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!