When You Have Diabetes, It's Not the Only Thing you Fight.

"Hold on a second," I told Dr. Wendland as I grabbed my glucometer from my backpack. We were in open lab, which follows classes every Monday and Thursday and gives us students a chance to practice our PT schools with the help of some of our instructors. I was going over some of my flexibility drills, but in the past few minutes I had started to feel the slight "after-buzz" of dizziness and heat that follow every movement and turn of my head.

44, the screen read. I grabbed my glucose tabs and walked back to the front where Dr. Wendland was lying on the plinth answering questions to someone. When she turned back to me I shook my head. "I'm 44," I told her, as I popped some glucose tabs and tried not to let the low get to me. I could feel that it was a bad one, though, as much as I didn't want to show it. I didn't want to seem like I was wasting Dr. Wendland's time, who was practicing with me. I know I shouldn't feel bad like something about that - but it's the same thing that happens when I get low in line for ordering Chinese and I don't have glucose tabs, or I'm in the middle of leading kids through games during a birthday party.

I don't have time to be low then. Just because I'm low doesn't mean I can ask people to cut in front of the line to order my food. And interrupting games for a bunch of little girls at a party - while Rapunzel stuffs some glucose tabs in her mouth while everyone is watching - simply doesn't look proper. I get frustrated about the timing of my low in times like that, and I almost feel ashamed that I can't hold it together.
Does that sound silly? I know it does, but know this if you don't already:

You'll be hard pressed to find a person with a chronic disease that doesn't have some sort of mental impact associated with their condition. Diabetes is a mental disease just as much as it is physical. It gets to you, and there's nothing you can really do about it.

"You seem to have a lot of ups and downs," Dr. Wendland noted as a sat on the plinth across from her, chewing. I had been around Dr. Wendland another time earlier that semester, and had a 40 - so I could see why she would say that. Maybe I shouldn't have mentioned it this second time, but my brain was turning to fuzz and I couldn't concentrate from the low when I tried to think of any of the answers to questions she asked me so I figured I should make myself known. 
I did my best to explain that I was so worried about coming off hyperglycemic that I tended to try and over-bolus to avoid it. I wanted to get my blood sugars in near perfect order. I put a lot of expectation on myself. I would be lying if all of the excessive talk of Diabetes in class didn't get to me, too. All we ever seemed to talk about was Diabetic complications. Imagine having a disease where everyone either a. makes fun of it everytime they eat sugar and 2. Talks about how extremely complicated these patients turn out to be - foot problems, ulcers, retinopathy, carpal tunnel, neuropathy, decreased sensitivity to hot or cold or finger and foot sensation, numbness and tingling, shortness of breath... the list goes on and on.
I know I have the power to control this disease, and Diabetes is a huge problem in our country today - mostly Type 2. And know that I realize people aren't specifically singling me out in class at all. Type 2 is the Diabetes everyone is talking about. But still, it's something that will inevitably get to you over time, and I realized in that moment trying to explain myself to Dr. Wendland that that's exactly what it had done: gotten to me. I explained my frustration that testing your glucose was like taking a static picture of where you are: unlike using a continual glucose monitor (CGM) which will monitor you 24/7, a glucometer can't tell you patterns or what direction your glucose is going in. So when I tested at 175 in class earlier, I ate a granola bar and counted 6 units of insulin to give myself - 5 units for the 25 g granola bar (1 unit for every 5 grams of carbs) and 1 correction unit to bring myself down to 135, or 30 mg/dL. According to my math that should have been perfect, but I must have been headed down the sugar scale because now I sat almost 100 mg/dL lower than I intended to.
Of course, this is just a regular day to me. Lows suck, and no one wants them. But all Diabetics (T1) know that it happens. Some lows are going to be unavoidable.
I told Dr. Wendland I probably get around 3-4 lows a week, which for me is ok. "I notice them almost all the time - around 95% of the time. On very rare occasions I will test and be low and not notice." Dr. Wendland eyeballed Dr. Taylor, who was standing close by. "It's that 5% I'm worried about!" She kind of laughed. My soul sank a little.

It worries me too, but it's not something that can be avoided.
I then went on to explain that I ate very healthy for the most part - limited alcohol and most processed sugars, starchy carbs. I told them I ended up eating a lot of the same things, because it was just easier to manage my sugar when I already knew what those foods did to me on a regular basis. It sounds ok in living, but I realized it sounded kind of shitty when I explained it out loud. I found a slight pinprick of resentment welling in me for Diabetes again, but I pushed it down. I had to sit down one more time to rest before finishing off practicing flexibility, then I went home for the night.

In hindsight, I felt bad that I couldn't explain myself better. But it's hard to convey the mix of feelings, helplessness, emotions and stubbornness about caring for yourself when you have Diabetes.  The fear - the worry - the what's to come? is so real that it almost makes life worse to live than the disease itself. Dr. Taylor's words echoed in my head when I couldn't quite sense the movement of Dr. Wendland's spine raising during one of the flexibility tests - this is the point at which the test should terminate. "How is the feeling in your fingertips?" He'd asked - and I said, slightly shocked that he'd asked it,
"Oh! Well, it's fine - I don't have neuropathy. I just tend to not use enough pressure," which was true. I had been having to train myself to not have such a light touch with people.
I could feel fine. I could. Could I?
I touched the car window as I drove.

Did it feel slightly less cold? Could I not feel temperature as well with my fingertips? Did I type worse and miss keys more because of my fingers? It was too soon to get complications and I managed my Diabetes well enough, right? My A1C has never been as low as I want, but since being diagnosed it hasn't been over 7.5, and that's why I'm continuously striving to make it better and lower.

But it worries me, don't you know? It worries me so much.
The tingles in my feet, my hands when I drive the steering wheel - and the fact that I have to catch my breath a little every time I go up stairs, no matter how fast - or sometimes when I leap out of bed in the middle of the night or morning my heart pounds fast and I get slightly dizzy - my always-cold hands or feet - they worry me. It makes me upset, because I have always treated my body with care and tried so hard to make sure that I manage my sugar well - but the fear is still awful sometimes. Or reading that Diabetes shortens the average lifespan by 5-8 years sometimes. 5-8 years is a long time.

I hate what this disease steals from me and what it gives me in return. The fear that someday this disease will physically limit me because of any complications it does to my body is something ever present, and each day I just fight and fight to try and make sure that doesn't happen.
Maybe it won't, but I was feeling particularly down about it yesterday and even today. No matter how competent I am, or how well people think I manage my Diabetes, the dark side of my disease lurks on the back side of my mind near constantly, haunting me with the scary thoughts of complications and heart disease.

We all have our own demons to battle. These are some of mine.