are times when I can resist food like this.  The food whose carb count I have no basis for even estimating.  But it was from our favorite local chain.  It was whole wheat.  It was topped with veggies. And I just couldn't resist.

Two hours later, after the last family had left, I headed to the bathroom for my nightly routine.  Teeth brushed, contacts removed, face washed.  I took out my testing supplies and was astounded when my meter flashed 95. I turned on my Dexcom to input my most recent reading and my eyes swooped from left to right, across the flat line displayed on my screen.  This had been a night of self-indulgence: a side salad, two slices of deep dish pizza, and a traditional Chinese sweet brought over by one of our friends.  And my sugar had stayed stable.

Take that, D!

Friday, April 27, 2012

Sick of it

I hate diabetes the most when I'm sick.  Not only do I feel rotten because I'm achy and stuffed up, but my blood sugars run so high.  After seeminly endless fiddling with my basal and bolus and a couple stable readings, I start experiencing the lows that indicate the virus has run it's course and I'm back to my normal ratio.  Grrr diabetes!

Wednesday, April 25, 2012

Bit by bit

I relish mornings like this one.  Mornings when it's time to switch out both my pump and my sensor.  Pump every 3 days, sensor every 7.  So about once a month, there's a morning where I have no electronic bits anywhere on my body for thirty minutes or so.  I love lathering up and drying off without needing to navigate around these devices.  Even better is stepping on to the bathmat and looking in the mirror and seeing just skin.

Then I insert my sensor, fill, prime, and adhere my pump, and head out the door.  

Saturday, April 21, 2012

Free(dom) Weights

A lot has changed since July 2011.  Scrutinizing food labels for sources of added sugar.  Racing my liver in the early morning to see which one of us can get glucose into my bloodstream the quickest.  RL had told me that my early morning highs when I delayed breakfast were the result of my liver detecting minimal blood glucose and dumping its reserves into my bloodstream.  Praying, deep breathing, doing anything to maintain a state of relaxation and keep my body's fight or flight response - and the associated glucose release - at bay.

But what I miss most about my life before Type 1 diabetes is the freedom to run, lift weights, stretch, crunch, and twist whenever I'd like to.  To push myself for however long I can withstand it.

A friend and I had planned a phone date a couple nights ago.  The appointed time came and went, and I hadn't been able to get ahold of her.  I pondered all that could happen between feeding two young boys and tucking them in to sleep - quite a lot - and reconsidered how I'd spend my evening.

My first thought was how good it would feel to get a solid workout in before bed.  My second thought was how I'd just eaten a hearty dinner and given myself insulin to cover the whole thing.  I couldn't work out without risking a low, unless I had a pretty substantial snack.  And after my hearty dinner, even a small snack wasn't going to fly.

During my last appointment, Dr. G suggested strategies to fuel my workouts.  Reducing my basal.  Which I'd already tried.  I had turned off basal delivery entirely during workouts, with little effect.  I had reduced mealtime bolus by one unit, two units, anything various sources advised would do the trick.  The only thing that seemed to work for me was to skip my mealtime bolus.  My sugar tends to drop by more than 100 points during workouts, and skipping my bolus has been the only way I've been able to maintain my stamina.  Yet, I fear the effects of letting my sugar run 100+ points higher than it should be just so there's room for it to drop.

Dr. G suggested bringing gels or other quick forms of energy with me to fuel workouts rather than skip my mealtime bolus, something I still need to try.

I'd really love feedback on what has worked for you all.  How do you fuel your workouts without running too high or risking a low?

Tuesday, April 17, 2012


I underwent a procedure a couple weeks ago for periodontal disease.  Dr. P assured me there was nothing I could have done differently to prevent myself from developing it, that having had undiagnosed diabetes was the likely culprit.  Yet, it was disappointing to be diagnosed with a second chronic illness - and just a few days after M and I returned from our honeymoon.  It would mean another set of quarterly appointments and hypervigilance about oral hygiene.  But, after a week on a soft food diet with black sutures between my teeth, my joy at being able to savor a vegetarian turkey wrap and to be rid of those unattractive black threads was such that my gratitude far surpassed any lingering concerns about managing this new disease.

I could now smile without looking like I got into an altercation with a spinach salad.  And smile I did.  I also began to recognize that I was the lucky one in all of this:  I still have my smile.  I still have my oral health.  The challenges associated with the procedure were only temporary.  I can still thrive.  And I can still love.  Which, really, is what this life is all about.  Nothing had stopped me from living the life I've imagined.

I suppose I could say the very same for my diabetes.  And for that I am truly grateful.

Sunday, April 15, 2012

It's the little things

M and I went out for date night last night to this quirky little place with really tasty really healthy food.  Once the server set my salad down, I eyed it quickly - mentally counting the carbs it contained - and excused myself to the restroom.  Upon opening the door, my eyes widened, and a smile lit up my face.

It's the little things, folks.  I'd become proficient at testing my sugar with little more than a toilet paper holder to balance my supplies.  But here, in the restroom of this quirky little place, was a richly stained wooden cabinet.  With marble finishing.  At waist height.  I set my purse down on the smooth finish, spread out my supplies, and tested my sugar, enjoying every second of this delightful gift.

Tuesday, April 10, 2012

A1C Me Go! (Part II)

Received fantastic news (and a high five) from my endo yesterday morning!  A1c of 5.9!!

Saturday, April 7, 2012

Things that go Beep in the Night

Another night of less-than-optimal sleep...My Dexcom has been going off around 1am every morning alerting me to a low.  One of the more dangerous lows.  The below 55 lows.  Except when I check my blood sugar, it's in the 80s, right where I'd like it to be.  It's gotten to where I've had to stash my Dexcom in another room just to get some shut-eye.

Last night my PDM joined in the chorus and chirped around 5:30am.  I should have changed my pod right then and there - or planned ahead and changed it last night - but being in the morning haze that I was, I acknowledged the alert and fell back to sleep.  To be awakened one hour later by the "Change me now" alert.  So I did and was up for good before 7am on a Saturday.  *Sigh*.

Friday, April 6, 2012

Letting Go

I alluded in my last post to having begun practicing yoga again.  For me, one of the blessings of going through difficult times is the way I turn to my spiritual practice for relief, and grow.  It was after a particularly trying day that I gently shut the bedroom door, selected a yoga video, and nestled onto the ground, in a comfortable seated position, eyes closed, hands placed gently on my knees, breathing in and out through pursed lips.  

I remember the first time I practiced yoga.  The discomfort.  The ensuing frustration when I allowed the discomfort to overwhelm me and broke a pose.  Two weeks ago when I pulled up a yoga video online, I was pulsating with energy.  Anger, upset, maybe even resignation coursing through my veins.  I felt discomfort this time around, sure, but I breathed through it.  Each time I wanted to break a pose, I focused on my in breath, and my out breath, and on breathing into the discomfort.  And each time I made it through.

Several quotes I've (over)learned throughout my life have been resonating with me during my practice, and have helped me to appreciate the way yoga not only nurtures my mind but my spirit as well.  The way it helps me to cope with Type 1 diabetes just a little bit better.

A few days ago, my practice was winding down, and the instructor was getting into position for a headstand.  Now, I'd never done anything even remotely close to a headstand, and when we would get to this point in a class, I would opt for the gentler modification.  But this time I sat up tall, leaned forward to rest my chest on my knees, then tucked my head into my interlocked fingers.  And slowly, ever so slowly, lifted my feet off the ground.  Higher, ever higher, until my body created a beautiful vertical line.  The question, "What would you do if you knew you could not fail?" reverberated through my body.  It was with this mindset, this shrugging off the possibility of falling that allowed me to attain this beautiful posture.

A few days later, I found myself in a Warrior pose.  Those tend to be some of the most uncomfortable poses for me.  My thighs burn, and I feel tight all over.  In an effort to loosen up my body a bit, I concentrated on relaxing my inner thighs.  And experienced the pain of letting go.  The joy of surrender.  The adjustment helped me to appreciate that pain will inevitably enter my life.  And that I can surrender to it or attempt to protect myself against it.  Either way, I will experience it.  But it is in the surrender, the letting go, that there exists true peace.

Tuesday, April 3, 2012

Peri - (Oh no!) - dontal disease

We had just returned from our honeymoon, blissfully (yes, blissfully!) happy.  Marriage was even better than we had anticipated.  Somehow, after saying our vows, we entered into an even more intimate, comfortable, secure, loving relationship.  Taking care of each other became our top priority. And we constantly teased, hugged, loved.  I remember thinking, "It doesn't get better than this."

Three days after we returned from our honeymoon, I attended a routine dental appointment.  Water shot out from Dr. L's high-powered cleaning device to clean the surface of my teeth and the spaces in between.  His assistant maneuvered a suctioning device around my mouth as Dr. L cleaned, and at one point she removed it.  I took the opportunity to swallow.  And tasted blood.

Dr. L pulled up a chair after the cleaning and told me that he was concerned about the amount my gums had bled during the appointment.  Usually this is a result of tartar build up, he told me.  But I had none.  He was concerned that my having had undiagnosed diabetes for awhile had led to the development of gum disease.  I couldn't believe it.  M is forever teasing me about how thoroughly I brush and floss.  How had this happened?

One week later, I was at Dr. P's office.  He was the periodontist Dr. L referred me to.  He used a measuring tool to assess how deep the pockets between my teeth and gums were.  The deeper he could submerge the tool beneath my gum line, the more concerning the pocket was.  I had remembered Dr. L telling me that 3's were normal.  When I heard Dr. P read out 4's, 5's, even 6's to his assistant, I fought back tears.  Closed my eyes against the pain and focused on taking one breath at a time.

Dr. P pulled up a chair after the procedure and told me I had periodontal disease and would need to schedule surgery as soon as possible.  Untreated, periodontal disease would lead to tooth loss.  This was all so overwhelming to me.  Within the space of 8 months, I had been diagnosed with Type 1 diabetes, learned how to manage diabetes with fingersticks and injections, began using a continuous glucose monitor, and a pump...and now diagnosed with periodontal disease.  And this in addition to all the good stress, the moving in with M, planning our wedding, taking and passing my licensing exam, getting married...

I've had about a week to adjust to this latest news, this new chronic condition that I'll have to manage for the rest of my life with quarterly visits and hypervigilance about oral hygiene.  This news stole M's and my bliss for a time, until we fought to regain it.  Until I renewed my commitment to yoga and my spiritual practice.

J, Dr. P's assistant, met with me before I left my appointment.  She told me that whenever she doesn't understand a condition her daughter was born with, why it was that other little girls don't have to manage what her daughter does, she tells herself that it's because they wouldn't be able to.  That if we're given it, we can handle it.

Wednesday, March 7, 2012

After All

Wow.  These past couple weeks have been a whirlwind.  We were fourteen days away from our wedding, then thirteen, then twelve, eleven, ten....  Four.  Now three.  We'd been putting in the daily 12 hours expected from our respective graduate programs and spending what time we had on evenings and weekends running last minute errands.

Amidst all the busyness, I learned from a dear friend that he had been diagnosed with a chronic illness.  I was shocked.  Then overwhelmed with grief.  Images associated with learning the news of my own diagnosis flashed in my mind.  I remembered very vividly a particular moment in time when I was sitting comfortably on our living room couch, cross-legged with the Bible in my lap.  I was doing my daily devotional and, right in the middle, I paused and considered what was going on inside my body.

Sitting there peacefully on a still summer day, sunlight streaming in through our patio doors, I felt a profound sadness at the fact that my very own cells were turning against themselves.  That my pancreas was becoming less and less proficient at doing what it was intricately designed to do.  And that there was absolutely nothing I could do to change this or slow this down.  I wasn't working.  I remember very vividly being directed to Psalm 139.  As I read, I felt the prick of tears, the warm traces that sadness left on my cheeks as my eyes welled up and overflowed.  I had never read anything so beautiful.  Or anything so timely.  I felt so comforted.

Listening to my dear friend speak last night about his experience led me to reflect on my own experience. Where was I?  I realized that my anxiety had all but disappeared.  Since July, I had managed to work full time, attend class, spend evenings at the clinic seeing clients and receiving supervision, prepare for and pass my licensing exam, learn to manage diabetes and implement lifestyle modifications, and plan a wedding.  All with minimal distress.  There were times that I would become saddened by my lack of free time, but I worried very little about getting it all done.  I think in part because it became less important to me that everything be done perfectly.  Things could be done well enough.  What merited my energy was my health and relationships.

I've also grown in my compassion for others.  I had once believed in the just world fallacy.  That things happened to people as a result of choices they had made.  When I learned that Type 1 diabetes happened to me for no reason at all, I came to appreciate that sometimes things just happen.  Even those things we often associate with lifestyle choices.  Some of those things are so much bigger than us.  There's a larger context within which we all make choices, a context that limits some of our freedom.

Maybe there is some gratitude to be had for this diagnosis after all.

Much love to all of you.  Will update once I'm back from our honeymoon!

Thursday, February 23, 2012

Now Weight a Minute

My first fitting was about a month and half ago.  I had been looking forward to slipping into my dress again for six long months.  It had arrived over the summer and hung in my closet, protected by a gauzy chocolate garment bag with cursive gold script.  Every once in awhile, I'd unzip it and take a peak.  Stand in front of it and drink in the sight.  Imagine how I would look walking down the aisle toward the man I love.  It was simple and elegant and I had never felt more beautiful than I did standing on the platform at the bridal salon, twirling around.  

I didn't exactly slip into my dress that January afternoon after work.  J, the sophisticated and utterly endearing gentleman completing my alterations, refused to zipper the dress all the way up.  He was concerned it would rip.  That's right, folks.  There was no zippering up my wedding dress.

It only made sense that a dress I had fallen in love with a year ago, that I had been fitted and measured for before being diagnosed with Type 1 diabetes, would no longer fit once I was pumping insulin and my cells were being fed.

The significant weight loss had been puzzling.  I was eating much more than I'd ever eaten in my life and yet weighed less than I had during college, a time of significant restriction for me.  I had survived on vegetables and precisely measured snacks during that time.  Yet, I was somehow able to convince myself that I must not be remembering that time very well.  I must have been eating more than I remembered.  For how could I possibly be putting back as much food as I was now and yet be underweight?  It didn't make sense.

Until I learned that I had Type 1 diabetes.  And that the nutrients I was eating were not getting into my cells.  I was indulging, yet my body was starving.

I'd be lying if I said it was anything less than extremely difficult gaining weight once I started taking insulin.  I gained nearly ten pounds the weekend I was diagnosed.  Eventually I learned what healthy portion sizes looked like - I had become so accustomed to eating so much food that I had to literally relearn how much a normal person should eat.

It's funny.  That incident with J should have left me feeling...I don't know.  Something.  I had told people it had.  But when I really reflected on it, I realized that I hadn't felt much of anything.  Taking out my dress was just what had to be done.  The price to pay for a healthy body.  And I'm loving this healthy body.  I stood and stared at it in my bathroom mirror the other night.  Turned around, walked across my bedroom, entered the kitchen.  Smiled at M and said, "You know, for the first time maybe ever, I really love my body."  Love what it can do more than what numbers it can make the scale read.

Tomorrow's my second fitting.  I could've tried to lose a few pounds, but I've elected to go in with some Spanx instead.  To make this body I cherish work.

Wednesday, February 22, 2012


I've read many inspirational stories written by women who overcame tremendous obstacles, including life with a chronic illness.  It always seemed that by the end of her story, each woman had maintained that her illness was the best thing that ever happened to her.  That it had inspired personal growth unsurpassed by any other event prior to or since.

My veggie smoothie-making fiancé jokes that I've one-upped him in the health department.  That I've never been so conscientious and strong.  And in many respects, that's true.  Before being diagnosed with Type 1 diabetes, I'm fairly certain I never went a day without added sugar.  And I couldn't help but get stronger.  Now that my cells were being nourished, I had the energy to run and lift weights.  In the beginning, it seemed that each time I worked out, I'd burst into our apartment afterwards with a grin on my face and a personal best to report to M.  I felt so *good.*

But I'll never say that diabetes was the best thing that ever happened to me.  Many days I get through without a hitch.  Others I'm chasing a low.  Or nervously awaiting the outcome of a meal whose carb content I had no basis for even estimating.  Some days I'm dealing with a malfunctioning pump.  Or a glucose monitor that routinely overestimates my blood sugar, or, worse, completely misses a low.

Yes, I'd rather feel as good as I do now than as poorly as I did the year prior to my diagnosis.  But not having diabetes would be better.  

How did you get into a place of gratitude?

Tuesday, February 21, 2012

A1C Me Go!

During that routine physical last summer, my nurse came into the exam room and told me there were traces of sugar in my urine and she'd like to get a blood sugar reading.  She appeared startled at the meter's output.  She looked at me and said, "You have a blood sugar of 465."  I looked back at her and said, "Okay."  What did 465 mean?

My nurse proceeded to tell me what a normal blood sugar should look like.  I proceeded to think, "Was it that big slice of cake I ate last night?"  I thought the diagnosis was a mistake.  That you couldn't possibly know from one reading that someone was diabetic.  I just didn't understand.

I was admitted to the hospital and had lab work completed which revealed an A1C of 12.  RL circled where on her chart my A1C fell in relation to the desired range.  I wasn't even close.  Was it the pancakes I had every morning for breakfast?  The energy bars I gobbled down between meals?  The sandwiches?  Endless sandwiches?  Before I was diagnosed, my stomach felt like a bottomless pit.  I was hungry all the time.  I would no sooner finish a hearty breakfast than be snacking again.  Usually dense, carbohydrate-rich foods.  I had thought if I only ate enough high-energy, high-carb foods, the fatigue and the weakness would go away.  I'd stop falling.  I'd stop needing to grip the shelves at the grocery store to pull myself up from a crouching position.  Had I brought this disease on myself?  

RL assured me that the cause of Type 1 diabetes was unknown and unrelated to my lifestyle.  Effective diabetes management, on the other hand, was closely linked to the choices I would make around diet, exercise, sleep, and stress.  Several months later my A1C dropped to 8.  Then 6.1.  I was so close to that magic number, that 6 that would offer a safe environment for the baby I would someday carry.

I looked up recommendations of the American College of Obstetricians and Gynecologists for optimal pre- and post-meal blood sugars and have been tracking my sugars more closely to keep them in line with these recommendations.  It's been discouraging at times since my honeymoon period is coming to an end and my carb ratio has been changing dramatically over the last few weeks.  I no sooner find the carb ratio that keeps me stable after meals than I get a dramatic and inexplicable spike after a meal I've eaten many times before.  And I need to begin the adjustment process all over.  It's also starting to look like my insulin needs are higher first thing in the morning and lessen as the day goes on.

Each time I feel frustrated at the effort required of me to manage my diabetes, I...let myself feel frustrated. And I talk to M about the frustration.  And he listens each and every time.

How do you manage the frustrations?  And celebrate the successes?

Monday, February 20, 2012

In Sickness and in Health

During the second appointment with my endocrinologist, he asked me if there was any possibility that I might be pregnant.  I remember being caught off guard by his question and answering, "No."  Looking down at my left ring finger, he probed, "Any possibility at all?"  I had thought at the time that he was one conscientious doc.

During my third appointment, my physician's associate, RL, - who I *adore*.  This woman emails me and calls me just to check in and immediately responds to questions and concerns.  I am blessed beyond measure that she is part of my health care team - told me that once I was pregnant, I would need closer and more frequent monitoring.

What I knew about pregnancy for Type 1 mothers was based entirely on these two interactions: that it was a question of some concern, that my blood sugar control would need to be tight, and that I would need to visit my endo much more often.  So when my fiancé - M - called me at work that day and asked if I had read the literature on pregnancy for Type 1 mothers, I replied, bewildered, ""  It was at this point that I realized I may have been naive to think that the hardest part of diabetes was determining the carbohydrate count of combination foods.

A quick internet search taught me about the havoc that uncontrolled blood sugar during the first trimester can wreak on a fragile fetus' developing organs.  How the growth of babies exposed to high blood sugars in utero could complicate natural childbirth.  The medical intensity of pregnancy and childbirth rendered my dream of a natural childbirth, possibly a water birth in my own home, rather absurd.

I sat alone at my desk in my office and cried.  I mourned the ease with which I had anticipated experiencing pregnancy.  The days when the biggest concern M and I had was how many children we wanted to have.  Despite my tears and a profound sadness, it was less a sense of defeat than of unfairness.  I knew I could do it.  Yet, I didn't want it to have to be so hard.

M asked me if he could call RL.  He wanted to understand what diabetes meant for our future - for my longterm health, for our dreams of a family.  What he would mean when he told me on our wedding day that he would love me in sickness and in health.  RL told him it was hard to know.  She had seen women with fantastic control have problems and those with poor control give birth to healthy little children.  And, her experience was primarily with Type 2 women and she wasn't sure to what extent these experiences applied to us.

Despite the pain of that day and the ones following it, I know that they've enriched the vows we'll be making to each other in less than three weeks' time.  In sickness and in health.  I do.

Sunday, February 19, 2012

Why Sweetie Pies in the Sky?

While registering for this blog, I breezed through the information fields, coming to a halt at the box requesting the title of the blog.  There was so much I wanted the title to reflect - diabetes, motherhood, the fulfillment of dreams made complicated by this condition, hope...I closed the lid of my computer and reflected, stewed over this on my run (running my warm-up mile has never gone so quickly!), and eventually opened up a word document and started typing as many words associated with diabetes and little ones as I could think of.

When I typed "pie," I knew I was getting close.  Cherry pie, cutie pie, sweetie pie...that was it.  What I call kiddos all the time.  And "sweetie" was a play on the natural association between diabetes and all things sweet.  Diabetes?  Check.  Motherhood?  Check.  Now, that piece about the fulfillment of dreams made complicated by this condition...Pie in the sky.  The promise of a sweet reward.  Or, sometimes, something that may be viewed as overly optimistic or even impractical.  Which would motherhood turn out to be for me?  

Would love to hear your thoughts during the run-up to your pregnancy or the way you're thinking about the possibility of motherhood now.  Do share below!

Saturday, February 18, 2012

New Beginnings

We had already known that weekend in July would be the start of a new chapter in our lives.  My fiancé and I had signed a lease on a charming two-bedroom apartment and were looking forward to moving in together that Saturday and spending the next eight months growing our relationship in preparation for our wedding day in March.  During a routine physical the day before moving day, I learned that I had Type 1 diabetes.  And so began this new chapter in our lives.

For me, the beginning of this chapter was marked by dramatic changes to what I had thought was an already balanced lifestyle.  I read everything I could get my hands on about diets for managing diabetes – vegan, raw, low glycemic.  I instated a bedtime to ensure eight hours of sleep a night.  I woke up early to squeeze in cardio and strength training before class.  The implementation of these dramatic changes to my lifestyle might have suggested that I had accepted the reality of my diagnosis.  Yet I remember being convinced that I was going to beat this diabetes.  This irreversible autoimmune condition.

Seven months later, I’ve grieved many losses associated with diabetes.  Not least of all the freedom I used to enjoy to eat what I wanted to when I wanted to.  To sleep through the night without fear of a low blood sugar or being woken up by alerts signaling an impending low.  To work out without needing to plan ahead of time by snacking or adjusting my meal-time insulin dose.  Or bringing my testing supplies and glucose tabs to monitor my blood sugar and treat lows.

As I’ve entered into acceptance, my fiancé has entered into grief.  He had been so focused on supporting me throughout those first months that he had taken little time to process how this diagnosis affected both of us and our dreams for the future.  Especially our dreams of starting a family together.  Maybe I was too focused on the day to day of diabetes management.  Maybe I was simply naïve.  But for whatever reason, the risks associated with pregnancy as a Type 1 mother were not something I had thought about.

Which leads me to why I'm writing this blog.  I was hungry for information from Type 1 mothers about their experience with pregnancy and found very few women blogging about this topic.  A community of Type 1 mothers, soon-to-be mothers, or even planning-to-be mothers (like myself!) was something I wanted for all of us.  Some of my posts will be about motherhood.  Some will not.  My fiancé and I are still planning for our wedding day next month, which means planning for parenthood is still a little ways off.  In the meantime, I hope my posts will meaningfully capture my experience of Type 1 diabetes as a young woman on the verge of much to come – intimate partnership, career, motherhood…

I’m delighted that you’ll be a part of this new chapter.  Please share your thoughts below, and let’s begin developing a special community of beautiful, bright, resilient Type 1 women.