Friday, April 27, 2012

So you had a bad day.

Lately, I’ve been reflecting on sources of strength – where do you turn or what do you turn to in difficult times? Or in more simple terms, how do I make it through days where diabetes is forcing me to have a terrible, no good, very bad day? Like the days where my body plays tricks on me and I feel low but in fact, I’m just a normal gal (according to my blood sugars anyway). There are days where I don’t feel well and I just plain and simple don’t have a choice but to deal with it. There are days when technology fails at the most inconvenient times and I am one sad, stressed out robot. I have to admit it’s these days that I truly feel the burden of living with diabetes and I loathe all of my pancreases even the plastic, wireless one that I usually find so nifty. So, how do you pull yourself up by the boot straps and get through the days, weeks, months, years? Survival mode to me is like a retroactive time machine – so what does that mean?

Often coping means checking-in with my team of experts: me, myself and I. I think to myself, how can I better this bad situation and calm my anxieties? How have I dealt with this in the past? I call this (as of 30 seconds ago) the “Destiny’s Child” method because it is intended to be powerful – imagine that your brain is dressed up in camouflage dancing beside Beyonce in the “Survivor” video and tell me that doesn’t empower you to get through a crap day. Yes – I can call, text, email or visit with friends and family but I’ve learned that while that coping mechanism gives me the “warm and fuzzies”– it is uber rewarding to pull from deep down in your guts and find inner strength to cope and then enjoy the sense of pride for what you’ve accomplished. Even if you didn’t really “accomplish” anything in the traditional sense, sometimes the feeling that you survived is enough to make you smile. And when that doesn’t work, there’s always malbec and cute animal videos on youtube.

Tuesday, April 24, 2012

The Anxiety Monster

Panic and anxiety are the grown-up versions of the monsters that lived under your bed when you were a little kid. They are menacing and core-shaking just like those craaazy monsters your parents had to kick out of your room each night. And just like the aftermath of surviving a midnight monster attack – you often realize how silly your thought-process actually was during that so-called terrifying event.

Like my fear of monsters – my anxiety is fairly irrational and certainly not based on facts or historical evidence. Often my hysteria is based on spooky stories passed through generations of other people with diabetes, their families, the media and complete strangers who feel it necessary to scare the living bejesus out of me. As I’ve dealt with my anxiety and attempted to wrangle my panic attacks – I realize that this takes a heck of a lot of compromise mentally, physically, emotionally. Living with diabetes means envisioning the worst and always being prepared for what highs and lows are thrown your way. It is difficult to stray from focusing on the negative and to continue learning from the days when anxiety wins and I lose. When I look at the positive, it’s clear that what feels like giant failure is actually a testament to how strong I actually am and how much stronger I’ll become. It’s like waking up and realizing that your army of stuffed animals clearly scared the monsters away for good except in my case, it’s slaying the low-blood sugar dragon and then realizing it wasn’t the catastrophe you were sure would happen in your mental picture.

Focusing on learned lessons has become a coping mechanism for anxiety and panic, by keeping a mental list of times where you’ve survived some serious shiz and didn’t lose your marbles in the process. Even now, I find it difficult to wrap my sometimes silly, sometimes anxious head around how I even got to this point and all the things I’ve accomplished/survived/thrived through since I was diagnosed. The biggest step to regaining control is accepting that just like the monsters – anxiety is a big friggen’ deal but not such that a little perspective, some family, some friends and maybe a few stuffed animals can’t cure.

Tuesday, April 10, 2012

The Mary Poppins of Diabetes

If you are a chick with T-1 – I’ll bet a million dollars that your purse is so large that it resembles carry-on luggage. If you happen to be a family member or friend of mine – chances are I’ve asked you to hold my purse so that I could test, bolus or check my CGM and you are most likely still in physical therapy for the muscle strain that occurred. My bad for not telling you to lift with your knees instead of your back!

When I leave my apartment, I generally do a checklist in my head of all the possible diabetes situations that could occur while I am out in the wild. Do I have enough juice and glucose tabs in case I have multiple lows? What if my pod malfunctions? Did I remember to even put my g-damn pod in my purse? Do I have test strips? Where is my CGM? Is it charged? Should I bring snacks in case I morph into a hungry/cranky diabetic? The list goes on and on…and by the time I actually get out the door I have a very heavy arsenal of supplies in my purse. I see girls carrying small wristlets and clutches as their ONLY bag and laugh at how I fit at least two of those in my purse everyday just to keep my diabetes schtuff organized. I have a magical purse similar to Mary Poppins – sometimes I worry about falling in it and never being able to find my way out.

Since I am the MacGyver of diabetes – I decided for this post I would do a fun(ny) inventory of what is currently in my bag. Surprisingly, today was not too strange of a day in the world of purse contents. The contents include: my wallet (which is actually a wristlet and therefore contains entirely too many coupons/membership cards), 5 pods in two different pockets, 5 lipglosses, 1 jar of glucose tabs, 2 juice boxes, a vial of Novolog, a book of stamps, my checkbook, approx. 50 used test strips that have fallen to the bottom of my purse, a smushed granola bar, a wristlet containing my OmniPod, Test Strips and Lancet, a glucagon pen, a moleskin notebook, sparkly gel pen, a few sets of keys that I'm not sure who/where they belong to, my cell phone, my DexCom, sunglasses, post-it notes to myself, a pack of sugar-free gum, Advil, car keys and finally about 10 bobby pins/ hair ties in every pocket.

So now that you think I’m a hoarder who lives in my purse – I will leave you with this:

At least I don’t carry pictures of my cat. The End.

Friday, April 6, 2012

Social Dieting

I learned in graduate school how social networks affect your health – studies have proven that who you hang around with influences your ability to make long-lasting changes to your health and lifestyle. It has been shown that many people are overweight and stay overweight because of their environment and the people that surround them. I read a review for the new book “The Social Network Diet” by Miriam Nelson and Jennifer Ackerman – who hopes are to inspire a “ripple effect” of healthy lifestyles through their diet. The idea is very simple – remove the negative and add in a lot of positive. This includes people. And while the focus of this diet like millions of others is weight-loss and reducing obesity rates – it made me begin to think about this concept as it applies to my life with T1.

After 10 years with diabetes, I have to constantly inventory the “negative” influences over my diabetes and replace them with positive cues. For example, leaving my yoga mat in plain sight next to the couch so that is practically screams at me to get my lazy bum up and use it. Or, not buying chips at the grocery store because I am a snacking monster. But, how does this apply to people? I’ve certainly had a number of horrible health professionals that I’ve given the axe – including the biotch that told me I should carry a scale and a carbohydrate book to the dining hall at college for every meal. That would have been a foolproof plan for me to make ANY friends my freshman year. For the record, this “health professional” then went on to show me pictures of her pugs in costumes, enough said. “The Social Network Diet” influences people to be the epicenter of change in their network of friends, family, co-workers, etc. I think this is something people with diabetes deal with more than most. Every time we meet a new person, there is an internal gauge for how much that person needs or wants to know about your life with diabetes. Sometimes this is a forced and uncomfortable encounter and other times it’s wonderful to share. It can be a difficult to navigate social networks with a chronic disease – and to decide how much is too much when it comes to sharing about your health and not making people feel like they have to act differently around you. I’m sure it’s similar with weight loss – how many food items in the pantry can you throw out before your family stages an intervention and takes over the grocery shopping? How many times can you harass your friends to join your boot camp class before they stop answering your calls?

I might have to buy this book just to see what solutions they offer for the backlash that comes from being the “agent of change” in your social groups. This could be a mad social scientist experiment in the making – so beware friends, if you suddenly get a barrage of texts, emails and calls from me asking if you want to cleanse our pantries together please don’t ignore, I’m only trying to change the world one enriched flour item at a time.

Monday, April 2, 2012

The Domino Effect

Morning time is not my strong suite. I don't function before 7am unless I happen to be waking up for a shopping spree or a beach vacation. I require gallons of coffee before I am aware that I'm actually awake. A special thanks must be given to Keurig for making every work day possible. Besides my cup o' joe, there is one other morning activity that makes me spring out of bed with a smile on my face. Every morning after I turn off my succession of obnoxious alarms - the first thing I do is check my Dexcom to determine the fate of my morning. Today, I woke up to 93 with a beautiful straight arrow and a graph line showing that my BG had been around 100 for the last 6+ hours. GORGEOUS! 

Night time BG's tend to be fabulous for me and this has begun to translate into fabulous mornings. So why the heck did I title this post The Domino Effect? Well, here's my latest idea that's sure to knock your socks off. I tend to be hyper-focused on the points of my day where my BG's tend to be crappy. I recently printed my Dexcom results and noticed that from about noon until dinner - I had a lot fewer normal range BG's than after dinner through the night. So I got to thinking, what if I focus on really fine-tuning my evening and nighttime BG's? This would be much less frustrating than tackling an already annoying part of the day AND it would likely cause a domino effect of great BG's leading into my afternoon sky-rockets in flight (minus the delight).

The ironic part about this idea is that once I put it down on paper - I had a succession of 3 mornings where the "dawn phenomenon" kicked my bleepin' arse. If I wake up in normal range - my dawn phenomemnon spike doesn't usually make too big a difference. BUT on the late night/early mornings where I spike around 3am and never come down - I am frankenstein even after my cup of coffee.

P.S. The title of this post was also inspired by a Sex & the City episode. I have got to stop being such a gosh darn stereotype of a girly girl.

Monday, March 19, 2012

Public Health Rave

Before you get excited - there's no glowsticks involved in this rave. Rather, this is actually a rant disguised as a rave about how ah-mazing public health is. Recently, I've explored what it takes to become a certified diabetes educator (CDE) - my public health experience has influenced my curiosity in exploring what it takes to combine my two loves: public health and diabetes advocacy. It's proving to be much more difficult than I anticipated due to the fact that you cannot sit for the licensing exam with an MPH (master's in public health) but rather you must already possess a clinical degree, a license such as an RD or an MSW (master's in social work). Part of me totally gets why this is the case.  It makes sense that you need to have one-on-one patient/client interaction experience. However, I feel like perhaps these eligibility requirements are slightly antiquated given the recent skyrocketing numbers of people with diabetes. It is so important now more than ever to not only prevent diabetes but also the expensive and painful complications associated with it. I believe that many health professionals who do "public health" work are more than qualified to become CDE's (I swear I'm not patting myself on the back while writing this!). Public Health represents a shift in how we approach health and wellness - it takes into account social, economic, environment and other factors that acute care does not. So as someone who addresses health at a community-level in their job - no, I don't have patient interactions but I do understand that preventing and caring for type 2 diabetes involves a lot more than diet, exercise and medication. And my lack of "clinical" experience is nothing professional training and education couldn't cure. If prevention is the new focus in U.S. healthcare, then public health and clinical care will certainly be marrying and becoming one big, healthy family.  I'm just hoping I'm invited to the wedding!

Thursday, March 15, 2012

Super Freak

So remember on Sex & the City when Carrie talks about “single-self behaviors” that you do when your significant other isn’t around. Well, I realized this morning that I have some “diabetic-self behaviors” that could potentially be viewed as weird and perhaps a little gross. For example, I am not the type to carry around gauze or alcohol wipes for my fingers after I prick them to test. Although I realize I am not and never will be a vampire or a character on True Blood, I find it’s much more convenient to just lick the blood off my finger and keep movin’ with my day.

I also discovered while changing my pod what I would like to call “doing the nerve.” Hitting a nerve while changing your pump site feels like a lovely combination of being punched in the stomach while having a bee sting you – my response is a dance that is a combination of foot stomping and shimmying my shoulders. It’s all quite graceful I can assure you.

I think everyone has secret behaviors that make them tick – but some of mine that are particular to how I deal with the everyday management of my diabetes are especially laughable because they are my ways of “cutting corners” so to speak. Like how I let my diabetes bag fill with used test strips because it’s a lazy habit that’s easier than always finding a trash can (and without fail, it always dumps out in the bottom of my purse). Or how I undoubtedly throw/drop/lose the plastic straw wrapper from my juicy juice when I’m low and find millions of them in my office/car/apartment/purse/bed/kitchen. Even better is waking up with fruit snacks or granola bar in your hair or under your pillow from a middle-of-the-night low BG.

I laugh at myself when I go to the supermarket and buy small bottles of juice rather than juice boxes. Why you ask? Well, because I think it looks much more grown-up and sophisticated to drink a mini-bottle of juicy-juice rather than slurping through a straw. Duh.