Life on Shots

1126293456438.injection5cThe first question people ask me when they find out that I went from wearing an insulin pump to using multiple daily injections is why?

Fair enough.

However, I have a hard time answering this question because it isn’t really the right question to ask. It’s not so much “Why did you stop pumping?” so much as “Why did you continue using injections?”

The reason I started taking injections, quite simply, is because my insulin pump broke. At a wedding at the end of March 2012, my insulin pump threw a hissy fit in the middle of the reception. Calling Medtronic’s customer service from the reception hall’s parking lot was not my idea of a celebratory occasion. They were prompt in saying they’d send one out and I’d be back in the game in no time. My brother-in-law is a physician and he kindly wrote me a script for Lantus (I had Humalog with me) and syringes and we drove to the nearest Walgreens to fill the order so I could, you know, not die from all the food I’d just consumed.

And it just sort of stayed that way.

At first, it was just going to be a week long “break.” Then I thought maybe I’d just use up the whole bottle. Then I thought maybe I’d go a little longer and somehow ended up with four bottle of Lantus. So then I thought I’d just use up those four, and by the time that happened, I was kind of digging the whole no insulin pump life.

One thing I noticed right away was that my control was not significantly hampered by being on shots. It didn’t really help, either, but it didn’t hurt. I was already in a pretty stinky pattern of diabetes management, and injections pretty much kept the status quo.

It wasn’t until January that I really fell hard into the Must Get Control Now phase of life. With a new Paleo diet experiment and newfound fitness comittments, I dropped a full percentage in four months. Of course, it wasn’t perfect. One month was nothing but highs, while the other month was nothing but lows. Even though my diabetes management looked good on paper, it wasn’t that amazing.

I enjoy not having to wear an insulin pump. I enjoy getting dressed and not having anything — not even a pod! — on my body. I like that I look like Allison, and not Allison with diabetes. I don’t find that it was very difficult to manage injections and last fall I discovered RapidCalc, a bolus wizard calculator app for my iPhone, which I think really sealed the deal on staying on shots for the long haul.

On shots, I take Lantus twice a day. I find that my timing of taking Lantus can vary wildly (I believe the technical term is “laziness”), and so having the buffer of the previous shot really helps catch any gaps in coverage. Even when I was perfectly timed in taking shots, I always noticed that by the time 24 hours was up, my blood sugar was climbing. I use syringes, because I find them easier to manage. I didn’t have anyone help me figure out my doses. I’ve always been pretty independent, which is perhaps ironic considering I want to be a CDE. I split my 24 hour basal dose in half to start with, half in the morning and half at night.

There was a lot of tweaking.

But life on shots might be coming to an end sooner than I thought… and I’ll have more on that next week. Happy Friday!

What Did I Do Wrong?

BLOmORZCMAAVtE0.jpg_largeOver the weekend, I was fortunate enough to meet a long-time online friend, Jess aka Saucygurl915 on Twitter. We both happened to be visiting Boston on the same day, so we met up for drinks to talk about work, travel, Boston, wedding planning, and of course, diabetes!

One of the things that came up was some discussion surrounding guilt in diabetes. It’s a feeling that all of us have felt at one time or another, whether from diabetes or some other health-related issue, like exercise or eating right.

I try to not let guilt infiltrate my life with diabetes. I know — easier said than done! But I don’t find guilt very productive or beneficial for me, and I don’t find it very accurate most of the time either. But it took a long time to get this way and I shared a story with Jess about my coming to terms with guilt and life choices that I’m going to share with you now.

When I was in college, I saw a therapist. Like most college students, I was totally confounded by a lot of things going on in my life and some of these things really upset me. I started to see a therapist on a weekly basis, and one day as I was walking home from one of our appointments, I had an epiphany.

My epiphany was that diabetes was causing a lot of my emotional issues surrounding friends, relationships, school and that sort of thing. Not directly in the blood sugar related sense, but I realized that diabetes had not only affected my actions, it also affect my thoughts. Diabetes had actually wired my brain to look at situations in a certain way.

Basically, I had grown up to look at each situation where something wasn’t what I wanted and then ask myself, “What did I do wrong?” Because that was how it was in diabetes. That’s how I — all of us really — have been trained to look at our diabetes. Each time our blood sugar is out of range or each time our A1C starts edging upwards, we ask ourselves — and are even sometimes outright asked by our medical professionals — what went wrong?

I started taking that question “What did I do wrong?” and I applied it to every damn thing in my life. And you know what?

I didn’t effing do anything wrong!

That’s not how life works and that’s not how diabetes works either. Yes, sometimes you do something wrong. Sometimes it’s very obvious that you missed a bolus or you snapped at your husband. Sometimes we do things wrong — we’re human. Name of the game. But sometimes — hell, most of the time — we don’t do anything wrong. Just like you can’t control the actions of other people, sometimes you can’t control the actions of diabetes. You just do your best. You anticipate what is likely to happen and you react appropriately with whatever comes your way. But you can’t become an emotional mushball every time something goes wrong.

If you know what you did wrong, excellent. No, really. Lesson learned and you can move on and hopefully not make the same mistake twice. But if you don’t know what happened, don’t assume it’s necessarily your fault. Sometimes it’s the other guy’s (or pancreas’) fault.

I’m not going to feel guilty over something that I have nothing to be guilty or sorry for. Figuring out this crap is hard, just like marriage is hard and child-rearing is hard. There’s no manual telling you how to control things that cannot possibly be controlled. If you are putting in the effort, then you have nothing to be sorry for.

If you are putting in the effort to manage your diabetes, you are doing absolutely nothing wrong.

News I Didn’t Want To Share

papertoyboxphotographyrainrobotsad-aedd22f0ed310ef5d842e0b42d1b1f0c_hAs some of you may have seen from my blog post on my personal blog, I was rejected from nursing school for this upcoming semester. I had applied to two schools, but unfortunately I didn’t get into either of them.

I will be re-applying for future terms (in fact, two schools actually have programs that start in January, so I won’t have to wait too long), but it’s disappointing nonetheless. I really wanted to get nursing school over and done with, and now I have to drag things out even longer.

One friend of mine asked about dietetics, so I though I’d explain why I chose nursing. In the area where I live, there are only a couple of accredited dietetics programs that I could apply to, which means competition is even higher. I chose nursing because I actually thought it would be easier, but it looks like that is not the case! At this point, it’s too late to apply to a dietetics program, although I’m considering adding it to my list of schools to apply to for the next round, just to up my chances of getting in somewhere. I’m not against dietetics or becoming an RD at all. I just felt that I had a better chance of becoming a nurse.

I’m disappointed that I don’t have better news to share, but this is simply a fact of life when it comes to entering an entirely new field of work, one that needs additional education. It’s disappointing that I have to wait even longer to finally have my dream career, but I also know that there are plenty of things that I can do to help the diabetes community in the meantime. I plan on spending a lot of time this summer and fall working on my book for young adults with diabetes, and I will continue to write about diabetes for various publications.

Thank you immensely for all the support.

The Thing I Don’t Think About

Hope paintingYesterday I attended a virtual conference on diabetes complications called the Diabetes Hope Conference. It’s an interesting title, because of all the words I associate with complications, hope isn’t really the first one I think of. Or the second. Or even the tenth. Maybe the twentieth?

One of the points that was emphasized by the panelists, which include folks like George Simmons, Karen Graffeo, Manny Hernandez and Kerri Sparling, was the importance of sharing our experiences with diabetes complications. To be completely honest, I really don’t think about diabetes complications.

Diabetes complications are not what motivate me to manage my diabetes. I was not raised to fear complications, although it wasn’t like they were completely without mention. I manage my diabetes because it makes me feel better. I don’t like having constantly high or low blood sugars. They make me feel nauseated and gross. I have to pee all the time, I become a royal bee-yotch, and in general I feel like those are the times when diabetes rules my life. I manage my diabetes so that diabetes doesn’t manage me.

But I have dealt with a diabetes complication, albeit minimally and almost to the point where I barely mention it. In 2010, when I was working at a public relations agency and living in New York City, I started developing a mild case of peripheral diabetic neuropathy. I call it mild because it really only affected me first thing in the morning. I would wake up, put my feet on the hardwood floor, and wince as I walked over hot coals to the bathroom.

Obviously I wasn’t really walking over hot coals.

I think it was mostly the effects of poor circulation, and by the time I got my legs moving, my feet were fine. I didn’t have any open wounds and I could feel everything just fine. No numbness or lingering burning or tingling. It was just in the morning. But it was painful enough that I wanted it to go away.

At the time, I was working on our Pfizer account, and Lyrica was one of the brands I monitored. Lyrica is recommended for treating diabetic peripheral neuropathy, but I knew from monitoring diabetes message boards that the side effects weren’t that great. Monitoring the conversation, however, taught me that another alternative is a supplement called alpha lipoic acid. So I started taking it every day and I’d say within a few months, my symptoms improved. I eventually stopped taking it, and I have not noticed any tingling since then.

Maybe I’m cured. Maybe I never really had it. All I know was that the conversation surrounding diabetes complications helped me discover something that helped me feel better. Which is exactly why we do what we do here in the Diabetes Online Community. We try to help each other feel better.

~*~

Another point that came up during the conference was diabetes guilt. Guilt is a powerful, ever-present emotion when managing diabetes. Whether it’s a single high blood sugar or a retinopathy scan that shows some bleeding, our lives are a constant flux of guilt, shame and humiliation. One of the reasons that I have a hard time sharing stories about my blood sugars, whether low or high, is because I find it embarrassing. I know it’s normal, but it’s embarrassing too.

It’s kind of like poop. You know everyone does it, but dear Lord, please don’t make me talk about it.

One of the things that I was reflecting on today was a life philosophy that my father shared with me. He likes to say, “There is no right or wrong, only varying degrees of success.”

Applying that to diabetes, I think that all of us in our own ways are managing diabetes successfully. Perhaps some appear to be doing so more successfully, but no one is failing at managing their diabetes. There is just varying degrees of successful management.

Even those who have complications are not failing at their diabetes. First of all, some of us are simply more susceptible to complications, despite management. But simply knowing that you have a complication and are working on treating it or reversing it is a form of success. It shows that you are aware of your health, that managing your condition is now a priority. Those are things to be proud of.

Be proud.

~*~

I don’t think about diabetes complications. I think about how I want to live my life. I think about the things that I want to do, like travel the world, become a mother and run a marathon, and what the best way to do those things are. I think about how I want to feel. Confident. Healthy. Strong. I don’t think about complications because I don’t manage my diabetes to prevent complications. I manage my diabetes so that I can live my life.

If I have a complication in the future, I don’t want to look back on my life and believe I should tried harder. I don’t want to feel like a failure. In a way, I suppose I have removed myself from complications. I won’t be ruled by fear or guilt. I won’t be motivated by threats or what-ifs.

I am motivated by my dreams and goals, by my heroes and role models, and by my self-respect and self-awareness.

In other words, I am motivated by hope.

I guess that word isn’t so far from complications as I thought.

Got Celiac? Meet Moonshrimp Brewing!

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Brewer Dan working on gluten-free beer

Although I’m not a huge beer drinker, I’m really excited to introduce you to a brand-new brewery, Moonshrimp Brewing. Moonshrimp Brewing is a specially designed brewery for people who can’t consume gluten, something very familiar to the one in ten PWDs who have celiac disease. The brewery is owned by a very good friend of mine, Daniel McIntosh-Tolle, who attended diabetes camp with me when we were in high school (he was also my prom date!). Diagnosed with type 1 diabetes at age 5 and celiac disease at age 22, Dan is in the process of opening the brewery and he needs our help!

In order to open the Moonshrimp Brewing facility, he needs to purchase some very expensive equipment. Dan launched a Kickstarter fundraiser yesterday to raise money for the hardware, plumbing, equipment, licenses and supplies. As always, Dan’s Kickstarter comes with a list of amazing gifts for supporting the brewery. Items include Moonshrimp pint glasses, t-shirts, a how-to class on making beer, and for the top three supporters, a personal thank you will be printed on the first 10,000 bottles produced! Cool!

Dan was kind enough to answer a few questions about Moonshrimp Brewery and life with celiac disease.

Allison: What inspired you to launch a gluten-free, vegan brewery?
Dan: I was diagnosed with celiac disease just over 6 years ago and missed out on craft beer. Vegan was added because it is not that hard to do and allows even more people to be able to drink the beer. (Also, wife is vegan). Yep, one of the lucky D-1 and celiacs

Fun. Beer involves so many grains, so how do you make it gluten-free?
Beer is normally made with barley (lots of it), I substitute millet and vegan certified beet sugar instead, along with the usual hops. My yeast is grown on molasses instead of malt so that there is no trace of gluten.

Are there other gluten-free beers out there? If so, what makes yours the best?
There are a few gluten free beers and a few more “Low gluten” beers (Omission by Widmer, Estrella Damm) The other main real gluten free beer is Harvester Brewing, also from PDX. Their beer is made from roasted chessnuts and oats and while tasty still contains oats which some celiacs (me included) cannot drink.

How will people purchase the beer? Will you sell it online?
My beer will be available around Portland at bottle shops, a few bars that specialize in huge selections and gluten free restaurants. People can also contact me and buy cases from the brewery. Due to its tiny size the brewery will not be open to the public but I will give scheduled tours if people e-mail me. Selling beer on line is a legal swamp I don’t think I want to wade into, best to leave that alone.

How much will the beer cost?
Moonshrimp Brewing’s beer will be available in conditioned 22oz bottles from bottle shops, retailers and restaurants for $4-5 per bottle depending on location. Case purchases will be available from the brewery at a discount compared to retail prices.

922721_109932165876214_1718026033_nGot it. So fill me in: what on earth is a Moonshrimp?
Ha ha ha. Number one question. My entire life people have commented about the man on the moon and I have never been able to see it. Instead I saw a large shrimp laying flat on a cracker ready to be eaten. Thus the name Moonshrimp and the idea of always seeing things differently was born. My beer is not like others, made differently from the beginning, it is an affordable gluten free beer that anyone can drink.

Awesome. And for the record, I can’t see him either.
I thought my shrimp was clear. A little photo touchup and tada! Facebook avatar.

Yes, I can definitely see it now! Do you have any tips or advice for managing celiac disease?
A few: Low gluten is not gluten free. No one on earth knows if chopped up gluten is still bad for you. Soy sauce is probably the work of the devil. Gluten free soy sauce is delicious and not to hard to find. If someone says “It’s totally gluten free, no animal products at all” don’t eat their food.

Haha. Why’s that?
If anyone ever says the gluten free-no animal products-line, run, not walk, away from their food. They have no idea what they are doing and will probably poison you. Had that happen once, not only did the pizza crust contain (as in, made from) wheat, it also had animal products.

If you get fully funded, when do you expect to open?
If fully funded I hope to open at the end of September, which puts our first batches available in October. It will probably get pushed back by the nature of reality (license issues, building codes, yadda yadda) but that is the goal.

DSMA May Carnival: Strengths and Weaknesses

Strengths-vs-WeaknessesI’m joining the DSMA for this month’s Blog Carnival! This month’s prompt is:

What do you consider to be your Diabetes Strengths?  What do you think are your Diabetes Weaknesses?

What a loaded question(s)!

Strengths:

I think my biggest strength is my positive attitude. I try to not let diabetes get me down. I don’t want it to have that kind of power over me. I don’t dwell on high blood sugars or low blood sugars, and if it’s something I don’t understand, I just move on. I know that diabetes is an incredibly convoluted and frustrating disease, and sometimes there just isn’t any rhyme or reason to it. I try to keep an level-headed perspective on diabetes because I think that if I wrapped myself up in every little detail or question, I would drive myself crazy.

Another strength I have is curiosity. By nature, I’m very curious (hello journalism degree!) and I think that curiosity has been very helpful in diabetes. I enjoy learning about it, whether it’s a new product or diabetes research or something that someone is doing to make life easier. Learning about diabetes has helped to demystify it a little bit and that makes it a little less scary. Obviously I still have worries and concerns about it, but an ancient Chinese warrior Sun Tzu taught that you should “know your enemy” and I think that’s very applicable to diabetes. Understanding diabetes helps me manage it better, and it also reminds me of when I need to let go.

Weaknesses:

Among my many weaknesses is my personal health habits. I tend to forget to test when I get distracted with work or school. I usually don’t bolus until the end of a meal. And for the longest time, I didn’t exercise. I’ve slowly gotten better over the years. I’m much better about testing and I exercise regularly, and I’ve started bolusing at the beginning of the meal. It’s still a work in progress, but I think my latest drop in A1C is a testament to the progress in those areas, although I’m still not very good!

Another weakness I have is in the area of food, which I suppose falls under health habits but this is a bit more specific. Most of the time, I think I can get away with eating whatever I want because I can “just bolus” for whatever I want. It led to other problems, like weight gain, because I let my ability to bolus influence my eating habits. Regardless of whether you can “just bolus” for something, that doesn’t mean you should eat it! But I absolutely hate being told no and self-restraint is a huge weakness.

What are your diabetes strengths and weaknesses? Anyone battle self-restraint issues?

Diabetes Blog Week: The Other Half

I’m participating in Diabetes Blog Week.

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Today’s prompt: Just like in the movie, today we’re doing a swap. If you could switch chronic diseases, which one would you choose to deal with instead of diabetes? And while we’re considering other chronic conditions, do you think your participation in the DOC has affected how you treat friends and acquaintances with other medical conditions? (Thanks to Jane of Jane K. Dickinson, RN, PhD, CDE and Bob of T Minus Two for this topic suggestion.)

~*~

type-2-diabetes-3The first thing I thought when I read this was “Does this have to be permanent?” I can’t imagine trading one chronic disease for another. They are all miserable. Trading one misery for another sounds like a rather pointless exercise, to be frank.

However, I then considered what disease I might trade temporarily. Just to see.

I decided I would trade my type 1 diabetes for type 2 diabetes. Spending so much time in the diabetes community has taught me that type 2 diabetes is often perceived as the “easier” of the two types of diabetes and I don’t think that’s necessarily true. I think they both have their own challenges, but I think it would be interesting to see how it really affects someone. I know how type 2 drugs are supposed to work, but what’s it like in practice?

As a budding diabetes educator, I think it’s incredibly important to understand as much as you can about what you’re teaching. I think it’s true that you really can’t understand someone’s experience until you’ve walked a mile in their shoes. If we spent more time trying to put ourselves in other people’s shoes, we might find ourselves being more sympathetic to what they are going through. It’s so easy to think that we wouldn’t ever get to the place where we’d have type 2 diabetes. That we would never “do this to ourselves.” It’s an incredibly judgmental, yet entirely pervasive perspective, isn’t it?

And honestly, perhaps I would prefer having type 2 diabetes. I’m already overweight with a smidge of insulin resistance. I’m already on insulin, so the progressive nature of type 2 diabetes isn’t that scary. The idea of not having to take so many shots or taking different injectibles is appealing, although I know that type 2 PWDs often have a much stricter diet than type 1PWDs. Of course, the freedom of a type 1 diet might be the very reason I’m overweight with insulin resistance. You can’t escape genetics, and it’s quite likely that I would have developed type 2 diabetes if I didn’t already have type 1 diabetes. I have several family members with it, so the predisposition is definitely there.

Most of us realize that living with another chronic disease is not really going to be any easier or pleasant than type 1 diabetes, and that most of  us would rather stick with what we are familiar with. That being said, most of us recognize that there are differences between the two forms of diabetes and I think that these differences often create a divide. I think more often than not, there is a certain amount of envy of the other half, whether it’s because there’s a lack of stigma for type 1 diabetes or because there are more mild blood sugar fluctuations in type 2 diabetes. I think if we could truly understand what each form of diabetes experiences, those barriers would drop, we would be kinder and more understanding, and we could truly be a united community of people with diabetes.