Life is mental right now. When I say it is mental I mostly mean that I am going mental with everything that I'm trying to manage. Some days are great and I feel like I have total control over what is going on in my body and other days I feel like I'm falling apart, physically and emotionally.
Since September 22nd I have had 13 appointments for my own medical purposes, had lab work done 3 times, taken my children to various appointments, taken my older son to preschool and swimming classes, and attended 2 births as a doula. This was me "scaling back". I scoffed at my diabetes nurse when she suggested I try to cut back on things for a little while. I have 3 kids under the age of 4 and the idea of scaling back is somewhat laughable.
When I look back at this month I realize that I actually HAVE scaled back. The problem is that I have scaled back in areas that I get great enjoyment out of for my own emotional well being. I've only adventured out on one playdate this month (fun but exhausting) and haven't done anything for purely social purposes. I have a coffee date with two girlfriends on Sunday morning and I am giddy with anticipation to get out of the house (sans kids) and NOT have to see any doctors, nurses, dietitians, psychologists or lab techs. Don't get me wrong - they are all great - but enough is enough. I am now attempting to find a balance between giving our children the life that they deserve while also making sure that they have a mother to enjoy it with them who hasn't gone completely nuts (or worse).
Now for some technical data. Type 1 diabetics need to have lab work done (at minimum) every 3 months. They do a blood test called hemoglobin A1c (HbA1c) that measures the average blood glucose concentration over a period of time (about 3 months). When I was diagnosed my A1c was 11.5 and I guess that is uber bad. I think that is about as high as it can go without something really terrible happening. Healthy non-diabetics would have a number more like between 4 and 6. Type 1s aim for a number between 6.5 to 7. The good news is that in the short month since my crisis I am now at 9.0 - a huge improvement in a short time.
In terms of blood glucose levels I am self testing a minimum of 10 times a day; always before meals and 2 hours after as well as at bedtime and anytime I feel "low". My finger tips look like a war zone but I am a little OCD about checking my numbers at this point. Non-diabetics can expect to see their blood sugar range anywhere from 3.8 to 7.8, although most often their bodies would keep the numbers closer to about 4.4 to 6.1. As a diabetic my ranges are more difficult to control as I am doing it with injected insulin so my targets are between 4 and 7 pre-meal and between 5 and 10 two hours after I eat.
Prior to this I had experienced what the average person might consider hypoglycemia - basically an unwell feeling, maybe some shakes, a foul mood and an urgent need to eat asap. Prior to my diagnosis I maybe had that happen once or twice a year, at most, and it was nothing that a little food couldn't easily fix. This is what I assume the average non-diabetic experiences when they wait too long to eat and we've all been there. In these cases blood sugar levels are likely in the 3.8 to 4.4 range and the body with a perfectly normal pancreas will very likely compensate before something really bad happens.
True hypoglycemia is somewhat like this but much, much worse. In my case my legs go to jelly, I get confused, I have trouble walking and my heart races. It is a scary feeling and makes my whole body hurt. After one of these episodes I am exhausted emotionally and physically and the rest of the day is usually a write off. I have been experiencing some lows while we figure out how much insulin I should be using and how my daily activity effects how the insulin works in my body.
I put the kids down for a nap yesterday and felt like it was dipping. I checked and it was 4.1 - low but not extremely low - so I had a quick snack. 10 minutes later I was at 2.6 and could barely function. A scary time since I was alone at home with our kids. I treated with sugar and got it to start coming back up just as Clint was getting home from work. Severe hypoglycemia can cause seizures and loss of consciousness. Neither is an option for me EVER, much less when I am at home parenting by myself.
We have an emergency glucagon injection kit that Clint will hopefully never have to use on me. If he finds me unconscious he will need to inject the glucagon into me. This is basically the same thing EMS would inject if anyone ever called 911 for me. Now, when I heard about this little kit all I could think of was that scene in Pulp Fiction when they have to stab the overdose victim in the chest with a giant needle. I picked up my glucagon a couple of days ago and it is MUCH less dramatic than that (thank goodness!). It really is just a simple syringe and he would inject it in my stomach with no stabbing effort required.
I spoke to someone at the diabetes clinic today that told me that the Chinese word for crisis is 2 characters that each mean "danger" and "opportunity". The danger is all of those scary things that I am at higher risk for (heart attack, stroke, kidney failure, blindness, etc.). The opportunity is that I now have this whole team of people helping me to figure out how to live a long and healthy life. This crisis is my job right now but I get to make decisions, inform myself, make choices and problem solve. I am the CEO of my diabetes, not the other way around.
Friday, October 21, 2011
Tuesday, October 4, 2011
Expired Pancreas
Just when I thought I was finally getting our home life organized and becoming Super Mommy, I have been given a swift kick in the gut. The pancreas to be more exact. It turns out I am the "lucky recipient" (the words of my nurse) of a gene that basically stamped my pancreas with an expiration date.
About 6-8 weeks ago I started having some symptoms... extreme thirst, frequent and excessive peeing, weight loss even when I wasn't really trying.... and I knew something was not right with my body. Denial prevented me from making an appointment with my doctor and I just kept hoping that it was just my body resetting after my last pregnancy and finally being done with breastfeeding. On September 22nd I went to my GP and got the bad news that I am a diabetic.
Now, she couldn't tell me what kind of diabetic I was (Type 1 or Type 2) and I have to admit that I really hoped it was Type 2. You see these people on the Biggest Loser that get themselves into great shape and basically "cure" their diabetes. They don't have to take meds or insulin and just need to be reasonable about diet and exercise. Diabetes wasn't brand new to me - I had gestational diabetes and required insulin when I was pregnant with the twins - so my GP had me start insulin that day. I still had all my supplies leftover from last summer thinking that I would never need them again.
The next 48 hours were dramatic and I ended up in the emergency room by 3:30 the next afternoon. My body had been suffering long enough and needed fuel. With no insulin to help the glucose entering my body to fuel my cells and brain, I actually felt like I was wasting away. Truth be told, I have never felt that bad. When I got home that night I collapsed in bed.
The next morning I went to the diabetes clinic (they fit me in on a Saturday even though they don't normally do that) and I met with a nurse and a dietician. I was told then that I am a Type 1 diabetic and will require insulin multiple times a day for the rest of my life. What? Why? How? Is there any chance you are wrong and this will go away? That my body will "fix" itself? Nope and Nope.
I had so many questions: How on earth am I going to manage this with 3 kids at home? What are the chances that any of our kids will develop it? What restrictions will I now have on my diet? How do I explain this to my family/friends/colleagues?
It sucks. I'm trying to find new routines for everyday things like providing meals for my family and taking Nathan to preschool. I feel like this is going to be my 4th baby - this baby requires 24/7 attention from me, I need to feed this baby carefully and always be aware of what this baby is doing. I can't leave the house without a drink and a snack for this baby and I need to always remember this baby's medication. However, this baby will never grow up, learn to take care of itself and move out. I am also a single mom to this baby since Clint and other family members can't really help me take care of it and I will never get a night or weekend "off" from this baby as it will always be with me. No babysitter in the world can take care of this baby for me.
I'm learning so much right now and slowly getting my blood sugar under control. I've been struggling with how to tell people about it or even if I should tell people about it. I decided to just rip the bandaid off and get it out there. I'm not embarrassed but I'm not at the point yet where I feel like I want to explain every detail to everyone I tell. People are generally misinformed and/or uninformed about diabetes. Here are some things I've learned so far that should help with the questions I pretty much would prefer not to talk about as well as some safety information in case of emergency:
1. Type 1 is most often diagnosed in childhood or adolescence but can occur in adulthood as well (my pancreas "expired" at age 33).
2. I am insulin dependent. My pancreas is producing little (if any) insulin at this point. I take insulin with every meal as well as slower acting insulin at bed and in the morning for a total of 5-6 injections a day.
3. If I feel crappy (and right now frequently even if I don't feel crappy) I will prick my finger to check my blood glucose. I'm sorry if that makes anyone uncomfortable but the alternative is me having a seizure and/or losing consciousness if I am hypoglycemic.
4. If you are going to be eating a meal with me I will need to inject insulin into my stomach. I will attempt to be discreet but you are more than welcome to look away if it makes you uncomfortable.
5. If I appear confused, drunk or otherwise not myself, please sit me down and give me some juice, sugar or other sugary treat. I have glucose tablets in my purse and if I am conscious you can give me 4. When I come around tell me what is going on since I likely won't have any idea what is happening.
6. If I am unconscious please call 9-1-1 and tell them I am a type 1 insulin dependent diabetic.
So, there it is. I have no doubt that I will be OK as I'm a planner and will take care of this. I'm angry that this is happening but also thankful that we were done having kids before it happened. I'm also so thankful that we have such great medical systems in place to help me cope and manage it (so thankful for universal health care!!). Insulin was invented in 1923 (by a Canadian) and life expectancies were only months prior to that so I'm also happy that I live here, in this time to deal with this illness. I'm also so happy that our family now has medical coverage through Clint's work so it won't be as much as a financial burden on us either. I am having a good day today but also know that not everyday will be a good day and I will be OK with that. I am fortunate to be an intelligent person with a lot of family and friends for support. I plan to live a long, healthy and happy life regardless of my useless pancreas.
About 6-8 weeks ago I started having some symptoms... extreme thirst, frequent and excessive peeing, weight loss even when I wasn't really trying.... and I knew something was not right with my body. Denial prevented me from making an appointment with my doctor and I just kept hoping that it was just my body resetting after my last pregnancy and finally being done with breastfeeding. On September 22nd I went to my GP and got the bad news that I am a diabetic.
Now, she couldn't tell me what kind of diabetic I was (Type 1 or Type 2) and I have to admit that I really hoped it was Type 2. You see these people on the Biggest Loser that get themselves into great shape and basically "cure" their diabetes. They don't have to take meds or insulin and just need to be reasonable about diet and exercise. Diabetes wasn't brand new to me - I had gestational diabetes and required insulin when I was pregnant with the twins - so my GP had me start insulin that day. I still had all my supplies leftover from last summer thinking that I would never need them again.
The next 48 hours were dramatic and I ended up in the emergency room by 3:30 the next afternoon. My body had been suffering long enough and needed fuel. With no insulin to help the glucose entering my body to fuel my cells and brain, I actually felt like I was wasting away. Truth be told, I have never felt that bad. When I got home that night I collapsed in bed.
The next morning I went to the diabetes clinic (they fit me in on a Saturday even though they don't normally do that) and I met with a nurse and a dietician. I was told then that I am a Type 1 diabetic and will require insulin multiple times a day for the rest of my life. What? Why? How? Is there any chance you are wrong and this will go away? That my body will "fix" itself? Nope and Nope.
I had so many questions: How on earth am I going to manage this with 3 kids at home? What are the chances that any of our kids will develop it? What restrictions will I now have on my diet? How do I explain this to my family/friends/colleagues?
It sucks. I'm trying to find new routines for everyday things like providing meals for my family and taking Nathan to preschool. I feel like this is going to be my 4th baby - this baby requires 24/7 attention from me, I need to feed this baby carefully and always be aware of what this baby is doing. I can't leave the house without a drink and a snack for this baby and I need to always remember this baby's medication. However, this baby will never grow up, learn to take care of itself and move out. I am also a single mom to this baby since Clint and other family members can't really help me take care of it and I will never get a night or weekend "off" from this baby as it will always be with me. No babysitter in the world can take care of this baby for me.
I'm learning so much right now and slowly getting my blood sugar under control. I've been struggling with how to tell people about it or even if I should tell people about it. I decided to just rip the bandaid off and get it out there. I'm not embarrassed but I'm not at the point yet where I feel like I want to explain every detail to everyone I tell. People are generally misinformed and/or uninformed about diabetes. Here are some things I've learned so far that should help with the questions I pretty much would prefer not to talk about as well as some safety information in case of emergency:
1. Type 1 is most often diagnosed in childhood or adolescence but can occur in adulthood as well (my pancreas "expired" at age 33).
2. I am insulin dependent. My pancreas is producing little (if any) insulin at this point. I take insulin with every meal as well as slower acting insulin at bed and in the morning for a total of 5-6 injections a day.
3. If I feel crappy (and right now frequently even if I don't feel crappy) I will prick my finger to check my blood glucose. I'm sorry if that makes anyone uncomfortable but the alternative is me having a seizure and/or losing consciousness if I am hypoglycemic.
4. If you are going to be eating a meal with me I will need to inject insulin into my stomach. I will attempt to be discreet but you are more than welcome to look away if it makes you uncomfortable.
5. If I appear confused, drunk or otherwise not myself, please sit me down and give me some juice, sugar or other sugary treat. I have glucose tablets in my purse and if I am conscious you can give me 4. When I come around tell me what is going on since I likely won't have any idea what is happening.
6. If I am unconscious please call 9-1-1 and tell them I am a type 1 insulin dependent diabetic.
So, there it is. I have no doubt that I will be OK as I'm a planner and will take care of this. I'm angry that this is happening but also thankful that we were done having kids before it happened. I'm also so thankful that we have such great medical systems in place to help me cope and manage it (so thankful for universal health care!!). Insulin was invented in 1923 (by a Canadian) and life expectancies were only months prior to that so I'm also happy that I live here, in this time to deal with this illness. I'm also so happy that our family now has medical coverage through Clint's work so it won't be as much as a financial burden on us either. I am having a good day today but also know that not everyday will be a good day and I will be OK with that. I am fortunate to be an intelligent person with a lot of family and friends for support. I plan to live a long, healthy and happy life regardless of my useless pancreas.
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