Hola, Low, We Meet Again.

It is 10:52, and I've just checked my blood sugar. 113. I smile, happy that I've dosed my insulin right. I'm getting good at this, no?

Spanish class begins, and I sit alert in my seat. Everything is fine at first, as we watch videos and go over drills, preparing for our next test.

Then I feel a little bit dizzy. It is 11:32. My fingertips and toes and then my whole body get a slight tingle. I'm not low, am I? There's no way. Anyways, I can just sit it out. We get out in 18 short minutes and I'm sure I'll be just fine. I sit for a while, confident that I can beat out this low until lunchtime. Besides, if it gets really bad I have a snack right?

Right?

Oh. That's right.

Not right.

In my rush to get to class this morning (having woken up late - again) my mental checklist definitively did have "grab 2 snacks and put them in my backpack" on it. That's great, except I'd forgotten. No worries, I'd thought, getting to my research methods class. At any rate, I'd probably run high all throughout the morning up until lunch.

But apparently I'd been dreadful wrong. The low was getting worse now, becoming hard to ignore. I turned to Crystal who sat next to me, a little bit panicked at this sudden realization. "I'm low and I don't have any sugar," I told her, my voice full of worry. She checked to see if she had anything in her backpack but she didn't. We were watching videos now, and it would be hard to get the attention of Professor Smotherman without disrupting the class. I really didn't want to call attention to myself, or interrupt anything. Sure, it was a medical emergency, but that would be rude and embarrassing. Ugh. My logic.

So I tried once again to ignore the low, meeting each attempt with less and less success. I finally pulled out my meter just to test and see where I was at. The meter flashed back at me: 59. I didn't need a Dexcom to tell me that I was most certainly still falling. I could practically feel it with each and every passing second. I got dizzier, the room span, my breathing grew slow and measured as I tried to control the weakness seeping through my limbs.

This wasn't even the lowest I'd ever been, but I felt worse than I ever had in a very, very long time.
I gave one last effort at waiting it out until I knew that if I stayed in class any longer it might end with somebody sticking a glucagon injection in me. Those needles looked plain nasty, but I figure if I'm ever low enough to need one, I probably won't care.

Note to readers: In case of a severe low, someone please stick me with this.

But getting a glucagon injection wasn't exactly at the top of my to-do list today, or ever. So I gathered up my belongings and quietly walked to the door, pausing by Professor Smotherman, hoping she'd turn around. When she did, I hurriedly said, whispering, "I have low blood sugar. I need to leave early and get something to eat." It wasn't as bad as I pictured it, actually. "Go," she told me, and I made quick work of leaving the room. I did my best to walk in a straight line. They say being low is similar to being intoxicated. I don't know if this is true, as I've only felt one of those sensations before, but I'd be hard-pressed to say that any alcohol drinker has ever felt as bad as I did in that moment. It felt like gravity was weighing down twice its normal pressure on me. My body shook, sweat dripped down my forehead and back. I had to grab hold of the rail to make sure I didn't fall down the stairs. Someone probably should have gone with me, just to make sure I made it to the cafeteria okay, but I managed myself. It was the longest walk of my life. 

I finally made it to the lunchroom, a panting, sweaty mess. I found an empty table, incapable of words at the moment, threw down my stuff, and walked as quickly as I could. Get.food. That was the only thing I was sure I could do at the moment, though making it to the lunch line and back to the table still seemed a pretty daunting task. Once I did, I sat down and scarfed it down as quick as I could. In the newfound heat of the coming early spring, sweat continued to bead down my back. I felt gross and sticky. I felt groggy. My tongue was numb. 

I wanted to cry, full of renewed bitterness towards what this disease had done to me. No person should ever have to feel this way. Not me, not my friends, not my family, not strangers, not other PWOD's, not my enemies. 

But I was okay. It was a close call, but I'd averted the emergency before it was too late. Yes, it was miserable, and yes, it was inconvenient, and I was upset that Diabetes had won out and made me leave Spanish class early. I hated being a shaky, sweaty mess. But I guess at the end of the day what's important is that I'm still here. Diabetes could have taken my life from the get-go, back when I was diagnosed. It very nearly did. But it didn't. And I learned a lesson. Next time, don't forget snacks. Tomorrow, give myself less Novolog for breakfast. If I'm low, don't be afraid to interrupt and leave class. 

It's a learning experience, slowly but surely. With Diabetes, more so than anything else I've ever experienced, knowledge is power. I can't always prevent lows, but next time, what I can do is be more prepared. And that's exactly where I've got the upper hand on Diabetes - so being more prepared is just what I plan to do.

New Reality

Argh what a hassle. My life is too busy to handle Diabetes. Lately life with my disease has just been... inconvenient.

Last weekend I sat, as a "Blue Princess", at the table, looking at the pizza in front of me and sighed. Someone loaded chips and cookies onto my plate. I smiled politely. The girls and guests would expect me, the princess, to eat. I had not told my customers that I had Diabetes. I very rarely do. My gloves cover my medical ID bracelet - no one ever asks, anyways. So I ate the pizza, and sighed. I worried about my blood sugar untul the party ended - thankfully, working with kids always drives my sugars down, so I was only 142.

With Diabetes, even the little things could - and usually do - become more difficult. Small things you take for granted and don't consider grow suddenly complicated with the weighted burden of (in my opinion) one of the most difficult to manage chronic illnesses there is.

Sometimes I am just so busy that Diabetes should take the backburner - I certainly have no time for it. I'm late for a show and have to drive halfway across Atlanta, while changing from princess Cinderella to a clown, in 45 minutes. But I'm low and I need to eat and I still have to input the right address into the GPS. Did I remember to grab all my paintbrushes from the last show? Hope so...

It's right before a test and I'm rushing across campus, about to make it to the classroom, but suddenly left shaking as I walk into the building. I have to check my blood sugar and make sure to treat it before going in. What if I forgot a snack in my backpack, or ate them already? What about when Physiology Lab runs late, it's 6 'o clock, and I'm low because I've had to skip dinner?

What about when you're at someone's house and they lovingly cook up a nice, delicious, warm batch of... pasta? They serve the plate for you? You can't weigh or measure it to get even a ballpark estimate of the carbs?
What if you suddenly realize you forgot your meter and insulin at home?

It's hectic. Diabetes complicates things, but I suppose that that's the nature of life. It's full of complications, but we move on. Overcome them. It's been nearly a year now --- one year with Diabetes, and it's hard for me to believe. Almost one year ago since I woke up in a hospital room and received news that forever changed my life, that forever changed me. Almost one year since I almost died. Almost one year since I've had a delicious XL 7-11 coke Slurpee.

Sometimes I wish I'd never gotten the disease. In a masochistic way I don't mind it, as it gives me a platform, something to stand up for. I like to talk about it. I like to share my experiences. But mostly I just wish that, one morning, I could wake up and be well again. I miss being healthy. I miss not having to live in Diabetes' constant shadow. I should be in charge of my body, not Diabetes.

But the simple fact is that I'm not. I'm not in charge anymore. I'm in charge of my treatment, sure - but when it comes down to it, I'm just here to try and fix everything that my body now messes up. Diabetes has changed things... a lot.
I don't want to think that I'll forget what it was like to live without my disease, to eat without testing my Blood Sugar, or never feeling the sting of an insulin needle in my skin, or having to worry about what foods will do to my blood sugar. To reminisce about what it would feel like to set the mental calculator aside and, for once, not look at the back of the packaging and see the nutrition label. To never have to keep the count the carbs in my head.
But sometimes I think I am forgetting. That kind of freedom is such a foreign concept to me now. I have dreams of eating a Chick Fil A sandwich and not having to so much as bolus for it. Eating a sandwich is something you take for granted until you suddenly can't do it anymore - not without insulin, anyways.

This life - this disease - has become my new reality for almost a year now, and like it or not, I'm in it for the long haul. My life is full of busy, but my schedule will have to make room for insulin shots, and testing, and lows or highs. But hey - I don't forget to count my blessings. At least I'm alive to complain about it. Because whether I like it or not, managing Diabetes has been, and will always be, better than my other option.

Diabetic Wishlist

I wish I had a CGM!

These things aren't perfect yet. You still need to check your Blood Sugar with the meter, to make sure the two match up. But lately I've just been thinking how much easier managing my Diabetes would be if I had one.

CGM is short for "continual glucose monitor" and it does just that. You put a sensor into your leg, arm, stomach, or wherever, and the CGM reads your blood sugars continually for as long as the sensor is in (you do have to change it every few days). I really like the concept because the CGM allows you to see trends in Blood Sugar. It gives you that graph you see on the screen - it lets you know where your BG has been, what it's at now, and where it's going. You can look back and see your BG trends throughout the night, or how much it spikes after breakfast. When I test I can't help but think how much I'd like to be able to see whether that 111 is an oncoming low or if my BG really is holding steady.

The only thing that would be better than having one is never needing it in the first place!

Etiquette Handbook: No One Ever Covered The "Giving Yourself Shots At The Table" Section

School has managed to engulf me once more, so my free time depends on how long I can put off the nagging "You should be doing something school-related" voice in my head. I wanted to blog about the scholarship luncheon two weeks ago, though, because I had this great blog post in my head that just disappeared as soon as I walked into my next Physiology class the following week.

It went like this:

The Scholarship Luncheon is hosted by Wesleyan and gives students with scholarships a chance to meet their specific donors, or "trustees". We all dress fancy, eat what is likely the same food being served in the cafeteria (just on fancier dishes) and get a chance to exercise our etiquette (which, in college, has likely gone sadly unused for quite some time.)

It is 12:06, and the scholarship luncheon starts at 12:30. I routinely check my blood sugar, fighting off the tiny shake of my hand. 62, and likely dropping. I sigh. I've just eaten a snack an hour earlier, and don't have anything left in my backpack. I walk up the steps to Candler Hall and figure I can hold myself together long enough to last until we eat. it can't be that long to wait, right? Inside, I receive my nametag and anxiously walk in my heels over to my assigned table. My stride is calm, as many years of entertaining screaming children in heels (AND a hoopskirt) will do to you. The table is covered in a pretty white tablecloth, with colorful carnations in a vase in the center. A basket of bread rolls, a slice of cheesecake, and cups of ominous looking liquid are set out in front of me. I sit down and take a small sip. Yep, sweet tea.

I stare at the food but know it would be rude to start eating before my donors even got to the table.

I wait a while, until a few more girls I know arrive at my table. Finally, my donor and his wife arrive. I greet them with a smile, standing to shake their hand and thank them for all they've done. We all sit down then, a blanket of awkward silence settling down for just a moment before we strike up a conversation. Mr. Bowen is to my left, and he asks me questions to which I politely answer as we wait for the luncheon to begin. Dean Fowler steps up to the podium, and speaks first. We have opening speeches from a few others before the Wesleyannes (I apologize if I spelled that wrong, Wesleyan people - I'm a Bio major, not a music one - ) began to sing.

I shift uncomfortably in my seat. The music is lovely, but the low is hovering around me, buzzing, annoying like a mosquito. I feel my head swimming and find my eyes lingering on the cheesecake. If only I could take a bite, I could stop feeling so bad ...

But it would be rude, wouldn't it?

Would it?

I didn't even know.

The songs are finally done, and more speeches resume. Finally, servers bring the food out. I try to wait patiently as I can, when all I want to do is yell to someone, "Please! I'm low and I need food now!" 


When the food does finally get in front of me, I am so low that the fork is shaking in my hand. I don't know what else to do. When I'm low, I get the need to just eat everything in sight. Carbs don't stand a chance. I engulf my food - the bread-crusted chicken and pasta - and leave the cheesecake alone, not wanting to tempt fate. I'm the first one to finish - likely in the whole building - and I look around, embarrassed, as I see others slowly working their way through still half-filled plates.

Well, at least I feel better now.

I exhale, feeling the low wearing off.

"You must have been hungry!" One of the students at my table remarked, staring at my empty plate. "You sure ate that fast!" My cheeks turn pink. "I'm Diabetic... " I try to explain. "I'm low, I can't help it, you see, I get all shaky and --" "Wow, someone must have missed breakfast this morning!" Mr. Bowen laughed. I turned to him, also trying to explain. "I have Diabetes," I say, but he doesn't hear me well. "I was low and I needed to eat..." I sigh and give up trying to explain. I sit, hands in my lap, waiting for everyone to finish.

Meanwhile I stare at my insulin pen, which lies on the table. I'm in a dress, my arms are covered by sleeves, I have on tights, and I don't know where I can give myself insulin. Is it even polite? I take the cap off the needle and try to give myself a shot in the stomach through the dress. It's hard - it's a lot of thick fabric to work through. "Ouch," I mutter to myself, trying to inject myself, but through the dress it just plain hurts. I look around, having no idea where a restroom would be where I could excuse myself. I shake my head, cap the pen, and throw it into my backpack. Guess I would just have to wait.

After a few more speeches, more conversation, and watching everyone else get to devour their cheesecake as I worriedly fret over what the breaded chicken has done to my blood sugar, the event concludes. It is 2:30. I've eaten an hour ago. I get up, setting my napkin on the table, and gather my things. I thank the Bowen's once again for how generous they have been to me and quickly rush out of the building to check my blood sugar. It ends up at 112, almost too good to be true, when I check it at 3:00.

It's been a long ordeal. You think you have Diabetes down, until life throws you curveballs which send you reeling. Forgetting your meter and insulin at Christmas lunch, not realizing it, and come to find out the chocolate covered pretzels have a lot more carbs than you expected. Driving 2 hours to Atlanta to find out that, yes, you've forgotten your meter and insulin again. Being paranoid about every bead of sweat, every slightly more than normal paced heartbeat, or feeling of thirst. Birthday parties where Princess Belle looks ridiculous drenched in sweat but can't start scarfing glucose tabs and rice cakes in the middle of The Chicken Dance in front of onlooking parents.

And formal events. With dresses. In all my etiquette lessons, no one ever covered the "giving yourself shots at the table" section.

(In all my expertise, maybe I should be the first.)

Rainbows Are Pretty... Just Not On Your Stomach.

I pull away my shirt from my stomach and grimace when I see the skin.
My stomach loosely resembles rainbow -
On it, several discolored bruises lie, ranging from blue, to purple, to yellow and light green.

It is ugly.

I don't care too much about it now, but what about during Summer? What about swimsuit season? What will people think when they see my stomach, dotted from side to side with the ugly marks?

There are parts of Diabetes that you can't escape, no matter how hard you try. The bruises, the fingertip pads stained with dots of red from old lancet marks. The lows that force you to have to eat even when you're not hungry, at 2 in the morning, or just an hour after breakfast.

Diabetes isn't pretty.


I like using my insulin pens. Ok, well, actually, I hate them. A lot. But seeing as insulin is not really a choice - well, they suddenly ain't that bad. I enjoy the freedom of being able to give myself my shot and then go off into an almost-Diabetes-less la-la land. Oh wait, until my next meal. Oh wait, until 9PM when it's time for Lantus, what is hopefully (but not always) my final insulin shot of the day. Life can seem almost carefree... until I look at my callused, ugly fingers, or my sore, bruised hips and stomach.

The stomach is my area of choice - it absorbs insulin the quickest, usually doing the best at preventing spikes of High Blood sugar. An insulin shot in a different area can affect me differently. I spent a while on the internet after seeing my stomach, trying to research if this was a normal side-effect of the insulin, or just user-error on my part. A combination of both, probably. In some places - like my arms - I always seem to bruise, no matter what. I have my father's skin - delicate light and paper-thin - not made-for-Diabetes skin. My frame is frail for a person who gives insulin shots every day - there are few easily accessible areas of fat for me to inject into. I site-rotate, of course, but after 4 or 5 or 7 shots a day it can be easy to hit close to the same area.


I guess this is just my stomach's way of telling me it's time to give it a break.
And here I thought its only form of communication with me was through gurgling...

What My Betta Fish and I Have In Common

Some days, I feel like my betta fish.

I live in a clear, glass box - one that a disease has singlehandedly constructed for me.

I was thinking this today as I was working at my job in admissions, mundanely shredding paper - as I reached for yet another pile to shred, one of the papers caught my eye.

On it was a short essay, and in that essay it said,

"I hope one day to someday do something great, like find the cure to Diabetes." 

I stared at that paper for what seemed like a long time, wondering if the author of that sentence ever thought that it would reach, of all people, a Diabetic's hands. Lancet-scarred fingertips and all.

I felt like somehow, God had meant for me to find that paper - one out of hundreds of others I could have found. It was as if he was telling me,
"See? I think of you - and others do, too. You are not alone."


And it's true - I am not alone. In fact, I am constantly astonished at the support base I have. Joshua - who has researched Diabetes so much that he probably knows more about it than I do. Laurie - who gives me all the syringes and medical care I need! Tonya - my insulin drug lord, who frequently gets insulin for me in mayhaps shady but effective ways. My mother - who patiently gets my prescriptions and mails them to me each month, who has never complained about taking me all the way across town to the Doctor's, who always makes sure that I eat regular meals each day and understands my need for counting carbs. My father, who taught me that living with Diabetes doesn't mean living a life without happiness - on the contrary, it means thriving, and learning to be ever more joyful than before, despite the obstacles in my way.

And those that support me even without knowing me quite as well - the people who I am surprised to learn actually find my blog interesting enough to read, who give me a reason to keep writing. The people that stick around to have an intelligent conversation about my illness with me, giving us both an opportunity to share knowledge and experiences. And those coincidental, anonymous people who unknowingly write things about hoping to find the cure to Diabetes someday that make me smile inside, knowing that there will always be people trying to find a cure.

And oh, how I hope they do.

Diabetics can enjoy a wonderful life - full of all the perks and freedoms of normal, healthy people.
But Diabetes also means sacrificing a lot of freedoms.
My silent disease places me in a glass box that no one but myself seems to ever really be aware of - but that I always am. Others notice only what's inside the box - often never realizing what it's like to be on the other side. It imposes on me its boundaries, a constant reminder that while I am free to see the world there will always be something that separates me from everyone else. Leave me without insulin, and suddenly I can't eat. Without a glucose meter - both bolusing and eating become dangerous games. Alone, and without any carbs - if I get low, it could be life-threatening. All reminders that I am free - but, in my insulin-driven world, I am not quite free at all.


And in that respect, my betta and I have something very much in common.

The Foreign Language of Carbs

If there's anything I've learned over the past 10 months, it's that carbs are a language in and of themselves.
In fact, the language of carbs is probably the most important one I will ever learn - namely because my life depends on it.

Carbs do not make it easy.
Go into a restaurant, or check the nutrition information given somewhere - you'll see figures like "calories", "fat" and "sodium" listed in bold - but everyone always seems to forget those other, pesky little things.
I guess the truth is, Carbs are outdated - counting them came and went with the last fad diet.
But Carbs, for me, will never be outdated. Carbs figure into my considerations daily, in fact, almost every second that I'm living and breathing. In my head is a constant calculator, keeping track of the carbs in each meal and snack that I consume.

Au contraire, Doritos - I saw everything. (On your nutrition information).

It's gotten easier. I count in sections - how many carbs? Divide by 8, equals the number of units of Novolog, or how many 50 BG's over, equals 1 unit of Novolog each. 63... 8, 16, 24, 32, 40, 48, 54, 60 - that leaves me only 3 carbs short, which is acceptable. 8 units. I'm a mental math whiz. Where should I inject? Abdomen - the fastest. Arms - slower, not good for higher-sugar foods. Leg - perfect for long-acting Lantus. I notice trends - my insulin ration is 1:7 in the morning, due to hormones, while it is 1:8 the rest of the day. Sometimes I just need a snack as a pick-me-up to keep me from any lows during midmorning or afternoon. In Spanish class I always seem to be low, or Work Study on Tuesdays - 11am always seems to be my trouble time. I'm showing over 2 lows per day? Back off 1 unit on the Lantus and see where I end up.

1/4 cup of carbs has about 8 carbs each, or, pizza about the width of my palm, 30 carbs. Chick Fil A ice cream cone? 3 units. Sand which bread? 4 units. Some carbs effect my blood sugar worse than others - white rice? I stay away from it. (Unless it's sushi). Pizza? With the combination of fats in it, you usually want to break up your bolus and give yourself half insulin before, half insulin an hour after - to cover the late spike in Blood Sugar the slow-acting pizza will cause. High Fructose Corn syrups? You're body "can't tell the difference?" Uh huh, let me tell you something. You're body can tell the difference... mine does everytime my blood sugar skyrockets from them, regardless of insulin. I try to keep a limit on these tasty yet deadly things and make sure to bolus a little extra for them. Apples and fruits? Most of the time, I needn't even bolus for them. Good carbs. Fiber One bars? My blood sugar loves them! In short, all carbs are not created equal.

It's tiring, sometimes - keeping the calculator in my head. I get sick of it, wish it would go away. But I know part of good sugar control is getting to know these skills. And it's paying off, too - with 80's, 100's and anything under 180 BG to prove it. It's tricky - I'm not perfect. Sometimes, I'll be 260, or 192. But the big picture is, I'm seeing less of those. I'm learning.

If only Wesleyan offered a foreign language class in carbs - I'd get an A+.