I Can Do This!

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I’m not a person who seeks out inspirational or motivational things. I don’t have any paperweights with words of wisdom engraved into them sitting on my desk, or posters of soaring eagles on my walls. None of that stuff ever seems to stick.

With one exception! A year ago, redhead diabetic genius superwoman Kim Vlasnik introduced us to one simple phrase that has gotten me through more crappy diabetes days than I would have ever expected. “You Can Do This.” The idea? To collect stories from people with diabetes who had been doing “this,” and to share those stories with the people who most need to hear them — other diabetics.

I’ll admit that I’m a moocher. A year after the YCDT launch, I still haven’t contributed my own encouraging story. Instead, I’ve just sucked up all the sentiments of motivation and support when I’ve needed them. And boy, have I need them lately.

Here’s where I bring it all back to me: Being pregnant with Type 1 diabetes is a tremendous job. I am so damn tired of it — the technical number-crunching itself and the waves of guilt and dread and disappointment that come along with it when things aren’t perfect. But just today, as I was bemoaning the draining effects of last night’s low blood sugars on my energy levels, the words popped into my head automatically: You Can Do This.

The phrase is so perfect because it’s so simple, and because there’s really no way to argue with it. I mean, of course I can do this — what choice do I have? I’ve been doing this for more than two decades, and a ton of other people are doing it, too. Elizabeth Hughes, the first person to ever use insulin, did this — pregnancy and all! And that was even before the Internet!

Even better, Kim has done so much to make You Can Do This work for so many people. T-shirts! Videos! Written stories! Booths at Friends for Life 2012! And behind all of that, a genuinely kick-ass woman who’s driven by a real concern for other people.

Happy 1st birthday, you can do this! And thank you, Kim, for reminding us all that we can.

Overcompensation Nation

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“It’s always safer to be on the high side than the low side.”

It was one of the first things my pediatric endocrinologist told me after my diagnosis in 1990, and it’s a refrain I’ve recited to myself dozens of times since then. I think a lot of us make a habit of cruising just a bit higher than ideal, whether it’s because we fear low blood sugars or we’re preparing for exercise or whatever. I’ve always felt further from the edge of the diabetes cliff when my numbers are closer to 120 (or higher) than 90-ish.

Of course, all of that has changed since I’ve started tweaking bolus rates and carbohydrate ratios to keep up with the insulin-resistant influence of the placenta I’m carrying around. (That sounds so gross. Sorry.) As my insulin needs creep ever-upward, and as the possibility of having to deliver a T-Rex-sized baby grows more immediate, I’ve started going out of my way to stay as low-ish as possible. Let’s put it this way: before, I was a moderate consumer of insulin, only bingeing on special occasions and always careful not to over do it. Now, I’m a junkie — a heavy user who’s growing less and less afraid of taking a few extra hits during the day.

It’s like I automatically add ten carbohydrates to any food item I’m counting, just in case. I’d rather have to eat a little more in an hour or so than watch the CGM graph on my pump jerk menacingly skyward. I think of it as preemptive rage bolusing. If I’m dealing with a sticky high, I’ve got no problem cranking my temporary basal up to 150% or higher until it comes down.*

I can’t tell if I’m making irresponsible and potentially dangerous decisions because I’m pregnant, or if this is the way I’m supposed to have been doing it all along.

After all, I haven’t passed out yet! I haven’t even had any crazy low blood sugars that I can attribute to this behavior. (The scary-as-hell 26 mg/dl I had a few months ago I attributed to unusually long periods of standing around.) And seeing that long, even CGM line over a 12- or 24-hour period brings me a sense of control and accomplishment that I haven’t felt since I found out I was pregnant.

For once in my life, fear and competition may actually be motivating me to take better care of myself. Each time I feel an extra-powerful head-butt from the inside of my belly, I imagine my baby growing to hulk-like proportions — feeding off of high blood sugars and lifting weights in her spare time. (She may be getting tattoos, too.) Then I see other Type 1 moms-to-be with A1c numbers in the low 5s. And although I know I shouldn’t compare myself to other diabetics (we’re all special snowflakes, after all), I want to be in the 5-point-something club, too.

I want to walk out of the hospital in September with a healthy, compact-sized baby and a birth story that reads like a fairy tale. I want to stand outside the sliding glass doors and give the finger to every doctor I’ve seen in the last 5 months who’s been lukewarm about my A1c or a fasting blood sugar number. I want to feel like a normal pregnant lady, and the only way I know how to get there is to keep taking a little more insulin than I might need. Pass the bottle.

*Special Disclaimer: DON’T DO ANY OF THIS STUFF. I am a crazy pregnant lady with no medical training.

Ode to a Type 3

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Dear Ol’ Husband,

You know how it makes me feel all weird and itchy when people get overly affectionate in public forums. Those elaborate declarations of love and devotion and you’re-the-best-ness always seem tinged with notes of overcompensation. Or, you know, plain old cheese.

But my hand here is forced, husband! Today is not only the 40th anniversary of your arrival on this earth — it is also the eight anniversary of the evening we first met. Therefore, I have no choice but to tell you how wonderful you are, and to do it the only forum I’ve got: this blog.

When I handed you my phone number wrapped around a piece of watermelon gum eight years ago, I had no idea how much I’d get in return. I was barely ready to answer the phone when you called, but if I had known then what I know now, I probably would have answered with a terrifying level of enthusiasm.

You’ve given me a new appreciation for things big and small: birds, road trips, pork tenderloin, life in general, early mornings, concerts, bicycle rides, gin, family, well-constructed flip-flops, my health, our health, liquid fabric softener, good landscaping, porch swings, foreign movies, blueberry pancakes and red velvet cupcakes, weekends with friends — and more.

You’ve joyfully dragged me around the country and across the sea — to the top of the Sagrada Familia, where you called out, “Come back in from the balcony! It’s too high! You’re freaking me out!”, to the craft breweries of Vermont and Colorado, to the seal-dotted beaches of La Jolla, to the cold, wet post-Christmas landscape of Buffalo. You’ve shown me that it’s possible to have fun anywhere — as long as there’s a cold beer and some delicious cheese to be had.

You’ve helped me carry what seems like a thousand burdens, including such debilitating tasks as keeping my car clean and figuring out our income taxes. Short of taking it on yourself, you’ve done everything humanly possible to help me care of the ‘betes: picking up prescriptions, waking me up to check my blood sugar in the middle of the night, rolling out of bed to get me a bowl of cereal or a granola bar or a juice box at 3:00 in the morning, delicately asking if I’ve “remembered to insulize” for whatever delicious snack I’m in the process of mowing down. You’ve always encouraged me to take the best care of myself that I can — no matter what it takes. You are, indeed, the shit.

You do so much for so many people, and it makes me proud to be your wife.

I wish I had something truly mind-blowing to give you for your 40th. A private dinner hosted by Anthony Bourdain, a jug of 150-year-old whiskey, a trip to some crazy geological site or a HGTV backyard makeover.

Instead, I’ll offer up the whole rest of my life, plus dinner tonight and a Hendricks martini with blue cheese-stuffed olives. Oh, and this baby of yours I’ve been carrying around town.

Cheers, husband, and happy 40th Birthday. I love you a bunch.

Fantasy Diabetes Device: Take My Autoimmue Disorder — Please.

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Tell us what your Fantasy Diabetes Device would be. Think of your dream blood glucose checker, delivery system for insulin or other meds, magic carb counter, etc etc etc.  The sky is the limit – what would you love to see?

This is a hard one. A really hard one, because my first, second and third inclination is to answer the Fantasy Device question with one answer: a normally functioning pancreas. How glorious that would be!

But “pancreas” is the obvious (and best) answer. And if I can’t have the shiny new insulin-producing organ I want, I can at least have some fun and flexibility with my diabetic life, can’t I? That’s where my imaginary device comes in: It’s as yet unnamed, but I have filed for several patents, and marketing focus groups are well underway.

Like the CGM, it’s an addition to the whole pump system I’ve got connected to my person, but it works more like a remote. My fantasy device allows me to bestow my diabetes on other people for abbreviated periods of time.

I’ve heard my loving mother and generous husband say it over and over again: “If I could take this disease on for you, I would.” I appreciate the sentiment, and I love them both so much for saying it, but I don’t know if I’d feel right giving them all the diabetes forever. I would, however, feel comfortable letting one of them borrow it for a  weekend.

They’d be responsible for the blood sugar control (or lack thereof), suffer the temporary consequences, count the carbs, inject the insulin, do the fingerstabs. And I’d spend the weekend sleeping and running and dancing around and eating and drinking and being productive. Then I’d take the diabetes back. It is my nasty little pet, after all.

Think of the temporary freedom! The empathy and understanding the device could foster. The fights, too: “I don’t want to take your diabetes next weekend! I did it last month!”

The most satisfying part, though, would be sharing diabetes with strangers. The next time someone made an idiotic comment about “diabetic folks who just don’t take care of themselves,” I could let them borrow mine for an afternoon — just so they can see how easy it is!

And if I ever again, God forbid, find myself stuck in a conversation with someone who’s all excited about their voluntarily carb-free, gluten-free, low-calorie, paleo raw diet of food items that begin with the letter S, I can give them my diabetes for a while. “Here,” I’ll say, “Sounds like you need a real problem to focus on!”

As soon as they started to whine too pitifully, I’d take my diabetes back. Everyone has their Stupid Life Thing they have to deal with, and for now, this is mine. I’m sure that just knowing I can give my diabetes away for an hour or a day would make the really tough days a little easier. Right?

One Thing to Improve: Emergency Preparedness

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Yesterday we gave ourselves and our loved ones a big pat on the back for one thing we are great at.  Today let’s look at the flip-side. We probably all have one thing we could try to do better. Why not make today the day we start working on it. No judgments, no scolding, just sharing one small thing we can improve so the DOC can cheer us on!

Here’s a reassuring thought: if my trusty insulin pump were to give out right this minute — for any reason: water, trauma, old age, spontaneous combustion — I would have no idea what to do. I have no emergency plan, and that is something I definitely need to work on.

Maybe I’ve grown too trusting of this tiny robot on my hip. In the last 12 years that I’ve used the pump, I’ve only had one real malfunction, and looking back, I don’t even remember how I dealt with it. I’m sure I got on the horn with Minimed and used syringes until my new pump arrived in the mail (which is always ASAP — thanks Minimed), but I don’t recall any details.

And that’s a problem. Were my pump to die this instant, here are the steps I would follow:

  1. Curse. A lot.
  2. Complain on Twitter and Facebook, beseeching the input and wisdom of the ever-present DOC.
  3. Curse some more.
  4. Call my CDE for advice.
  5. Leave work to go home and curse.

There’s no long-acting insulin in my refrigerator, and all the syringes I have are ones that I inherited from my friend Tammy when her diabetic cat went to eat cupcakes in the sky. Worst case scenario, I figure, I’ll just stay close to home, snort cinnamon and jog in place as much as possible.

Of course, I’m assuming everyone else has a holy-shit-my-pump-broke plan, or something resembling one. What does it look like, and where do I get one?

One Great Thing: A Blood Sugar Check Before My Feet Hit the Floor

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Here’s today’s Diabetes Blog Week prompt:

Living with diabetes (or caring for someone who lives with it) sure does take a lot of work, and it’s easy to be hard on ourselves if we aren’t “perfect”. But today it’s time to give ourselves some much deserved credit. Tell us about just one diabetes thing you (or your loved one) does spectacularly! Fasting blood sugar checks, oral meds sorted and ready, something always on hand to treat a low, or anything that you do for diabetes. Nothing is too big or too small to celebrate doing well!

It only takes a second (or 5, to be more precise), but the one thing I’m good at has made a huge difference in the way I take care of myself and my friend Diabetes.

I am so damned good at checking my blood sugar first thing in the morning.

I know there were great spans of time when I was not so dedicated to the morning check, and looking back, it’s hard for me to imagine how I functioned. These days, I don’t check my blood sugar first thing in the morning because it’s something I should do, I check it because it’s a compulsion, a habit that I can’t stop.

“Your blood sugar is two-seventy-what?!”

First-thing blood sugar checks are a little easier to take than others, I think, because they tend to come with a lot less baggage than checks at other times of the day. After all, all you’ve been doing is sleeping, right? If I wake up to a high number, it’s almost certainly not because I miscalculated the carbohydrates in the pizza I had a few hours before, or because I’ve forgotten to bolus for a midnight snack (nocturnal hypoglycemia notwithstanding). More so than at any other time of day, I’m able to look at my morning number and think, “Well, there it is.” (I should admit that it doesn’t hurt that my morning blood sugars are usually pretty nice to look at. But it took a lot of tweaking to get there.)

Checking my blood sugar before the day begins is almost like checking my horoscope for the day: neither are sure-fire predictors of whether or not my day will be frustrating or wonderful, but they offer little glimpses — tiny reassurances.

Let me add, too, that since I’ve been pregnant, my wonderful husband has perfected the art of waking my semi-comatose ass out of whatever super-deep sleep stage I’m in at 2:00 a.m. for a blood sugar check. And not only does he make sure I’m coherent enough to insert the strip into the meter right-side-in, he’s also kind enough to illuminate the process with the flashlight function on his iPhone. Those numbers are rarely perfect, but they’re informative, and I like being able to correct in the middle of the night without relying on my CGM.

So, yes: it only took 20+ years, but I finally mastered one of the basic tenets of diabetes care. Now, on to that lancet-changing thing.

Finding Friends

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It’s Diabetes Blog Week again (yay!), and today’s topic is as follows: Think about the d-blogs you read that you think we may not know about and introduce us to one that you love!!  Let’s all find a new friend today!

This is hard for me, because I feel like all of the blogs I know and love I’ve come to know and love through the greater DOC.

I could go on and on about how much I love and admire Kim at Texting My Pancreas, or talk about how Jess’ empathy and kindness shine through everything she posts. We could discuss Karen, and how I draw on her pregnancy journey and all-around radness when I’m feeling defeated, or touch on the d-mom genius of Joanne and the way she writes about caring for a CWD day in and day out. I love everyone, but pointing them all out makes me feel like that person who just discovered Keyboard Cat and is like, “Hey everybody! Look at this new awesome funny kitteh that I found on the Interwebs!” Yes, it’s hilarious, but duh. Everyone already knows.

So, let me continue my string of obnoxious gestational posts and talk about my newest DOC friend, Katie at Princess of Pavement. A few weeks ago, I was complaining about the frustrations of being pregnant and diabetic and not knowing who to listen to, and Scully was like, “This other person is pregnant, too!” And poof! There was Katie, being just about the same amount of pregnant as me, and writing posts about it with all kinds of re-enactment pictures. Hooray for simultaneous life events and helpful DOC connections!

Katie pees in containers too! And she sends pictures of her pregnant belly to terrified strangers! And, she’s a runner, which I always pretend like I’m going to be one day, so she’s an inspiration, to boot.

Thanks, Katie — and everyone else whose blog I read — for helping to keep me sane. Or at least feeling a little bit less alone.