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.