Details, Details, Details.

I sometimes rue the complications that Diabetes creates for me in life more than the act of dealing with Diabetes itself.
What do I mean by that?
I mean that, in comparison, the act of sticking a needle in my skin 5-10 times a day and testing my blood sugar around the clock is simple in comparison to having to actually obtain the insulin, worry if it will be mailed on time, deal with pharmacies, insurance companies that want nothing to do with me, the new health care bill and how it will effect me, whether my future career will be able to support me medically, trying to schedule endocrinologist appointments in Florida when I only come home 2-3 times a year, the thorny issue of my residency and terms more complicated than they should be such as "Medicaid", "Medically needy", and "Share of Cost".

In other words, one of the biggest hassles of having Diabetes lies in the seemingly little issue of the details.

Dealing with blood glucose numbers suck but trust me, if all I had to do was worry about how to give a couple of shots a day, I'd be golden.

My plan when I moved to Georgia was this: change my address, get a Georgia license and registration, apply to the Georgia Medicaid office and bam: Georgia Medicaid, easy and simple.

Hahahahaahahahahahaaha.

How little I knew.

This plan was way more difficult than I thought it would be..... I realized, upon getting to Georgia, that changing my residency would require me to renounce my Florida Medicaid before applying, leaving me with a potentially 60-day long gap of waiting to see if I apply for Georgia Medicaid. And no one at the Medicaid office seemed to be able to tell me if I would actually qualify for Georgia Medicaid - I'd just have to see, and I turned down, I'd have to switch my license and registration (requiring a trip back to Florida) back again, and re-apply, a difficult process in and of itself. Not to mention the change (and upcharge) in car insurance switching my residency would create.... what a mess. Maybe I'm making it out to be more difficult than it really is, but as someone who lives month to month depending on test strips to show up in the mail, the thought of being unable to get medication for a few months fills me with a sort of vague, cold and unknown fear.

Did I want to go to Georgia State for the Doctorate of Physical Therapy Program? Well, yeah, I did. And I could as a Florida resident, but I'd have to pay out of state. So I've had to switch my grad school plans, which does frustrate me. I wish that I didn't have Diabetes, if only so that switching my residency would be an infinitely more simple matter that I could have addressed in a week, versus months of waiting, with far smaller consequences. I could go pretty much any where I want then, but I feel as though with Diabetes my options are more limited than without. I hate to feel barred, limited. But I guess that's just life.
Instead, I decided to look into an old possibility that I had given up a few months earlier amidst my agonizingly slow grad school decision making process; after juggling about 6 different schools, I finally think that I've settled for a very likely contender, which is Mercer University located in North Atlanta. Mercer is a private university, which means I don't need to pay out of state. Private education does come at a cost, however, which is initially what discouraged me. But after looking at the numbers and weighing the possible costs and benefits, Mercer seems like a good choice for me. I have a high chance of getting at least some financial aid, I already have a successful business (aka form of income) practically run out of the Atlanta area, and I know the area decently well. The prospect of Atlanta is scary to me, but I've taken some time to mull it over in my mind the past few weeks and I'm gradually becoming more comfortable with it.... I think....

Ok, I'm still scared. Truth be told, I've become comfortable with Macon. It's cushy, familiar. I don't want to leave that familiarity behind. I hate uncertainty. But trying to envision Atlanta life in my head (granted I get accepted to Mercer) helps, and hopefully in a year I'll be ready to peel myself away from this town and move on to bigger and better things. To get one step closer to my future career!

It's a dizzying prospect, but if there's anything that life has taught me, it's that we people are more capable of handling things than we think.

A Snack-less Outing.

The sun hangs high in the sky, and birds sing their songs back and forth to each other from the branches above me. I step into the cool arboretum, sighing as if I've returned to a long-lost home. I love the outdoors, but let's face it: I'm pretty lazy. I work out in the AC, but I don't go outdoors much. Joshua laughs at me because I drive to the Wesleyan gym (which is just across the lake). So today, I was really proud of myself that I had decided to take a hike in Wesleyan's Arboretum. I've been there a few times, but did not know the area particularly well. I was not entirely sure what to expect.

Stepping into the arboretum is almost like stepping into another world. Everything surrounding me falls silent; the grating sound of the lawnmower across the hill, the screaming children on the tennis court, the cars of Tucker Road. The path descends and a wooden bridge takes you over the creek, where frogs hurriedly splash into the water upon hearing footsteps.

I walk on, basking in the afternoon sun that falls in fragments between the leafy canopy above me. My footsteps make soft sounds on the dirt path; squirrels play noisily in the leaves, darting up and down trees. It is peaceful.

A flash of color draws my eye downward. A box turtle sits, solitary, before eyeing me and retreating into his shell. I bend down to get a closer look. I decide to pick the poor little guy up, and I walk onward until I reach this absolutely beautiful clearing. I cannot believe Wesleyan has been hiding this place in their backyard this long and I never knew! It seriously looks as though it is straight out of the book Bridge to Terabithia, which brings me back to 3rd grade. A creek runs through the clearing, and the water running over the rocks makes little gurgling noises.

I set the turtle down as I sit on a rock and take my water bottle out of my bag. I realize then that I was in such a rush to get out the door that I had neglected to pack a snack. (Hiking and I have a bad history, don't we?) I check my phone. It is nearly dead. But I shrug, figuring I'll be ok. It is doubtful that I will meet calamity in the Wesleyan woods. I walk on, stopping in the clearing by the cabin to read for a bit with the turtle, who peeps his head out only a few times. Then I pick another path, walk down, and walk on, on, on.

It has been over an hour now. I know where I am, and I know what direction I should be going in to get back to the path, but I realize that I have become very entangled in the path, didn't study the map and it would take so long for me to retrace my steps back that I might as well keep going. After another good 30 minutes of walking, I realize that I, indeed, do not know if I will ever emerge from the woods. I am beginning to worry that I may get low at some point and not be able to call anyone due to my dying cell phone. Stupid, stupid, stupid!
I knew that I should have thought this through better, but the beautiful summer day had beckoned to me.
I trod on and on, still enjoying the hike but acknowledging that I would be enjoying it far more if I knew how far away from the school I was. As far as I was concerned, the path appeared to have no end as it snaked past a slow-moving creek and rose to surround me with thin young pine trees.

Shoot, I think, swatting at a gnat. I am half-lost in the woods, Diabetic with no food, and I have a turtle in my hand. Taking stock of the situation I press onward, certain that if I go in the right direction long enough that I must emerge at some point. It takes me a while, but I finally realize where I am and, with great joy, reach the trail's end out by the MAC. I am relieved as I crouch down to set the turtle back on the ground. The poor guy was probably feeling seasick.
I can feel myself  shaking just the slightest bit, and sweat clings at my back as I struggle up the hill and finally make it back to the apartment.
I know I am low at this point, and when I test back in my room I see that I am 59. I am mad at myself but sigh with relief that I narrowly dodged a bullet. No harm done, but I'll be sure to take more care in the future.

I sure do love the outdoors, but lesson learned: I'll bring not one, but a few, snacks next time!

Playing Make-Believe.

I used to play all sorts of games when I was little. Artist, teacher, archaeologist, detective, journalist - I could go through 3 different careers in the span of a single day.
I played Doctor, too. I used to grab a mechanical pencil, push down the eraser and pull on the lead until it nearly fell out. I'd put it up to my skin then, and push the eraser down, pretending that it was a needle as I watched the lead disappear into what looked to be skin.

Pretending was a lot more fun than the real thing. I'm no Doctor, but then, I play Doctor to myself every day. 
I guess after two years it's sunk in that this will be my life for the long haul. Am I a Diabetes whiz by now? Do I have perfect BG readings all the time? No way. But after this time I do think that I am beginning to get my confidence back - my confidence in myself, that I had lost for so long since my diagnosis. There came to be a constant worry, hanging like a shadow over me. The worry waited, unnoticed at times, until I fell headfirst into the right situation. Suddenly, the questions, the second guessing, would be there again. Hitting me headfirst like a train...

Now that I have Diabetes, will I ever be able to reach my goals?
Can I even be a physical therapist having Diabetes?
Will school and Diabetes be too much to handle?
Can I come to terms with the fact that I am imperfect when it comes to treating myself?

The worry isn't gone. But I feel like I can better confront the questions now.
Having Diabetes makes things more difficult, but I don't have to let it stop me from achieving any of my goals.
Will I get discouraged? Yes.
Have my bad days? Yes.
Wonder for the millionth time why the odds of having this disease fell upon me, when statistically they shouldn't have? All the time.
I've tried for so long to be perfect when it comes to my treatment, but I can't be. I am imperfect, I am flawed, my body is messed up. But everything comes one step at a time. Wake up, test, eat, test. Repeat. Every test, every shot, every Blood Glucose log carries me forward. 

So what if I want to get a Doctorate with Diabetes? It won't stop me.
So what if my job will require being on my feet a lot? I'll adjust my insulin if I get low. 
If I want to hike a mountain? I'll bring snacks. 
Diabetes won't stand still for me, so I won't stand still for Diabetes. 

I'll keep doing what I know how to do - keep on moving forward, setting goals, and achieving them. 

Looking back now, I realize something monumental - Diabetes, for me, was the defining line in my life between childhood and adulthood. Was I mature before my diagnosis? Certainly. (Ok, well, maybe my mom doesn't think so - ha-ha.) But Diabetes gave me something else.... changed my personality, tweaked me in some small but monumental way. 
When I got Diabetes, I think I truly became an adult. I learned things about myself that some people will never get the chance to learn. I learned that I would do what it takes to survive. I learned that I would let nothing get in the way of my goals, that nothing would stop me. That if I keep my chin up and keep pushing through, that I'll surprise even myself with what I can achieve. 

And something else.....
That life isn't perfect. That happiness isn't about perfection, or how few things are going wrong. Happiness is about the little moments; 
The sun in your hair, stolen moments with the one you love, a phone call to home. A walk on a crisp fall day, the smile of a stranger, the laughter of a friend.
Cracks, glimpses, fragments of life between life; this is what happiness is about. Learning to find the joy despite the craziness, the intensity, the anxiousness. Learning to find peace despite the turmoil. 
And to treasure all of it.

Sometimes, I still feel like the little girl playing Doctor. 
Sometimes, I wish it was all make-believe. That I would wake up one morning laughing, saying, "it was all just a dream."
But it's not make-believe any more. And I've made the choice to learn, and to grow, from this experience instead. 
I can never forget my life before; unlike some Diabetics, who have suffered with this disease since toddlers, I remember with a crisp, painful clarity all that my life was and used to be. There is and always will be an ache in my soul for that life.
But though I may look back sometimes, the past will not hold me back.

I will always keep moving forward.

Two.

Today is my two-year anniversary with Type 1 Diabetes. 

Did I celebrate? Cook a special sugar-free treat? Have a party? 

Well, no... today was just like any other day.

But as I checked my blood sugar, gave insulin, counted the carbs, went through the motions that over the last two years have become second thought to me...

One part of me silently mourned for the life that I lost two years ago,

And the other celebrated the woman I have grown to become. 

Here's to another two years, Type 1, and many more years living in spite of you. 

4.3.2011.

I Wear My Insulin Bruises Like Battle Scars

Ouch. The insulin has struck back again, and this time with a vengeance. I know I've already blogged about my colorful, rainbow-riffic insulin bruises before, but this morning as I was getting ready, I just got to thinking about all of the things Diabetes would be like in a perfect world. (Granted if, in a perfect world, Diabetes did exist, which in mine it wouldn't).

1. In a perfect world, insulin injections wouldn't leave bruises. Or, for that matter, it wouldn't leave tiny microscopic holes in my skin, either. My stomach, my arms, my.... legs, would be perfectly bruise-free. Some people fear bikini season because of too many Holiday cookies - I fear bikini season because of my bruises. Nothing like having a great swimsuit to wear and a great bruise to match the color of that swimsuit right on the side of your stomach. In that elusive, perfect world with perfect Diabetes, bikini season would be worry-free for me, and people wouldn't have to wonder about whether my apartment-mate, Crystal, is beating me up. (ha-ha).

2. In a perfect world, the lancet would work on my finger the first time. Not the second, not the third, not the fourth... the first.I wouldn't have to keep upping the lancet depth from 2, to 3, to 4 and now, finally, to 5. My callused, though once-delicate fingers would not be as tough as a man's now. I wouldn't get ugly calluses on my fingertips, or tiny shallow depressions from where the lancet has pricked (the red marks have finally gone away) that just plain don't look good.
It's a good thing I'm not a fingertip model.

3. In a perfect world, I would NEVER, EVER not notice my insulin pen is nearly empty and either a.) run out of Novolog right in the middle of dinner (at a friend's house, out to eat --- never at home, it seems) or b.) run out of Lantus right as I'm about to go to bed, and am spending the night somewhere that is not my typical abode. This typically ruins my entire day, evening or outing and forces me to have to go back and get my insulin, or eat nothing. This has happened on Christmas... at a dinner out with friends... out with the family... nothing is sacred to Diabetes.

4. In a perfect world, I would never have to forgo eating lunch in the car when on the way to work. When I'm in full costume, driving and have no access to arms, legs or my stomach (such as a long-sleeved, full length gown), there's really just no way to give an insulin shot. Sometimes, I am able to stab myself with an insulin pen through my clothing, while driving (can you say impressive?), but most times I simply have to forgo eating. Which... is lame.
While we are on the topic of parties, I would never get random lows in the middle of parties. Doing a fashion show, painting 30 children and trying to act cheerful while doing so are all extremely difficult things to do, and they suddenly become about 5x more difficult when you're feeling low.

In a perfect world...... oh, forget it.

Chinese For Lunch.

"What do you want for lunch?" Joshua asked, as he climbed into my truck. I had just gotten out of my class at Mercer and had stopped by Josh's work on the way back to Wesleyan so that we could have lunch together. I take a class at Mercer, one of the other colleges in Macon during the week, because they offer several classes that Wesleyan doesn't and it gives me a good chance to get off campus. I told Joshua that I was still debating, and he suggested Zaxby's or Chinese. I eat Zaxby's about every other day it seems (I'm a big fan), so I decided to go with Chinese, and we found a place in the shopping center not far from his workplace.

We walked inside, the bell above the door clinging as we entered. I stared at the menu for a brief moment, saw that they offered chicken and vegetables sans-rice, and approached the man behind the counter. To this day there has only been one time that I have eaten a dish of rice since becoming Diabetic, and I found that I didn't like the direction rice pushed my glucose levels in. Rice and I just didn't agree with each other very well.

"I'd like the chicken and vegetables, please," I said, pointing at the menu.

The man stared at me quizzically.

"Erm..." I said, trying to figure out which would be the best way to convey to him my menu choice.
"I don't want the lunch with rice." I told him.

At this point, another man on his lunch break had gotten in line behind us.

Despite my best efforts he grabbed a plastic white lunch crate and started loading rice into it.
"Wait, no," I said quickly. "No, I don't want the rice."

The man starts shoveling more rice into the box. I wave my hands frantically. The man behind Joshua and I snickers a little.
"I just want chicken and vegetables! I'm Diabetic. I don't eat rice," I told him, trying to make him understand. The effort seemed futile as he hesitated for a moment, but then he dumped the rice back into the metal dish and called a woman who I assumed was his manager. He told me to wait.

The man behind us gets his lunch as we wait. As Joshua and I are waiting to get my correct order and the man is waiting to pay, he turns to me.

"My wife is Type 1 Diabetic," he says. "She doesn't eat Chinese often."
I look at him, realizing his laughing earlier suddenly made a great deal more sense.
"I don't either," I said. "But sometimes, I like to spoil myself," I said with a hint of a smile. "...minus the rice, anyways!"
I turned to Joshua. "What a small world, isn't it?" I was amazed at the random people I seemed to meet, who had connections to Diabetes,

The other woman finally came out. It took a good 5 minutes to explain to her what I wanted. "Chicken and vegetables," I said again, pointing to the lunch dish which was on the menu... "No rice, please", I said, almost pleadingly. After a few quizzical glances, the woman disappeared in the back for about 10 minutes. When she came out I had my box of chicken and vegetables... and at long last, NO RICE!

Joshua and I walked back out to the car, and he opens the door for me. The other man comes out as I shut the door, sees my and smiles. He mouths,

"That woman is crazy!," And I laugh.

Not only do I have Chinese for lunch, but, at least for a few short minutes, I have met someone else who I know understands what I'm going through. It makes me feel a little bit less alone.

One of the Only Roller Coasters I Can Honestly Say I Don't Want to Ride...

*Note to reader: I've been meaning to publish this for a while, but this post was started in February, and my blood glucose levels have evened out considerably since then.

My forehead began to sweat and I watched as my hand, covered in a latex glove, trembled erratically. My breath caught in my mouth and my heart sunk down low, picking up force and rapidity steadily. I swallowed and walked to the trashcan, pulling the gloves off of my hands, balling them up and tossing them away in disgust. I walked into the coat room, already knowing exactly what it is I was going to find:

52, staring at me on the screen, the tenth low over a 3-day period. I closed my eyes, trying to clear my head, and then throwing my meter down stormed into the dining hall. I grabbed an apple from the fruit basket on my way to the floor, sinking down in an utter state of mental and physical exhaustion. I bit into the apple, tasting salty tears as I did so. I fought the tears back, but it was like trying to hold back water behind a dam riddled from top to bottom with cracks. Tears began to roll down my face.

Oh, how I cried. This was the first time I had gone to any type of camp since being diagnosed with Diabetes. I've experienced a great deal of things with Diabetes, but this was all new to me. The physical work that we did for a good deal of the day with little break was very tiring. My friends and I were on Work Crew for Northland Church's Christmas camp. But as an ex-competitive gymnast, hard work was something that could be easily dealt with. I was able and strong enough. In fact, camp so far had been a wonderful experience. When it came to the work, my mind wasn't the problem, and neither was my stamina. It was my compromised body that was ultimately failing me, as my glucose levels just couldn't catch up and level out to adjust with the sudden increase in physical activity. Despite the lower amounts of insulin I had been giving myself, I had had 5 lows consecutively on Day 1, 3 on Day 2 and now, on Day 3, I was on the 2nd of the day, and it was only 11:15 AM.

My friend Trent walked over, saw me, and sat down next to me silently. His presence comforted me, reminding me that I wasn't alone, reminding me that my friends and the people close to me made this struggle to live with my disease worth it. But still, coping with the frustration of not being able to control my body was so frustrating. I was used to telling myself to do something, and then doing it - always. To find that now I couldn't always do that was a difficult pill to swallow, and I resented the fact.

Two months later, I stared at the meter screen. The meter at 9:00 AM had read 232, and it now read 545 after bolusing for breakfast and giving myself a correction dosage (to bring my levels down).

Two days later, my meter read 182 after going out to eat at my favourite pizza place 4 hours earlier. 3 hours later, the meter read 447. My mouth was so parched I could hardly swallow, and my body felt physically immovable. I suffered through the night with a bottle of water by my side.

My sugars have been doing exactly what they are not supposed to do; "roller-coasting".

High.

Low.

High.

High.

High.

Just right.

Low.

High.

Low.
... Wow, am I really 92? *Re-checks* Really? Seriously??

Low.

Acceptable.

High.

I'm so over this. It seems as though every time I get my levels just right, and my insulin dosages spot-on... something causes them to change. Activity levels, insulin-to-carb ratio... the weather in Greece... someone sneezing across campus... I swear, my insulin ratios are as finicky as a 3 year old.

From December all the way until February, I just couldn't seem to get my levels in check. Sometimes they will be perfect, but most days my sugars won't miss a chance to read either something way too low, or something ridiculously high. I have no clue why all of the insulin changes are happening. Before Winter Break my insulin ratio was one level (12 to 1), then it changed and it took me a good 3 weeks to figure out that it was 6:1. Then, right after my endocrinologist visit in December it changed to about 9:1...and then after Christmas camp to 12:1... back to 8:1 again in February. These changes seem very small and infinitesimal to the healthy non-Diabetic, but in actuality they can make an enormous difference. Picture it this way:

If you think your insulin ratio is 10:1 and you eat 45 grams of carbs, you'll round up and give yourself 5 units of insulin. But if your ratio is 6:1, suddenly you need about 8 units. If each unit of insulin lowers your blood sugar by 50 mg/dL, your sugar will end up being about 150 milligrams per deciliters too high... which could be the difference between an "80" and a "230". That's an enormous difference, especially if you decide to have a slice of cake one evening. It works the opposite way too - if you think your insulin ratio is lower than it actually is, you will bolus too much and end up low every single time you eat.

This is the extreme frustration that I've lived through for 3 straight months. After a while it makes you fearful to eat carbs at all - I just can't pin my numbers down quite right and have resorted to living off of protein shakes and salads, mostly. It also changes your perception - 200 doesn't seem too bad when your levels have read 400 for the last 8 hours. But I have been so disappointed in myself, because 1. I tend to be hard on myself and 2. Once again I feel like a failure and feel as though people would look down upon me for not being able to properly control my blood sugars. After all, perception or no this is a very bad thing, because any way you look at it, your sugars simply shouldn't be at 200, especially when you're aiming for a target of 130.
In fact, it's this roller coaster of sugars that is so bad for those with Diabetes, and to my understanding is what causes a good deal of the future complications like Diabetic retinopathy and neuropathy, not to mention slower healing.

Great, huh?

Diabetes, can I please get off of this roller coaster now?