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.

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