Walking A Mile

Easy-3They say that you really don’t know someone until you’ve walked a mile in their shoes. Well, I’ve never walked a mile in the shoes of someone who has type 2 diabetes or gestational diabetes or someone who was diagnosed with diabetes as an adult or any other variation of this dreadful disease. And there are a lot of variations.

When I saw the prompt for this month’s DSMA Blog Carnival (which I’m horribly remiss in responding to regularly), I was stumped:

Anything easy about living with your type of diabetes that isn’t easy for another type?

There are a few things about this that made me question whether or not I could even answer a question like this. First and foremost, I speak for my diabetes. Not yours. Or hers. Or that guy over there. Just me. And my perception of what is “easy” may not be so easy for someone else.

The second thing that got me thinking was that I don’t really know what is easy or hard for another type of diabetes because I don’t live with that disease. For example, I have a horrible gag reflex. I choke on aspirin. I had a hell of a time taking metformin a few years ago when I decided to see if I could help my insulin resistance. So to me, taking injections is easier than swallowing a pill.  Does that mean taking injections is easy? Not by a long shot (ha! pun!). But other people might think, Allison, it’s a freaking pill once a day. Get over yourself.

A few years ago, I had dinner with a friend of mine who has type 2 diabetes and she mentioned how her blood sugars affected not just what but when she could eat. She said if her blood sugar was high, she would have to delay a meal and often would go on a walk to bring it down. She couldn’t just pop a pill to lower her blood sugar. It took a lot more effort. I remember thinking that sounded terrible, because I just pressed a few buttons on my pump and that took care of business.

I suppose the flexibility to take insulin whenever I want is a perk of type 1 diabetes… or at least, a perk of someone who uses insulin. (And if there’s even such a thing as a perk with diabetes.) But using insulin comes with a whole host of things that are not easy. Pump failures. Bad insulin. Poor absorption. Miscalculating carbs and crashing or soaring. It’s really not that easy.

I can’t even talk about stigma, because the stigma against type 2 diabetes often trickles down to the rest of us who bear the title “diabetic.” I suppose there is less outright discrimination against me, because most people have a general concept that type 1 diabetes is not lifestyle related.

“That’s the one you’re born with, right?”

“That’s the really bad kind, right?”

“Should you really be eating that?”

I might not be discriminated against, but my ears are still bleeding.

On the surface you might think, “Well, type 1 PWDs can eat whatever they want,” but that mentality can end up being a lot more dangerous and counterproductive than you’d think. I don’t even want to think how many high blood sugars I’ve suffered because I thought “Well, I can just bolus for it” and then completely underestimated what I was eating. I might not have to suffer with people telling me that I “did it to myself” but I still have to listen to stupid, ignorant remarks and misguided advice from the Diabetes Police. And while I didn’t have to integrated diabetes into the already chaotic world of college, I still had diabetes in college and it still sucked, regardless of how long I’d had it.

But I will tell you what I do think is easy. I think it’s easy to think that you have it worse than someone else. We live in our own skin with our own experiences coloring our perceptions. We struggle to overcome the obstacles that diabetes puts in our way and because we are so intimately familiar with our own journey, we can feel each painful rock we have to step on in order to get where we want to go.

We are so focused on our own arduous path that we rarely look over to see if someone else needs help. We judge people based solely on a few sideways glances, never really looking to see what they’re working against.

I think it’s easy to think we have it worse than someone else. It’s much harder to swallow that belief, make ourselves vulnerable and ask if there is something we can do to serve other people.

That Time I Ran A Half Marathon

B0z0cM_IgAAaVbBSo, I ran a half marathon on Saturday.

I know, I know. I didn’t really tell anyone about it. I had a couple false starts this summer with other half marathons and I got a little gun-shy talking about it. I didn’t even really talk about it on my other blog. But I did it! Want to hear how it went? Good, because I’m telling you anyway!

Friday evening a couple of my local D-friends and their respective husbands came over for dinner. Even though it was right before a race I felt comfortable because they are both healthy eaters so I knew I wouldn’t have an issue. Well, turns out I did! Not with high blood sugars, but with lows. I crashed pretty bad after dinner (I think I overestimated the carbs) and ended up having to drink and eat more than I expected.

At about 4 am I woke up to a blood sugar of 187 mg/dl on the Dexcom, and took a baby correction. No, I didn’t test. Yes, I know better. I’m sorry…

I woke up at 7:00 am with a blood sugar of 90 mg/dl. Not terrible. But context is king in diabetes and I was not so happy with that number at that time. I had a gluten-free piece of toast (more on that another day) with some chocolate peanut butter and coffee then we were out the door!

When we arrived at the start, I took a quick test. I was only going to carry my Dexcom with me, and Erik was going to meet me at the halfway point for a quick test to see how on track the Dexcom was. At that point, I was 89 mg/dl. Ugh. So I gulped one of two juice boxes I had (the other would be staying with Erik if I needed it at the halfway point) and prayed that would be enough. I was carrying five HoneyStinger gels which have 25g each. I only planned on using 3, maybe 4, so I anticipated it being enough but I was starting to get nervous!

I felt really good for the first couple of miles, but at mile 2.5, I heard a familiar buzzing sound. It was my pod. My pod had failed. As predicted.

You see, as much as I love the Omnipod (and I really, really do like it a lot), it has this really unfortunate tendency to fail on my runs. It doesn’t happen all the time and it doesn’t happen with any particular mileage or any particular pod placement. But if it’s going to fail, it will be while I’m running. I had actually prefilled a pod earlier that morning in anticipation of this but, as luck would have it, that doesn’t work.

Pods apparently start a timer when you put insulin in it, and by the time my pod failed, the backup pod had already timed out. The PDM couldn’t recognize it as being a new pod. I quickly called Erik and told him he need to go home, get a new pod and bottle of insulin, and meet me at the halfway spot, which was 4 miles away.

Just a little while later, the Dexcom started buzzing that I was below 75 mg/dl. Ugh. I was at Mile 3, and had planned to fuel at Mile 4 so it wasn’t too far off from my plan. I took a little extra walking break but continued my run / walk pace because I felt just fine. In fact, I’ve noticed that the lower my blood sugar is, the better I run, so long as I don’t actually have hypoglycemia symptoms.

After mile 6, the Dexcom alarms again that I’m 58 mg/dl. I’m not sure I believe it but I take another HoneyStinger just in case. I wasn’t far from where I was planning on fueling again anyway. Erik calls me just before I reach our meeting place, and he’s actually behind me, so he sprints to catch up! We pull over and I do a pod change and BG check. I’m actually 108 mg/dl, and I’m glad I checked. Dexcom can be such a little liar sometimes.

I take off again and manage to keep a pretty good pace for the next few miles. The Dexcom doesn’t alarm at all the rest of the race, but I take a HoneyStinger at Mile 10, and a little bit of Powerade at mile 12.

I finish the half marathon with a time of 3:05:34 and a BG of 187 mg/dl.

The first half of the race projected me at a sub-3 hour, and I know that stopping for a pod change really slowed me down. I’m pretty pissed about it, because I don’t know what to do to stop it from happening. I’ve been on the pod for over a year, and did tons of runs without any issue until it started this past August. Part of me wonders if there’s something funky with the last shipment of pods. There just isn’t any rhyme or reason to it. I wish I’d known not to prefill a pod, because it was such a waste of time. If I’d had a pod and bottle, I could have easily changed my pod while at least walking.

I’m also pissed off at Dexcom. It told me I was 106 mg/dl at the finish, a whole 80 points off from what I was. It just isn’t reliable when I exercise. I never wear it while running or working out anymore. I find it totally useless. I don’t know why I thought I could get away with only testing once.

I definitely should have brought strips and a poker with me. My FlipBelt that I was wearing could have easily held everything I needed: a PDM (which I was already carrying), test strips, poker, pod and insulin. None of those things even weigh that much, so it’s not like that would be a big issue. I could have done what I needed to do during the walk breaks I was already taking. Sigh. Lessons learned, right?

Of course, I’m happy to just have finished. I keep telling myself that the time doesn’t really matter, at least not for the first one. No matter what, I set a personal record because I’d never done a half marathon before. Overall, it was a pretty good first race.

Yep. First race. Not last race. There will definitely be more.

 

Wanna Talk To The FDA?

SurveyOn November 3, there will be an unprescendented conversation between the diabetes community and the FDA taking place and YOU can get involved! DiaTribe wants to collect as much feedback from the diabetes community (type 1, type 2, caregiver, whoever) so that they can really know where we stand and what we need from the FDA. This is our chance!

There will be a live webcast from 1-3pm EST so you can listen to the conversation happening between patients, the FDA, and experts from ADA and JDRF. Registration and a finalized agenda for the meeting will be available soon, but save the date!

Head on over to the survey now and answer the questions. They need the answers within the next five days in order to have time to analyze the results before the meeting. I took it and it takes about 5-10 minutes to do. Very easy! No trick questions!

The After

This is the part where I usually start fucking things up.

I’ve lowered my A1C before. A quarter, a half, even a full percent. Now I’ve jumped one and a half percent and all I can think is: “How long will it last?” Because I’ve seen my A1C go down. And I’ve also seen it go up. And down. And then up. And then down.

My A1C rarely stays put and it rarely stays moving in one direction.

I get my A1C done. It’s above where I want it to be. I spend the next three months diligently counting carbs (possibly even lowering my carb count), testing more often, correcting more aggressively, exercising more often, and in general just being a totally bad-ass diabetic. Okay, well I am always a bad-ass diabetic, but this time I’m extra bad-ass. And then I get my A1C. And it’s awesome (eh, awesome-ish). So I think, great, I have it figured out. We’re all good here. Then the days, and the weeks, and the months go on and I start maybe being a little more careless with the carb counting or bolusing early, but I think, well, my A1C was such-and-such, so this one little (::cough::) indiscretion isn’t going to be the end of the world, right? Until I finally make my way back to my endo, get my A1C done, discover it’s crawled back up to where it was six months ago.

And so it goes.

It just pisses me off because I feel like good control is a recipe for diabetes burnout, but if I relax for even a millisecond everything goes to hell anyway.

I need to find a happy medium between being completely obsessive and completely lackadaisical.

My next endo appointment is on December 29th (Merry Christmas to me!), and my main goal for my next A1C is to keep it exactly the same. Well, within reason. Mid-sixes. To do that, I’m trying to focus on a few things:

1) Download my Dexcom receiver and review my graphs every time I change my sensor. I don’t do this enough. I need to do this more, and if I do it every time I change my sensor, that should be somewhere between every 7 to 14 days.

2) Change my goal BG to 90 mg/dl instead of 100 mg/dl. I saw someone recommend this a few months ago and from what I’ve seen in the last two weeks since I did it, it’s pretty helpful. By having just a tiny bit more insulin going in, I think it helps account for any discrepancies in carb counting or in absorption.

3) Not be afraid to make tweaks to my pump settings. I have a bad habit of thinking things will just “fix itself.” Sometimes it does, sometimes it doesn’t. If a pattern emerges, I should fix it, even if I might need to change it back later. It takes less than a minute to change a pump setting. I should be more proactive.

4) Have regular appointments with my CDE. Sometimes patterns don’t always make themselves known to me, or sometimes I don’t realize that by fixing something, I’ve caused another problem somewhere else. After all, our days are cyclical. What you do at one time of day can impact another part of the day. I have an appointment with Jenny for Monday, and I’m hopeful to keep up monthly appointments with her.

 

Do you have any tips for making sure you don’t start slipping back into old habits?