Monday, May 27, 2013

Brilliant

</sarcasm>

It's weird how I can ace upper level Biology classes but make the same stupid mistakes over and over again with my health.

Technically, I have fibromyalgia, which is my rheum's fancy way of saying that he has no idea what the heck is wrong with me and I probably have the early signs of some autoimmune disease. What it means practically is that I have good days and bad days, which, as I experience more, seem to be controllable.

On Sunday, I went shopping with my sister and a friend. We walked a LOT. You'd think I know better than to go shopping after five hours of sleep with HOURS of walking, but nooooo, I know better than what my body tried to tell me.

Which is how I took two one-hour naps when I came home, and then fell asleep on the couch for another two hours before I could drag myself up to bed.

Something like that is fairly typical for me after a long day, five hours of sleep or fifteen. It's the way my body works.

Today, I spent the day playing guitar and doing MCAT practice tests and packing. Tomorrow, I'm going to Maryland with my friend. The bus ride is long and I have about an hour's drive to the bus stop. After the bus ride we're taking a cab for another half hour or so (maybe longer, depending on traffic). The next day, we're going home by train.

I don't know what's wrong with me. What prompted me to say yes? Other than the fact that this is my best friend, I can't imagine what possessed me. After pulling a stunt like that, I'll be lucky if I'm functional by the time my internship is scheduled to start.

But wait. It gets better.

A trip like that will mean less than idea blood sugars, because I'm staying in someone else's house and will eat what's available. More, we're probably having pizza for dinner. And maybe wine will be involved. That will definitely add to the wonder that is exhaustion.

And my friend and I have a habit of talking to each other in the dark well past the time we intended to go to sleep. She was over for a few nights this past winter vacation, and we hardly got any sleep.

Furthermore, I get motion sick. I know, I know, the bus we're taking is a coach bus. It shouldn't matter, right? WRONG. It matters to my messed-up body. And I'm pretty sure I get sick on trains, too (though not nearly as bad as buses).

All of this leads to my perfect storm of stupid, from which I am going to need days to recover from one favor for a friend.

I hate having a lack of freedom because of my health. For crying out loud--I'm not sixty! I'm young! I shouldn't have to worry about wearing myself out or eating the wrong foods. I shouldn't have to worry about one sleepless night. I shouldn't really have to worry about anything except my MCAT scores!

Anyway, it's...sad? that about half of the stuff I packed are health-related. I have a backup meter and extra strips. I have vitamins and Metformin enough to last me three days. I have two water bottles (and will likely be bringing a third). I have...all kinds of crap, really.

The good news is that I get to spend two days with my closest friend. And that she's understanding about my health and its fits of terror. If I tell her I can't handle pizza, she'll figure something else out. If I tell her that I'm too tired to talk, she'll get a good night's sleep. If I tell her that I can't watch movies on the bus, she'll watch them herself or ditch the movies and just talk.

The problem is voicing this stuff instead of letting her figure it out for herself.

I've spent so much of my "adult" life (read: from age 14 or so) pushing myself far beyond my capabilities that I don't even know where the cutoff is anymore. Until the point where my speech is slurred because I'm so exhausted and I collapse for hours just to nap, I can't let up. I don't know how to stop until I'm not given any more choice. According to medical schools, this is a fairly good quality, but everywhere else, it's a failure. I need to learn that if I think I'm going to live to see twenty five.

Anyway, the next few days will be busy. Wish me luck!

Progress

I took the remaining two sections of the free practice MCAT on the AAMC website today. Like I said, I did okay on Verbal and bad on Physics/Chemistry. The biggest reason? I didn't know they don't give formulas on the test! (My Physics 1 professor told us it has most of the formulas.) I can live with the no calculator deal, but I definitely don't like this bit about no formulas.

In other news, a small piece of apple crisp (made with Splenda brown sugar blend for baking) and a small piece of cake (I was hungry and I was taking a practice test!) brought me up to 167 today. *sigh* I really, really wish I knew what was going on with this whole blood sugar thing.

"I'll put one foot in front of the other one/I don't need a new love or a new life/Just a better place to die" ~Fun.

Saturday, May 25, 2013

The Balancing Act

Everyone who's been to college knows that it's a balancing act between classes, schoolwork, sleep, and sanity. Anyone with a chronic health condition knows that college can be a pain in the neck--especially if you have food restrictions.

The semester is, technically, "over", though I consider it no such thing until the grades are in (I'm waiting for all five...and for various reasons, not expecting to be happy with them). But the work is just beginning.

I'm taking the MCAT on July 2nd. For those of you who aren't familiar with it, the MCAT is a horrible, terribly, no good, very bad TEST. It's one of the most defining factors in the life of a future doctor--maybe THE most, including the Boards. If you want to go to med school, you need a wicked-high MCAT score, especially if your grades aren't wonderful. (Like I've said--various reasons, including several semesters of the worst luck possible with health and another few semesters of terrible teachers/mean teachers/overly harsh graders.)

So this summer I'm studying for the MCAT. But wait--there's more.

I have a full-time internship from June 4th to the end of the month.

I'm very excited about this internship. I'll be shadowing doctors and it was, apparently, very hard to get in to. (They accept 8 people, and I know that a LOT more than that applied.) This will be the highlight of my summer.

So MCAT and full-time internship. Doable, right?

Well, maybe. But additionally, I want to start real exercise this summer.

There's this program called Couch to 5K. It's supposed to get you up and running in 10 weeks. I really, really want to try it. And because I have this lovely undiagnosed (and apparently undiagnosable) breathing disorder, I'm expecting it to take me twice as long to get to the 3.1 miles.

I can't start until I see my podiatrist about my ankle. It's been hurting since February and while I've had issues with this ankle before, this pain feels like it's in the joint, rather than the muscles around it, where it's been for, oh, seven and a half years or so.

I get joint pain. That's why I wasn't too worried at first. But short of the elbow I broke when I was 12, I've never had joint pain that lasted for so long. I think I might've stress fractured it (though why it would continue to hurt for so long I don't understand). Regardless, it's time to get it checked out, and that must be done before I do any more damage.

If I get cleared for the exercise, I'll be "running" (read: dying of shortness of breath) three mornings a week. I'll also be doing most of my MCAT studying in the morning, before anyone is awake to bother me (which will probably be about 5:30 AM).

Why not wait until after the MCAT? Well, the program is supposed to take ten weeks. I'm expecting double that with my breathing issues, which will juuust put me into the second month of next semester, so I want to start ASAP. Also, last summer I walked every morning on the treadmill for an hour and forty minutes. (I pre-studied for organic chem and then read books on my Kindle during that time.) I felt healthier, more awake, and less hungry. I was more satisfied from the food I did eat, and I therefore didn't snack as much (not that I lost any weight, but my blood sugars haven't been stellar and I don't like it. Less snacking and less food overall=less carbs and a happier, healthier me). Also? Though it was never great, my breathing did have a general upward trend during the day. (From April 2012 until October 2012, I had the worse episode of shortness of breath I've ever had. It scared me terribly--I couldn't finish a sentence without taking a breath in-between. The worst part was that my pulmonologist couldn't do anything about it. She still can't, but at least I can breathe now.) I'd be happy to have less shortness of breath overall, even if it means a few weeks of hell to go through in the beginning.

I've made a schedule and, honestly, it doesn't seem doable. It involves very early mornings and somewhat late nights (I do best with 8 hours of sleep, because that's the amount my crazy fibromyalgia body insist on). I like nights and I don't like mornings, but there's something about getting up early that makes me NEED to do whatever it was that I got up to do. I studied for APs this way in high school--3 AM wakeups a few times a week. That got me a 4 on one of the hardest Calculus AP's ever given, after a year of learning zero from my teacher. I won't be getting up quite that early for this, but the idea of getting up at 5 or 6 or whatever and then spending the whole day on my feet in the hospital sounds...exhausting. And kind of unnerving.

We'll see where I'm holding after I take the sample tests online. So far, the Biology/Organic Chemistry section seems doable for me. I'm hoping the other two sections are as good or even better (not likely--at least not for Chemistry/Physics. Verbal will probably be okay). But at the moment, I'm freaking out.

And lets's not forget the amount of time that goes into making healthy (blood sugar-friendly) breakfasts, lunches, and dinners. That takes careful planning, carb-counting, and loads of patience. I don't know yet how I'll be balancing food and blood sugar during the days in the hospital. I'm not sure how accommodating they'll be. I don't really know much of anything about this position, and that scares the ever living daylights out of me, because I'm a planner and it scares me when I can't account for everything.

So this summer is...intense. It's the most action-packed summer I've ever had. It leaves ZERO room for down-time and lots and lots of studying, which I haven't even started yet. As long as it gets me into medical school, I'll be happy, but in the meantime, I'm worried.

Some balancing act. We'll see how well this works out.

Thursday, May 23, 2013

Of All The People...

...who aren't accommodating, who would've ever thought the Office of Disabilities would be on the list?

I'm registered with my school's office of disabilities. I take tests there when they have a lot of hand writing, because thanks to the fibromyalgia, the muscles in my hands are too weak to handle extended periods of writing. Basically, I get to type essay-format tests.

I took a final there this week. It was the first time I'd taken a test there. Despite the mix up with my final and the lack of its presence there (and the start time that was delayed by an hour), they were mostly okay.

Except they wouldn't let me bring my epi-pens in the room.

The rule is simple; nothing goes in with you except the materials you need to take the test. Everyone leaves their bag in a room off to the side. No one else has a problem with this.

I explained that I have diabetes and I need to bring my meter. I explained that I have a severe food allergy and need to bring my epi-pen. The woman who runs the office, the one who interviewed me who blinks so much I have trouble speaking around her, just blinked at me.

She made me open up my meter case to show her my meter. She okayed the juice box I asked for permission to bring in. She absolutely REFUSED to let me bring my epi-pens in.

"I also have a food allergy. If someone ate nuts in here, I'd be in the ER right alongside you."

Yes, except she'd have had immediate access to her epi-pens, and I wouldn't have had immediate access to mine.

Allow me to explain.

I've had four very severe allergic reactions, and several more minor but also Very Scary reactions (none of these are counting non-food allergies). They aren't something to mess around with. I'm so allergic that if I'm in the same room as nuts I could go into anaphylactic shock. If someone snuck a Snicker's bar into the room and I was taking a test there, I could die before anyone could find my bag.

What's wrong with letting me bring a set of epi-pens in the room? I can't cheat off of them. I can't use the internet from them. I can't consult with them for answers. All they do is take up an extra square foot on my desk.

In fact, it's distracting when my epi-pens aren't by my side. Outside of the house, they NEVER leave me. They were just down the hall, but it terrified me.

You could tell me that I'm overreacting. Maybe you're right. But until your pulse hits 180 because your blood pressure is so low it can't sustain your body, until your throat swells and you want to bite your tongue off because it itches so much, until you think you might actually suffocate because your chest is too heavy to breathe, and until you can't stop coughing long enough to talk, you can't judge me.

Diabetes is scary. Anaphylaxis is scary. Ironically, the one thing I'm registered for is not scary. It's my least scary chronic disease. They're accommodating me for that and for diabetes, but next time, I will argue with them. Next year, if they refuse me my epi-pens, I will take it up to a higher power.

Next time, I will make sure that they understand that I will not take no for an answer.

Sunday, May 19, 2013

On The Title "Diabetic"

His name was Joey.

I was in his class from pre-K through second grade (I switched schools going into the third grade). He had dark, curly hair, and skin as glowing-white as mine. He was a bit chubby. His eyes were blue.

He had diabetes.

One of my earliest school memories is the nurse kicking us out of the classroom so she could test his blood sugar. I have countless memories of him crying because he was low. He had these little rectangular yellow packages of skinny pretzel sticks that he got to eat during class.

I don't know how it's possible, but I still remember that he smelled like insulin.

The school nurse used to come on school trips with us, because of him. She did the same thing for his two siblings--a brother and a sister--who also had diabetes.

He wore a Medicalert bracelet--one just like mine, but with a red decal instead of purple.

I've been thinking of him a lot lately.

I don't know if he minded the label "diabetic". I don't know if he felt empowered because he had two siblings with diabetes, or if he felt annoyed because they tried to help him. I don't know if he understood what "genetic" meant, any more than I did when I was that young and my mother told me that his form of diabetes was genetic.

I don't know if his mother died because of diabetes or something else. I'm not even really sure if his mother really died, or if that was some kind of very messed-up rumor.

Someone told me a few years ago that he really had reactive hypoglycemia. I don't know if that's true or not, either.

The truth is, I don't know very much at all.

I do know that when I hear the word "diabetic", his face as it was thirteen years ago, pudgy and sweet, is the first thing that comes to mind.

Today I was tutoring my neighbor in math. She offered me an Oreo and I declined. She asked why, and I told her that they annoy my blood sugar. She asked, as she has a few times before, if I'm a diabetic.

And I realized that I can't say no to that question anymore.

I'm a diabetic. We don't know what kind yet, but we know I am. Without Metformin, my blood sugars are not controllable. My endocrinologist has finally admitted that I have something.

Joey, I don't know whether you had type 1 diabetes or MODY, but I want you to know that I've officially joined the club. And I'm okay with the label.

Saturday, May 18, 2013

DBlog Week Day 6

Since I'm not the most artsy person in the world, I've opted for one of the wild cards today!

What is the ideal diabetes service animal? Think beyond the obvious and be creative in explaining why your choice is a good one. For example, maybe a seal would make a good service animal - it flaps its flippers and barks every time you get a good blood sugar reading! 

The best service animal...hmm....

I think it's going to be a hamster. It lives in your shirt pocket, and it climbs on to your shoulder when your blood sugar is out of range. It then stays there, cuddling, until you feel better and your blood sugar is back to normal. Then it goes back into your pocket and hands out there! 

(Please note: I like animals, especially ones that are small and furry...which is why I have two parakeets? But I had a hamster, and I had gerbils for a looong time.)

"Take my hand tonight/Let's not think about tomorrow" ~Simple Plan

Friday, May 17, 2013

DBlog Week Day 5

Just like in the movie, today we’re doing a swap. If you could switch chronic diseases, which one would you choose to deal with instead of diabetes? And while we’re considering other chronic conditions, do you think your participation in the DOC has affected how you treat friends and acquaintances with other medical conditions? 

Switch? Can't I just drop one (or all), instead? 

I have some form of diabetes. I have Hashimoto's Disease. I have many, many allergies, some of them life-threatening. I have an undiagnosed breathing problem (we used to call it asthma; turns out it isn't). I have "fibromyalgia" (which was the name the rheumatologist gave it because he had nothing better to say). Do I need more?

Given the choice, I'd drop it all in a heartbeat. I'd love to go for the rest of my life never seeing another doctor unless I'm sick. I'd love to never take another pill, never worry about another diagnosis that's evaded me for years, never worry about every, single bit of food that I put in my mouth for more reasons than one. I'd love to just walk out of the house with my wallet and my phone. I'd love a day without pain, or worry, or fear of the future. I'd love to just be me. 

Of course, if I had to pick, I'd stick with the Hashimoto's. I have it already--I'm on the list of autoimmune crap as it is. And the most I do for it is a blood draw once every four months or so and a nice chat with my endocrinologist. I can handle that, right? And if I need pills, then I need pills. I can live with that, too. 

Compassion? Man, have I grown a compassion bone in the last four years! Between all of my issues and my family's issues, I have a pretty decent handle on how medical problems affect you emotionally and physically. I have other friends who've gone through the undiagnosed runaround, and I "get it" because I've been there so many times for so many years that I can't help but empathize. 

"I'm holdin' on your rope/Got me ten feet off the ground" ~Timbaland

Thursday, May 16, 2013

A Confession

I know this isn't part of DBlog week, but, well, it's a Thought. It's a Thought that I've had for...a long time. Now I have somewhere to put it. And that feels nice. So here goes.

I blame myself for my diabetes.

The idea is simple. And yet, it's not only complex, it's wrong.

You see, I'm 20 years old. If my endocrinologist's opinions of the last four years are to be believed, I have insulin resistance, otherwise known as type 2 diabetes.

I'm sure the first picture that comes to your mind is of a morbidly obese young girl, slowly eating her way to death.

Would you believe it if I told you I'm thin? (Ha!)

Okay. I'm not. I'm going to put my height and weight out here, on the internet, for all to see.

I'm five foot two (ish--maybe one and a half) and 142 pounds.

That adds up to a BMI of just over 26.

Decidedly NOT obese, huh?

I don't eat too badly. Considering the fact that I'm in college, I eat well. I walk a mile minimum each way to school. And my campus is huge, so that's more walking. I walk a lot.

I don't have a family history of T2 (or, at least, not a strong one).

What gives, huh?

As of two years ago, I was antibody negative. My endocrinologist currently believes that I may have a genetic form of diabetes called MODY. Honestly, that makes much more sense than type 2 does.

Unfortunately, if it is type 2, then we're back to where I started.

Have I mentioned that I blame myself?

The funny thing is, I don't even know what for. It isn't like I lived on pizza and ice cream for the years before I was diagnosed with reactive hypoglycemia. It isn't like I haven't done what I could to do better. And it certainly isn't like I ate my way to diabetes.

I'm pre-med. I'm also naturally curious and I love puzzles (except when I'm the puzzle, which happens all too frequently around here). I've done my research on type 2 diabetes. Here's what I've found:

1. The latest research suggests that insulin resistance causes extra weight gain, which causes more insulin resistance, which causes more weight gain. It's a vicious cycle that starts with insulin resistance.

2. Insulin resistance is very, very genetic. Despite the fact that about 30% of Americans are obese, very few of them have glucose intolerance. They think that insulin resistance is compounded by the lack of enough beta cells to make the insulin to compensate. This means that a person may have a significant amount of insulin resistance,but their body should be able to keep up with it by making more insulin.

I know better than to blame myself, type 1, type 2, LADA, or MODY. None of them are cause to blame the person with diabetes--we haven't done anything to deserve this. We didn't ask for this.

My plan goes as follows:

I hope to be tested for MODY through a study at the University of Chicago's Kovler Diabetes Center. If I qualify, I'll be tested for free.

If I have MODY, I (finally!) will have a diagnosis. If I don't, I'm asking my endocrinologist for a FULL antibody panel. (Two years ago he tested me for GAD antibodies and Islet Cell antibodies.)

If that comes back negative, I'm going to suck it up and quit this irrational blame game. I haven't done anything wrong. I don't have other medical conditions that can exacerbate blood sugars. This isn't my fault.

We'll take it from there.

"Take my hand tonight/Let's not think about tomorrow" ~Simple Plan

DBlog Week Day 4

We don’t always realize it, but each one of us had come a long way since diabetes first came into our life. It doesn’t matter if it’s been 5 weeks, 5 years or 50 years, you’ve done something outstanding diabetes-wise. So today let’s share the greatest accomplishment you've made in terms of dealing with your (or your loved one’s) diabetes. No accomplishment is too big or too small - think about self-acceptance, something you’ve mastered (pump / exercise / diet / etc.), making a tough care decision (finding a new endo or support group / choosing to use or not use a technology / etc.). 

What have I accomplished? 

The truth is, I don't feel like it's been much. But I gave up juice and regular soda the second I was diagnosed with reactive hypoglycemia. I didn't drink much soda, but orange juice was my best friend.

I've stopped treating low blood sugars with chocolate, and I've even stopped treating with those awful candies called winkies. (They're the kosher version of Smarties, and 3g will raise me more than one juice box will.) I now carry juice everywhere. I carry my meter everywhere. (I also carry my EpiPens everywhere, which was a lesson I had to learn the hard way.)

I've convinced my endocrinologist to not only put me on Metformin, but raise the dose when I was still having some pretty bad numbers. (It's funny--he HATES medications. And by the time he put me on Metformin and I was ready to beg, no begging was necessary.)

I've learned to love healthy food, sometimes just as much as chocolate, and often more than cake.

When possible, I get the whole wheat version of things. 

I've learned that I LOVE avocados, which happen to be healthy and low carb and full of protein! 

I've stopped having migraines every day. THAT's one of the biggest wins. What more could I want than to just feel better?

DBlog Week Day 3

Today we’re going to share our most memorable diabetes day. You can take this anywhere.... your or your loved one's diagnosis, a bad low, a bad high, a big success, any day that you’d like to share. 

This story happened three years ago. So much has happened since then...I can't believe that I'm the same girl. Back then, I had reactive hypoglycemia...now I have diabetes, even if we don't know what kind yet. Anyway, it goes something like this:

I was a senior in high school, and I had a HUGE college interview that day. Like, really big--for a program that has a lower acceptance rate than Harvard. They accept 15 students per year. They only interview 90. My entire school was ecstatic that I was actually going to this interview. (FYI, I went to a small girls high school--there were 200 students in the entire school. We were close-knit.)

So I got up crazy early and did my hair. It was loooong, and I straightened it. I packed clothes for the interview (we had a strict dress code). I packed a bag to take to the interview. Food and candy and my meter were in that bag. 

I got myself a double shot latte at the local Starbucks before I got on campus. Back then, caffeine really annoyed my blood sugar. Caffeine plus exhaustion usually equalled lows. But I was fine during the interview. 

As I left campus, I wondered if I should eat something. None of the food in my bag appealed to me, and I decided against going to Starbucks for the second time that day; I headed to the train, instead. 

Of course, I got on the wrong train. (I'm SO not a city girl!) I figured out where I could transfer to and got off there. 

And as I stood waiting for the train, a voice in my head whispered, If you don't step back, you're going to faint into the train tracks

I took a large, shaky step back. I knew I was low. I didn't know how low. I thought about eating the food from my back, and decided that it still didn't appeal to me. I wasn't going to eat the candy unless I tested, and I was too embarrassed to test in public. 

So I got on the new train, knowing I was low but not doing anything about it. I was still too embarrassed to test. (I test on the train All. The. Time. now. I can't believe I used to freak out about it!)

I got off a stop early so I could grab lunch at a nice cafe on the way to school. Needless to say, I could't find the cafe. After wandering after it for nearly half a mile, I gave up and went to school. 

At every candy stand I passed, the voice urged me to get a candy bar. At the Walgreens I passed, it told me to go in and get orange juice. I'm pretty sure I was talking to myself out-loud at this point, but I told it to shut up, that I'd have juice at school and everything would be fine.

I finally got to school, having walked nearly 3/4 of a mile while seriously low--low enough to be too low to know how low I was (how confusing it that??). I walked in, and at that moment I realized that the only thing keeping me conscious had been the frigid February air, and that the warm school air was...definitely not that.

I made a dash for the teacher's kitchen, where I knew they kept juice. One of the administrators tried to ask me how the interview had gone as I rushed past the office, and I just called back that I needed juice. 

They didn't have juice. I had a cup of regular Coke. I stood there, shaking, for a half an hour. I never did test to see how low I was, but I know it was pretty darned low.

More than the serial lows I've had, sometimes for hours or days at a time, this low scared me more than anything. In it, I was too low to understand just how bad things were. I was too low to be smart and eat something. I was too low to suck it up and just TEST. 

That's what I get for being a stupid 17 year old. But things are different now. I test anywhere and everywhere, and I don't care who sees. I've dumped a roll of candies in my hand and shoved them into my mouth while I was sitting in the front row of a lecture hall. I've drank juice boxes on the train, my feet swinging like I'm five years old. I'm not afraid anymore.

But boy, was this low memorable.

Tuesday, May 14, 2013

DBlog Week-Day 2

Recently various petitions have been circulating the Diabetes Online Community, so today let’s pretend to write our own. Tell us who you would write the petition to – a person, an organization, even an object (animate or inanimate) - get creative!! What are you trying to change and what have you experienced that makes you want this change? (Thanks to Briley of inDpendence for this topic suggestion.)

The first petition I want to send out is to the insurance companies and mail-order pharmacies. 

My insurance company, for some reason, lets me test 10 times a day, no questions asked. If it weren't for that, I'd probably never have found out that my blood sugar was spiking within ten minutes of eating, and then continuing to rise for hours, content with letting me sit at 180 for the length of time I sat for two or three classes. (That, by the way, it the basic reason why my endocrinologist FINALLY agreed to let me start meds, even without a high A1c.) I'm not complaining about that. 

I'm complaining about the fact that the mail-order pharmacy that my insurance company uses (with NO co-pay) gives me a hard time about those supplies. 

For example: I use 10 strips a day. A 90-say supply is 900 strips--exactly 18 boxes. But 18 boxes need 18 control solution tests (yes, I actually use that stuff). That's 2% of my order, going toward the blue-green dye? Hello! But nope, they won't cover for that. 

I could live with that. Overall, it isn't much to complain about. But they keep changing the types of strips they carry, or the lancing devices and lancets they carry. They keep trying to send me their SMS control solution, which I get yelled at for using by OneTouch. They keep trying to send me their SMS lancets, which hurt worse than the fingerpricks they do in doctor's offices. They keep saying that they carry a type of lancet, then they don't, then they do, then they don't. And then they don't tell me when my preferred lancet type is available. 

Let's get something straight, CCS. My fingers are full of tiny holes and black dots. Some of them are so calloused at the moment that I can't get any blood from them. If I say that the Fastclix hurts less and is less annoying than the OneTouch lancets, than the SMS lancets, and even than the Multiclix, then I want the Fastclix. You can say whatever you want about getting supplied with them, but at the end of the day, I'd rather get my lancets late than not at all.

The second petition I have is for endocrinologists, the ADA, and anyone else who will listen. 

Diabetes needs to be diagnosed properly in order to be treated properly. It's very easy to say that people over the age of 20 have type 2 and people under 20 have type 1, but it ins't true. Your body can decide that it hates your beta cells any time it wants to, including and up to the age of 90. The best way to decide whether someone has type 2 isn't through a BMI calculator, it's through a blood test. At the very least, do a c-peptide! Antibody tests are covered by most insurance companies; take advantage of that and test your patients!

Also, there are more than two types of diabetes. There's type 1, type 2, then there's LADA, and there's MODY. Type 1 has a typical presentation, but type 2, LADA, and MODY do not. Within those subtypes are multiple diagnosis stories. And between type 2 and MODY, there are many things that can be wrong. 

If you have any sense at all, you'll change the guidelines for diagnosing diabetes. 

Furthermore, a diagnosis of diabetes should not be made from A1c alone. My blood sugar will spike over 200 with ANY significant amount of carbs (read: 10 or more) if I weren't on Metformin. My last A1c, even without Metformin, was 5.1. My A1c doesn't reflect the highs or the amount of time I spend high. Get your facts straight: 200's do damage. They make me feel sick. I hate getting that Look from doctors when I tell them I'm insulin resistant instead of type 2. (I also hate saying that I'm type 2, but that's because I'm sooooo overweight because I should lose about five pounds.) 

Finally, to the media.

STOP BLAMING TYPE 2 DIABETES ON THE PEOPLE WHO HAVE IT!!!! When you do that, you cause everyone else to judge them, like they aren't judging themselves enough. Actually, let me repeat that: they're judging themselves. The most recent evidence suggests that insulin resistance causes weight gain, which then leads to more insulin resistance, which causes more weight gain. It's a vicious cycle initiated by insulin resistance, which is caused by a problem with the way the body processed insulin, not by being fat. 

Type 2 diabetes can be controlled by diet and exercise to a point. And then there's no choice but to take medications, sometimes eventually insulin. Even if a person loses weight (which is very, very hard to do), they still may need medication. There is no reason for them to feel badly about failing when they didn't fail. Don't make things harder for them; they have enough to deal with.

"I'm deafened by the silence/Is it something that I've done/I know that there are millions/I can't be the only one" ~Simple Plan

Monday, May 13, 2013

D-Blog Week Day 1

Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one's daily life with diabetes? On the other hand, what do you hope they don't see?  


He’s my favorite doctor. He’s probably the smartest, too. Though he doesn’t always agree with me, I don’t know what I’d do without him. Dr. Z, this one’s for you.

I wish you knew what it felt like for those three years, knowing that there was something wrong but never getting any acknowledgement. I wish you knew what it felt like, finally being told the magic words, “insulin resistance”. I wish you knew that it felt like, during the months after, wondering what the hell? all the time. I wish you’d seen the tears in my eyes the second you said, “MODY”.

I wish you knew what kind of self-control it took tonight, refusing to get even so much as a cookie from the bakery. I wish you knew that, bad mood I was already in, I almost cried when we left. I wish you knew what it felt like to feel guilty about every, single carb you put into your mouth. I wish you could understand why I eat them, anyway.

I wish you knew what it feels like to be pre-med, decidedly not healthy, but doing it, anyway, because it’s the only profession worth chasing. I wish you knew how hard it is to eat “normally” without feeling like you’re starving to death—especially in college. I wish you knew, well, everything.

But I also wish you’d seen the perfect blood sugars today after having a salad for lunch. I wish you’d see how responsible I am for my healthcare, even though I’m so young. I wish you could see that, even though I’m terrible about taking pills, I’ve never missed a dose of Metformin. I wish you could see the person behind the 15 minute appointment—because I’m so much more than the sum of my chronic health conditions.

Also, I hope you don’t see the pizza, the ice cream, the nacho cheese chips, the cookies…any of the carbs, really. (Even though you once offered me a doughnut, and when I refused you told me that there were fudge pops in the freezer and I could forget about my blood sugar for an hour or two.)

"My head is on fire/But my legs, they're fine/After all they are mine" ~Fun.