Inconvenient Health

Accepting responsibility for one’s personal health is a theme that I’ve noticed frequently popping up in my life recently.  I’ve noticed that on a general basis, tending to one’s health in a short term context is much more widely practiced in society than tending to one’s health in a long term context.  Most people seem willing to take small, short term precautions (such as getting more sleep, drinking tea or taking vitamins) to prevent a cold or flu, but taking precautions (such as regular exercise, a healthy diet or wearing sunscreen) to prevent long term health problems such as heart disease or cancer, is much less practiced.  Maybe this is a result of societies need for instant gratification, a tendency to ignore long term pain if the short term gain is rewarding enough, maybe it’s rooted in the naive belief that “it’ll never happen to me”, or maybe my theories about society are completely wrong.  Whatever the cause of this attitude, I can’t help but feel that this blasé approach to our health is extremely ignorant and dangerous.     

I’m an employee of Leave the Pack Behind, a tobacco awareness organization present on campus’ across the nation, and I was recently talking with a friend about his smoking habits (we’ll call him John).  Having been bombarded since youth with “smoking is bad for you” messages, John is pretty tired of the same old reprimand, and he made a comment that really stuck with me:

“Smokers aren’t stupid. We know smoking’s bad for us, but repeatedly telling us that it is won't make us want to stop.”

But why do we knowingly do things that harm our health?  Why is knowing something is bad for us not a good enough reason to make us want to stop? I don’t mean to only target smokers, this question pertains to nearly everyone: anyone who eats fast food on a regular basis, or who rarely exercises, or who eats junk food, drinks pop or energy drinks, goes tanning or simply foregoes sunscreen.  We know all these things (plus many more) are bad for our health, yet I have never met a person who isn’t guilty of doing at least one thing on that list.  Sometimes our reason for doing these things is indulgence (we love the taste of good ol' fast food fries), other times it is mere laziness (going to the gym can be so inconvenient).  I know from a diabetic perspective that my blood sugars are not perfect 100% of the time, not even 90% of the time.  Why do I sometimes decide to eat 30 grams of carbs worth of dried mango when my blood sugar is 11.0 mmol/g, even though I know that my insulin won’t work fast enough to bring my blood sugars down and combat the carbs? Why do I fail to pay enough attention to my blood sugars on days when I’m really busy? Why is my health not my number one priority all the time, including on those busy days? 

It is ignorant and irresponsible to ignore our health in the present.  Our futures quite literally depend on it.  Aside from the obvious selfish reasons for wanting a long, healthy life, the burden of our poor health in the future will not fall on us but instead on our children and our grandchildren.  Ontario’s new Ministry of Health Promotion, which focuses on increasing health awareness, is, I believe, a baby step towards improving the health of the nation, but health begins on an individual level.  I think my friend’s comment about smokers exemplifies that statement.  Just because someone has educated us about the risks or health concerns of a particular habit doesn’t mean we’re going to stop doing that habit. Nobody can force us to take our health seriously, it is a personal responsibility we bear on a 24/7 basis.   Only caring about it 50% of the time or 75% of the time is not enough.  I know I will try harder to take control of my own health, to consciously think about it and make it a number one priority.  Will you? 

"To keep the body in good health is a duty... otherwise we shall not be able to keep our mind strong and clear."

- Buddha

A Technology I Cannot Live Without

 I am enrolled in a course this semester called Technology and Society, and I recently had to write a paper on my relationship with a technology of my choice.  Of course my diabetes somehow factored in to the assignment and this is what I came up with...

There are more technologies in the world, from the wheel to the Smartphone, than a single person can list. Our list grows substantially when we extend our definition of technology to include almost every man-made tool, whether it physical, social, economic or political.  Despite the magnitude of this list, I can say with utter certainty that there is a single technology in the world that I cannot live without.  I say this with no exaggeration, as one is inclined to do when describing one’s love of chocolate or one’s affection towards one’s bike. I am always plugged in to this technology and it travels with me everywhere, yet it is not my cell phone, laptop, iPad or any other mobile device.  Despite being a new, highly sophisticated technology, not very many people own one, nor would they want to.  Yet for a select group of society this device is in high demand.  This technology is my insulin pump, and every drop of insulin it injects allows me to live.

My stylishly zebra print insuling pump

Eight years ago, having only been diagnosed with type 1 diabetes for one year, my relationship with insulin pumps began when I replaced my daily needle injections with the promising technology of the pump.  A pump was beneficial for many reasons, but at twelve years old I was mainly attracted to the flexibility that it offered.  When injecting insulin via needles, I had to follow a strict dietary regime that dictated I ate the same amount of carbohydrates at the same time every day in order to balance the insulin doses.  Pumps, however, are designed to mimic a functioning pancreas’ role in regulating blood sugars.  They do this by secreting small amounts of insulin throughout the day to prevent naturally rising blood sugars and large amounts with food intake to combat carbohydrates.  Therefore my pump allowed me to eat fewer or more carbohydrates at irregular times of the day while still maintaining good blood sugar control.  At twelve years old, the ability to eat both a piece of cake and pizza at my friend’s birthday party, rather than having to chose the one with less carbohydrates, was incredibly liberating.

An insulin pump looks like a pager with a tube sticking out the side which attaches to an infusion site that enters the body. Since my first blissful experience with a pump, I have upgraded to a newer and smaller model which has further enhanced blood sugar control.  Despite the advantages of the pump, I have always battled with the annoyance of its omnipresence.  Many people complain of being constantly hooked to their phone, but I literally know how it feels to be continually attached to a piece of technology.  At times I wish I could have a break from my pump’s ubiquity, but that would mean a break from diabetes which is one break I will simply not experience. 

My belief in a cure is strong, however, and I hope that one day within my lifetime somebody will be writing their perspective paper on the cure for type 1 diabetes. Until that day, I will continue to depend on my important piece of technology, and focus on the life saving abilities which make this particular technology a blessing.  

Zip Lining Through Diabetes

I recently spent a week at a cottage in northern Quebec where I had the chance to explore an aerial park and enjoy the beautiful scenery from way up in the trees.  Aerial parks are a truly exhilarating experience because although they are safe and have all the necessary safety precautions in place, you still experience those terrifying but exhilarating ‘what if’ moments when your mind starts to wander to the worst case scenarios.  This particular aerial park was tiered by beginning lower to the ground and gradually becoming higher and higher throughout the three courses.  There were also 14 amazing zip lines, one of which spanned 850 feet across a lake.        

Although the park is designed for people of all abilities, and I didn’t find it particularly difficult to navigate through the various ropes and ladders, I was definitely using muscles that I don’t use on a regular basis, and as a result my blood sugars were running on the low side the entire time, despite setting a temporary basal rate of 0 units for the 3 ½ hours it took to complete the aerial park courses.  In the case of the aerial park, when you are wearing a harness similar to one you’d wear for rock climbing, I found a fanny pack (however retro that may seem) was the best choice for storing my tester and sugar supply.  Where a backpack would throw off my balance and not allow me the ease of sneaking through some of the smaller parts of the park, I barely noticed that I was wearing a fanny pack at all, but it was still able to hold enough supplies to keep me safe the entire experience.    

I’d like to think that for that day, equipped with my fanny pack, I was the most retro diabetic in all of Northern Quebec.  Whereas I may have been self conscious of the added bulk of the fanny pack in the past, I barely noticed it that day and had an amazing aerial park experience.  

Travelling Daydreams

I’ve been yearning for a travelling adventure for a long time.  It’s been two years since the last time I “travelled” which was only up to a friend’s cottage for a week, because unfortunately as an undergrad paying my own way through university I don’t have a lot (ahem no) disposable income.  There are so many places I would like to explore, and so many nights I’ve spent dreaming about travelling adventures.

Today I was thinking about how, when I do get the chance to travel, I’d love to live in another country for a couple months to become completely immersed in the culture.  Of course my mind, always so practical, turned to the problem of diabetes and extended periods of travelling. I started thinking about the amount of pump supplies I would have to bring with me, along with investing in some back up needles, in case, heaven forbid my pump stopped working, and how it’d be best to fit all my diabetes supplies into my carry on, since they’re too important to risk tossing in luggage that can end up at a different destination.

I love the idea of packing light and going on an adventure with no timeline in mind, but I think that’s something that is nearly impossible to do as a diabetic.  Different standards of healthcare in different countries make it especially important that I ensure I have everything I need to survive on me at all times when I travel.  Travelling is one daydream that will hopefully come true sometime soon, but travelling light might be a daydream that will have to stay a dream for this diabetic.     

Embarassment

This week at camp I have a group of tiresome 10 and 11 year old boys, but I was very excited to discover that one of my campers is also a type 1 diabetic.  Thinking he’d share in my excitement, I sidled up to him on the first day of camp and excitedly asked if he was a type 1 diabetic.  He gave me an unenthusiastic yes, and then I dropped the (what I thought was exciting) news that I was diabetic too! He barely responded before going off to hang out with the other campers.    

Needless to say, I was slightly disappointed that my camper didn’t match my excitement upon finding out we were diabetic buddies.  But his response reminded me of a time when I would have been less than enthusiastic to meet other diabetics- not because I had a problem with other diabetics but because I had a problem with my own diabetes.  That problem was embarrassment.  I’m a very proud person and one thing I had always been proud of was my healthy, active lifestyle.  Even though I knew that type 1 diabetes was an autoimmune disorder that couldn’t be prevented, I felt that a lot of people didn’t realize this and that they might judge me for being diabetic.  Instead of striving to educate others about type 1 diabetes and eliminate any misconceptions, I chose to hide diabetes whenever possible.

It’s not surprising that hiding diabetes from others sometimes meant I hid it from myself, but since that point in my life I’ve learned, and am still learning, how to balance hiding it and including it when appropriate.  I’ve chosen a new path that seeks to be proud of my diabetes, or at least to be proud of myself for controlling my diabetes and not letting it define me.  I’ve surmounted my fear that people will tag me as ‘the diabetic” and accepted that if that’s all they see in me, they don’t know me very well. 

So I sympathize with my diabetic camper, who ironically probably doesn’t want to be known as “the diabetic” camper.  And I hope that he’ll learn just as I did that he has nothing to be embarrassed about.             

Right to Play

This summer I’m participating in the Mitsubishi  City Chase, an adventure race (sort of like The Amazing Race, except for a single day in one city) around Toronto in support of Right to Play, a non-profit organization that uses participation in sports and games to improve the lives of disadvantaged children through empowerment and education.

This morning I heard a member of the organization talk about the history and goals of Right to Play.  When the non-profit organization was first established by Norwegian Olympic speed skater Johann Olav Koss, there was a lot of scepticism regarding the importance of Koss’ goal to bring used sports equipment to children in third world countries.  Issues such as AIDS, malaria and political unrest were deemed much more important, but what people didn’t realize was the value of using sports and games to educate and empower.  Right to Play identified citizens of developing nations as not just mouths to feed, but as people.  People that deserved the right to be nurtured and educated.

Why do I support Right to Play? My whole life I have been given the right to play any sport or activity that I’ve shown interest in.  I’ve flirted with ballet, jazz, figure skating and tennis lessons.  Through school I’ve had the opportunity to play on badminton, volleyball, basketball, cross country and track teams.  I’ve competitively played soccer and basketball.  Through all my experiences in sport activities, I’ve developed and enhanced important qualities that are applicable in all areas of my life.  As captain of my basketball team I enhanced my leadership skills, learned how to diffuse confrontation and was given the chance to inspire and motivate my peers.  As one of the weakest players on my volleyball team, I worked on my discipline and perseverance in refining my skills, and gained a new appreciation for the importance of practice. In general, sports have allowed me to appreciate teamwork and communication.

All the skills that sports have taught me are only a few examples of the many different life skills that sports can teach.  But aside from all the social and educational benefits of sports, they are fun.  And everyone deserves a little fun.  Everyone deserves the right to play.   

Even a dollar can help enroll one child in a week of sports activities.  Donate to Right to Play by following this link http://righttoplay.akaraisin.com/Pledge/Participant/Home.aspx?seid=3716&pid=575670&mid=9 

My Froggy Voice and Camp

Camp started this week and as a counsellor, I’m expected to go swimming with the kids at the end of the day. Imagine a giant pool filled with up to 300 kids on any given day.  It looks like a fun time, kids laughing, splashing, passing around a ball, flipping around on the floaty toys.  Now imagine the same pool under a microscope, and the ridiculous amount of germs, bacteria and viruses floating in that water makes that fun, splashing scene seem more like a horror story. 

Thanks to those germs, bacteria and viruses, after only 2 days of swimming in that pool I got sick.  Having a stuffy nose, aching ears, pounding headache and sore throat isn’t exactly ideal when one spends all day cheering with, talking to, and singing with a bunch of 11 year olds, but that’s what I’ve been doing for the past couple of days.  Luckily I’ve been blessed with an amazingly well behaved group of 11 year old girls for this session, and they’ve been fantastic at listening to me despite my cracking, froggy voice.

Not that diabetes is usually a blast, but diabetes combined with sickness can be absolutely brutal.  Yesterday while my campers and I were doing art in an air conditioned room, I felt my body heating up, and after the campers confirmed that indeed it was just me who felt an increase in temperature in the room, I had to test to decipher whether my warm body temperature was from a low or just a mild fever (turns out it was a mild fever, stupid cold is throwing me off my game).  A lot of symptoms of a cold, such as a fever, cold sweats, dizziness, also happen to be symptoms of a low or a high, so I tend to test a lot more when I’m sick (my poor fingers) in order to rule out diabetes related causes. 

One strange thing about my diabetes is that my blood sugars don’t tend to run high when I’m sick which is something many other diabetics experience. I’m glad I don’t have to worry about this additional symptom of a cold, however that’s not to say my blood sugars were perfect this week.  At times when I was doing an activity with the kids and wasn’t able to test, if I felt symptoms of a low I would drink a quick juice, and then test 15 minutes later only to realize that I hadn’t been low, it was just the cold.

Despite being sick, I had an awesome first week of camp and I definitely appreciate that my job for the summer is active because my blood sugars tend to be better when I’m more active.  In time for the weekend, I’ve begun to feel much better and I’m looking forward to my second week of camp, illness-free. 

To Tell or Not to Tell: Diabetes Disclosure

I kicked off the week by attending an overnight camping trip that was part of training for my summer job at a day camp.  Camping with 28 strangers can be a little intimidating, and as a type 1 diabetic it brings up that tricky issue of disclosure.  Do I make a big announcement to all the staff: “Attention everyone, I’m a type 1 diabetic which is why I can chug juice like a champ”, do I try to be stealthy about it and answer questions as they come “Excuse me Miss but did you know you have a tube sticking out of your side?”, do I find a way to slip it into conversation, “Speaking of volcanoes, I’m a type 1 diabetic!”

I have, in different situations, used one, two or a combination of the above to disclose the fact that I have diabetes.  Usually people are interested or curious when they find out I have diabetes, sometimes they are indifferent, and occasionally they are judgemental or weirded out.  It’s the few experiences I’ve had where people have reacted in the latter two manners that fuel the nervousness I have about telling people I’m a type 1 diabetic. 

On the camping trip I chose to only tell the senior staff members, for safety purposes, and then I just answered questions as they came. Some people noticed me testing and asked if I was diabetic, and I found it very refreshing to not only have people recognize a tester and make the connection to diabetes, but also to have people asking ME if I was diabetic, as opposed to me always informing others that I’m diabetic.

I also found out that another staff member is a type 1 diabetic.  Since I don’t know very many type 1 diabetics that are in the same age bracket as me, I always get overly excited when I do meet such a person, and I’m happy to report that he too shared my excitement upon discovering that we’re both type 1 diabetics. 

The camping trip was successful in having all the staff members get to know each other, and my disclosure technique was successful in having nearly all the staff learn I was diabetic without having to make a big announcement.   

A Scary Story

I have thankfully never passed out from a low blood sugar, nor have I ever been rushed to the hospital due to ketoacidosis, and my A1C has never been over 8.1 mmol/L, so I often get told that I have good blood sugar control.  But before it sounds like I’m bragging, I should say that I’m nowhere near perfect, and the following diabetic horror story about a “scary” low is more than enough proof of that.

A week ago I arrived at Chris’ house (the boyfriend) and I think my blood sugars were already dropping because his housemates’ loud jamming session was really irritating me while we tried to make dinner (I tend to get very irritable and emotional when low).  I tested and sure enough I was dropping, though I had not yet dropped into that range classified as hypoglycemia.  I had forgotten to bring juice or fruit to gos (one of those chance occasions that rarely happens, I promise!) and Chris didn’t have any quick sugar (or really much food at all) at his house as he had not been grocery shopping in awhile (oh the woes of student life) so I decided I would take the 7 minute walk to the convenience store. Naturally Chris didn’t like the idea of me going by myself and tried to stop me, but he was also unsure whether it was the loud music that made me want to get out of the house, and since I rather rushed out, he couldn’t stop me (and the dinner on the stove made it hard for him to follow me).  It was obviously a poor decision on my part to go walking by myself in search of sugar when I was dropping (mistake #1), but I was irritated by the loud noise, errr music, and I was in that low blood sugar survival mode where all energy is focused on getting sugar, quickly, and so none is left for reasoning. 

So I set out to the convenience store on my own, and I remember being conscious of my walking speed and thinking that walking too fast would make me drop faster, but walking to slow might mean I might not get to the store in time (it’s funny, the things that become important when my brain is lacking sugar).  I got to the store fine, but as I only had $1.50 in change, (and my sugar lacking brain decided that it was important that I not use my debit card) I debated over which single candy had the highest carb count. I chose a pack of Cherry Blasters (48g for the pack) which cost me $1.45 and immediately started downing them (which was a little hard to do since they were sour).  I headed back to Chris’ house immediately (mistake #2, I should have sat down to let my blood sugars rise) because I knew he’d be worried about me (mistake #3, having my phone on silent).  I was still walking slowly, but it was no longer deliberate, I now felt that I couldn’t possibly walk any faster. Uh oh, that could only mean one thing.  I tested, and yes I was still low. But this wasn’t a normal low at 3.6 mmol/L, or 3.1 mmol/L or even 2.8 mmol/L.  My meter told me I was 1.3 mmol/L (24 mg/dl).  You don’t have to know much about blood sugars to know that once you get to 1, there isn’t much farther you can drop. 

At this point I was about ½ way to Chris’ but decided to turn around, go back to the store, and buy an overload of sugary things (mistake #4, I didn’t call Chris to update him about this dangerous situation I was now in).  I headed back, thankfully made it to the store okay, bought a bottle of juice and two packs of candy for good measure (of course this time I had to use my debit card).  I paused for a moment (at least I had enough sense to do that) and downed half the juice and a whole pack of candies.  At this point I checked my phone, which was still on silent, because I had been gone for about 20mins and thought Chris might be worried.  Sure enough, I had 3 missed calls from him and 2 texts asking me where I was.  I called him back right away and told him I was almost to his house and I was okay.  Once I got to his house and he knew I was okay, he was understandably upset at me. He had his shoes on and said that right when I called, he had been ready to go searching the streets for my body.  I’m sorry he ever had to feel such worry on my account, especially when I had caused such a dangerous situation for myself.

I made a lot of mistakes that day, from my initial mistake of heading out on my own without first eating any type of carb, to not calling Chris to update him.  But everybody makes mistakes, that’s life, and life as a diabetic means that sometimes those mistakes might be life threatening.  Yes it was scary, but on the positive side, both Chris and I learned from it.  He decided to buy juice for his house for my lows that he would refrain from drinking (which is very thoughtful and sweet of him). And I was reminded of the importance of having quick sugar on me at all times (you won’t catch me without juice or fruit 2 gos anytime soon, that’s for sure).    

2am Daddy

There’s an old, unkempt orchard beside my house where long grass grows high and is sprinkled with the purple, yellow and white of clovers, buttercups and daffodils.  When I was little, and the grass was about as high as I was tall, my dad would, after spending an hour in the hot sun cutting the rest of our grass, take the time to cut windy paths through the grass and my brothers and I would spend all day running through the fields, playing out exciting adventures from our heads.  

In the evenings, if the weather permitted, my dad would make a campfire in the backyard where we would roast marshmallows and hotdogs, and we would spend the evening sitting by the fire, our clothes and hair holding the smoky, firewood smell long after the fire was gone.

After a long day of these outside adventures, we would cuddle on the couch and my dad would read us bedtime stories- often repeating our favourite ones by request.  Many of them he has read so many times that even now, about twelve years after the fact, he can recite Dr. Seuss lines flawlessly.  Once the stories were finished, he would give each of us a piggy back up the stairs to our beds, even after we got just a little bit too big for piggy backs. 

My dad remained a solid figure in my life as I grew.  In the 20 years I've lived, he has always been able to make me giggle with his silly faces and goofy jokes.  My dad is always singing around the house, a lot of classic rock and songs from the 70’s and 80’s when he was growing up, and he always seems to have a song for any word or situation that comes up (example: we named my cat Cinnamon, so of course my dad will burst into his own rendition of ‘Cinnamon Girl’ when we mention her name). 

When I was diagnosed, my mom took on most of the responsibility of my diabetes, including testing me every night at 2am.  But she found it very difficult to fall asleep again after testing me, and combined with the stresses of work and being a mother of 3 busy kids, she relinquished the night time duty to my dad.  I’m not quite sure when my dad started testing me at night, but in the 9 years that I’ve had diabetes, I think he’s been doing it for about seven.  Seven years of not once sleeping through a single night. Seven years of waking me up and making sure I drink juice when I’m low, even on the nights where I’m still half asleep and try to give back the juice after taking only a little sip.  Seven years of making sure I give the right amount of insulin when my 2am blood sugar is on the high side.  Seven years of a huge and tiresome responsibility.  Seven years of being my 2am Daddy.

In two years time I’ll be moving out, braving grad school with my own place, and setting numerous alarms to make sure I wake myself up at 2am which means that after a decade of 2am alarms, my dad will finally get a chance to sleep through the night.

Happy Father’s Day, Dad. Thanks for my beautiful childhood memories, for always managing to make me smile, and for the 2am juice and crackers we've shared.     

A Night on the Town

Last night was my organic chemistry exam, which means today is officially my first day of summer. Although, as a university student, “summer” is synonymous with “summer job” which I suppose I’m lucky to have given how difficult it seems to be for students to find jobs.  But the job (I’m going to be a camp counsellor, a job I’ve done before, though at a different camp) doesn’t start till next week so I have exactly 1 week to rejoice in sleeping in, enjoying the sun, hanging out with friends and starting up the diabetes support group that I’ve been slowly putting in motion since May. 

A photo I took of a peony in my mother's garden

After my exam, my boyfriend told me he was ‘taking me out for a night on the town’ (his words, not mine), which, when one is living the student debt life, meant wearing something other than jeans, going to a semi-swanky restaurant in town and ordering a delicious chai milkshake, along with salmon and cream cheese quiche.  I know it was a magical night because despite the extremely sugary (but oh so delicious) chai milkshake, my blood sugars were perfectly behaved all night.  It was a beautiful summer evening for walking around town, both peaceful and romantic, and fragrant summer air filled our lungs and reminded me why I love summer.  Afterwards there was a get together of friends, who had also finished their summer exams, and it got loud and rambunctious, but the relaxing summer walk was my favourite part of the night.     

More photos of flowers....

The past week I’ve woken up every day knowing that most of the day is going to be spent studying, which makes sleeping in seem mighty appealing most of the time.  But today, despite being out late last night, I woke up energized and excited (must be the weight of studying finally being lifted from my shoulders).  I’m hoping to spend today rollerblading or strawberry picking or doing some other wonderful summer activity.  Before I get carried away, I’m reminding myself that whenever I get excited and energized, I run on the low side, so I’ll need to set a low temporary basal for today, especially if I’m going to be active.  With a little luck, my blood sugars will be as perfect as they were last night.  I think they will be.  Today is going to be a good day.        

And more flowers...

YouCanDoThis Project

I'm reposting my vlog submission for the YouCanDoThis Project, created by Kim of Texting My Pancreas in honour of the project launch today!  The purpose of the project is to have type 1 diabetics around the world share a non-sugar coated telling of what type 1 diabetes is like for them to let other type 1 diabetics know that they are not alone, and that they can do this.  Thanks Kim, for this wonderful opportunity.

"Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, 'I will try again tomorrow'." -Mary Anne Radmacher

I like this quote because I'd like to think that courage exists in everyone. In some it may show itself more vibrantly and in others it may be  subdued, but it is there and it keeps us strong in the face of adversity.  As type 1 diabetics, sometimes each day feels like a struggle.  A struggle to manage our health, a struggle to be cognisant of complications without letting the thought of them get us down, a struggle to keep it together when an irregular blood sugar makes us feel like falling apart.  But we each have that tiny voice inside of us reminding us that we're not defeated.  One day, one week or one month of poor blood sugar control does not mean that diabetes has won.  We have a lifetime to show diabetes that it has not defeated us, that we are the victors.  That when it brings us down, we only become stronger.  That by occasionally ruining a perfect moment, it gives us a greater appreciation for those moments.  That by threatening our health, it reminds us to be thankful for all the ways in which we still have good health.  

This is why I know that you can do this. It is why I know that I can do this.  Because we have the courage, and the willpower, to not only ovecome the adversities that diabetes throws at us, but to grow and learn from those adversities.  Don't stop listening to that inner voice telling you to try again tomorrow.

You Can Do This.

Kind Words

I’ve been linking my friends and family to my blog, to share with them something that I am proud of, but also to help educate them to what my life with type 1 diabetes is like.  After emailing my technology-savvy grandparents a link to my blog, I received this very touching reply from my grandma:

"I was looking through my Book of records and saw that in 2002 on November 6th I had written 'Emily diagnosed with diabetes ONE. Home on Friday, Nov. 8/02.'

I remember feeling like I’d been hit with a truck when I got that bit of news.  And here it is 2011 and you are still your vibrant, UP self and dealing with your problems as only you can.  Having a blog is really a good thing although I wish it had a white background.  I practically went blind reading green on black.  It’s like reading someone’s diary.  Good for historic reasons as well.  We love you lots and are very proud of you for all your accomplishments.

Rachel’s artwork is great too!  I will print the whole thing out maybe tomorrow.  Thanks for sending it to us.

Love You

Grandma and Grandpa"

These kind words brightened my day.  Everything about the email- from the fact that my grandma can be so nifty with her email and the internet, but still keeps a Book of Records, to the compliments and advice about changing the background/font colour (I’ll keep that in mind Grandma!) to her recollection of my diagnosis- reminded me that my diabetes doesn’t just affect me, it affects many of the people in my life.  They may not be certified diabetes educators, doctors or nurses and they may still be learning about type 1 diabetes themselves.  They may not be able to tell me what to do if I’m suffering night time lows or morning highs, but what they have to offer is just as important.  They offer support.  They believe in me and my ability to manage the disease, even at times when I don’t believe in my own capability.

Thank you Grandma for reminding me that I CAN do this and that despite 9 years with the disease, it still doesn't define me. 

Wasted Time

Today's post is short, as I've been spending the past couple of days studying for an upcoming organic chemistry exam. Remind me not to take any more summer courses.

Have you ever wondered how much time a low blood sugar wastes?   I can’t do most things when I’m low (or at least, I can’t do them well).  I can never fall asleep because upsetting thoughts always seem to fill my head, and if I do fall asleep I have nightmares.  I can’t focus so studying, blogging or reading is out of the question.  Obviously exercising is a definite no, since it would not only make me drop lower, but I’d also run the risk of injuring myself in a bout of low-induced clumsiness.  The only thing I can, and must, do is eat and drink juice, which gets pretty annoying when it’s 2am and there is only 5 hours left of sleep in the night.  

 Any time that I’m low, it takes a minimum of 15 minutes till my blood sugars are up enough to function properly.  If I’m low 5 times a week, that means I waste approximately 1 hour and 15 minutes every week being low.  That’s 5 hours a month, 60 hours a year and 600 hours a decade.  That is a lot of time.

Aside from the constant testing, carb ratio calculations, insulin administration and doctor appointments, hypoglycemia is just another way that diabetes consumes time.  That time does add up, and it does put extra strain on diabetics in other aspects of our lives.  Which is why it is important to recognize all that time spent on managing our diabetes, and congratulate ourselves for doing that on top of all the other stresses of life.  This disease is tough, and it can certainly get me down, but if I let it, it can also give me a sense of achievement.  Because of, or in spite of, diabetes, I can be triumphant on a daily basis by acknowledging the fact that each day I am actively taking care of my health.             

Responsibility

The funny thing about responsibility is that it always seems to gain more importance and notice when other people are affected.   We are responsible for our self, our own health, our own life, but this important responsibility too often comes second to the responsibilities we have to our family, friends and coworkers.     

An example that comes to mind took place two years ago when I spent the last week of summer with my three best friends at a cottage.  It was the perfect trip. No arguing, lots of laughing, a nice amount of relaxing mixed with adventure and only one rainy day!  The cottage was in the beautiful Canadian wilderness, so a lot of time was spent hiking, kayaking, fishing, swimming and ATV-ing.  ATV-ing might seem out of place in a list filled with peaceful, natural activities, but the ATVs were used to quickly get to the minnow pond to gather fishing bait.  Since there were four of us and only two ATVs, each ATV would have a driver and a passenger.

On one trip back from the minnow pond, I was driving with my best friend Scarlett riding passenger.  We were travelling along a paved road and my friend had told me to keep one set of wheels on the gravel shoulder since ATVs were not meant for pavement. The left side of the road was cottages and the right side was a steep, forested drop into the lake.  We were travelling on the right side, as proper driving protocol requires, and the shoulder on this side was rather slim.  I was trying to keep one set of wheels on this thin shoulder, and a large rock is why I think I failed at doing so.  The accident happened so fast that I’m not too sure of the details, but I think the rock shifted the wheels quickly so that they were no longer pointing straight along the road, they were now pointed to the right- over the steep incline towards the lake and into trees. I remember flying into the forested area, holding on to the ATV as it flipped in the air, realizing I was below it and that I should let go and then laying flat beside Scarlett on a bed of pine needles while the ATV flipped down the incline until it hit a tree and stopped.  My initial instinct was not to check if I was injured, but to turn to Scarlett and start with a steady stream of “Are you ok? Is anything broken? Does anything hurt?”.  I wouldn’t let her stand until I had felt her legs and arms for any protruding bones, for fear she had broken something (I’m not a doctor and I’m not really sure what I would have done if I had found any, but I felt it was important to check before she put weight on any injuries).

By the minnow pond pre-ATV accident

I suppose my worry makes me sound like a good, selfless friend, but what was also at play was that feeling of responsibility (and a lot of adrenaline, nothing like almost dying to get the blood pumping).  I had been driving the ATV, I had launched us into the trees, I had put us in danger, I had almost killed us.  If I was injured, so be it, it was MY fault, but if Scarlett was injured, the fact that it was my fault and not hers would have caused me a lot of grief.  Somehow the stars were shining on us that day, and neither of us were severely injured- Scarlett’s head had been bumped around inside her helmet, the ATV handle had given me a pretty nasty bruise when it dug into my thigh, and we were both covered in scratches, but nothing was broken or even fractured, and we were in good enough shape to go for a 4 hour long hike the same day.

It’s amazing how responsibility for others trumps responsibility for oneself. I’m not saying that I should have first checked to make sure I wasn’t injured before asking Scarlett if she was, but I do think that the strong feeling of responsibility I felt for Scarlett in that instance escapes me when it comes to feeling responsible for myself.  My diabetes affects me more than it affects anyone else and the pressure of taking care of it lies solely on me.  I should experience those strong feelings of responsibility for my diabetes, and they should prevent me from neglecting my diabetes, but somehow it doesn’t seem to work like that.  It doesn’t mean I should be ridden with guilt every time I neglect my diabetes, but I should be conscious that it is my responsibility and my health.  And if it isn’t enough to be responsible to myself, I can always think of all my friends and family who expect me to live a long, happy, healthy life in spite of my diabetes, and employ their support with this complicated disease.

Study, study, study, RUN, study...

It’s the time of year when taking a University summer course seems like a big mistake.  When I signed up for the class, at the end of April when the weather was still cold and wet, it seemed like a great idea to take a tough course during the summer when I had more time to focus on the material.  But now, with the weather so sunny and hot, there’s nothing I’d love more than to chuck the text books and spend all day outside.  The only thing keeping me going on days that I spend inside studying, like yesterday, is knowing that the course is short (only 6 weeks long!) and that taking a break to go for a run doesn’t technically count as procrastinating, because it is necessary exercise so it has to be done, right?  And if it gives me a chance to spend some time outside, all the better. 

I love running in what other people would call unfavourable conditions.  Extreme heat? Terrific, there’s nothing better than a real good sweat every once in awhile.  Snowing out? A little slip-sliding can be fun on a run, especially when you can appreciate the beauty and silence of a snowfall.  Torrential downpour? Runs in the rain are the most refreshing, energizing runs. 

My wonderful yellow running shoes I purchased in Iceland and my Organic Chem textbooks

Yesterday I had a lot of pent up energy for running in the heat (30 degrees plus the humid X) from spending all day inside studying.  Yesterday’s run had challenging windy conditions that made part of the run seem more like a wind resistant workout than a tempo run.  Before starting the run, my blood sugars were dropping so I had to drink a bit of juice and eat some bread and honey.  I opted for honey on toast instead of peanut butter because I knew I was going to do a quick (-30min), tempo run and would need the quick sugar more than the lasting protein.  Luckily, half a piece of bread with honey or peanut butter never seems to give me a cramp.  The run itself was wonderfully sweaty and hard, with quite a few hills, but very rewarding.

Taking the time to go for a quick run, even when bogged down with studying, helps me keep control of my blood sugars, and has the added benefit of keeping me healthy, strong and in good spirit.  I know from experience that it is easy to get busy with school, work, or life in general, and how quickly one missed workout can turn into a week of missed workouts, but it really is important to make exercise a priority.    

Fear of Fainting

One of my greatest fears as a type 1 diabetic is passing out due to low blood sugars.  I’ve been fortunate to have never had this happen in the 9 years that I’ve had diabetes, but there have been enough close calls to know it would not be a very enjoyable experience.  However I have had a couple unpleasant, non-diabetes related, fainting experiences.

I had gone my whole life not knowing what it felt like to faint, until a couple years ago when I was working at an art school in the summer.  The first day of work, I clumsily cut a chunk of skin off my finger, right to the bone.  Since the cut was so deep, I went to my doctor’s office to see if it could be stitched, and the nurse unwrapped the bandaids I had applied, before going to fetch the doctor.  As I sat there with the wound unwrapped, the blood began to pool on my finger and I felt my vision slowly going darker.  I think it is important to note that blood has never grossed me out or made me queasy, nor have needles or any of the other medical related necessities that seem to cause many people distress, and as my vision slowly got darker, I was thinking to myself “This is silly, I’m not panicked or grossed out at all. Why does it feel like I’m going to faint?”.  Yet I fainted anyways.  My blood sugars were not low, but according to the doctor, tall people (I’m a 5’10 female) are more likely to faint because their hearts must pump harder to get the blood to their heads. 

In the 4 years since that initial fainting experience, I’ve fainted a few times, usually during instance when I’m in pain.  On the weekend, I was walking down my stairs holding my cat, as I do a billion times a year, but this time my foot slipped on one of the lower stairs and I fell hard. Most of my weight came down on my left elbow, but after the initial moment of shock subsided, I could feel pain shooting up both my arms and my back.  I’ve always had a high pain tolerance, but this didn’t stop me from passing out quickly.  According to my mom, I wasn’t out for very long, but when I came to the first thing I shouted in panic was “What happened? Am I low?”.  Even in this confused, hurting state, my first thought immediately went to diabetes, and my fear of fainting from a low.  The pain combined with the panic made me feel like I was going to faint again and I had to lie down on the floor while my brother got my tester.  My mom fed me some juice, and it wasn’t until I tested and realized I was 9.0 mmol/L (actually a bit on the high side!) that the panic subsided and I was able to calm down.

Fainting is definitely one matter that is much more complicated, and frightening, for a diabetic.  Even though I’ve never passed out from a low blood sugar, I know that the fear of doing so will probably scare me any time I faint or come close to fainting.  That’s just one of the scary realities of living with type 1 diabetes.   

The Week of Cake

When I was a child, the week in May which held both of my brothers’ birthdays was always a week of excitement.  I was the middle child, stuck between two boys who had their birthdays within 5 days of each other, but I never had a problem relinquishing the spotlight to them since two birthdays meant double the birthday parties, double the cake and double the candy-filled grab bags.

Once I was diagnosed with diabetes, this week in May became a bittersweet time because eating cake was no longer a carefree experience.  Diabetes had transformed it into a carefully calculated procedure of matching cake piece size and sweetness with insulin dosage.  When I was on needles I struggled the hardest with this balance because extra carbs for dessert meant I needed to cut carbs in my meal, which was often difficult when special birthday dinners included my favourite homemade fries.  Once I began using an insulin pump I gained more flexibility in being able to have more or less carbs as I chose, but even still, I find that having over 60g of carbs in one sitting is too many carbs to deal with and giving the proper insulin to carb ratio won't necessarily stop me from flying high.   

Mmmm....Chocolate Chip Banana Cake

This year, there were actually three cakes featured as we had one cake for each brother’s birthday as per usual but the day after my older brother’s birthday, his girlfriend brought over another home baked cake.  Monday I baked a New York style cheesecake that we topped with whipped cream and strawberries, Thursday involved a cookie dough explosion ice cream cake and Friday was a delicious banana chocolate chip ganache covered cake (definitely my favourite of the 3, and the one pictured here).  Since I wasn’t home Friday, I had my piece of delicious banana cake Saturday morning (dessert for breakfast...it’s a thing), which caused some elevated blood sugar levels in the morning, but everything was under control by noon.

The week of cake will always be a great week in May, and my diabetes will definitely never stand in the way of great celebrations with friends and family.  Despite my diabetes, I can still have my cake, and eat it too.

Guest Post: My Best Friend is Diabetic

I met Em when I moved to a new town and a new school in grade three. I was the shortest girl in the class with a floppy denim hat and braids that my mom still tied ribbons in. Em was tied for tallest in the class in a highly contested match-up with another girl/Amazon woman. Physically, the differences between us were striking, especially when my hair was undone to reveal a mass of tightly wound curls that looked particularly frizzy when compared to Em's pin-straight locks. However different we looked, we were both particularly assertive (bossy) and headstrong (stubborn) little girls. We built forts on the playground, dramatically re-enacted pioneer life in my backyard and worked on class projects.

Em drew this masterpiece for me in grade four.

When Em was diagnosed with diabetes at the age of 11, her life changed in ways that I am only now starting to realize and appreciate, but the life we shared together remained relatively unchanged. After the initial confusion upon learning about her diagnosis, we quickly returned to trying to figure out how to pass notes more effectively in class and how to eat even more sunflower seeds than we were already eating. Over time I got used to seeing Em prick her finger under the desk or scowl at her glucose meter or discretely munch on a fruit-to-go in class. It was just part of our day at school.

As we grew older, the challenges or hassles associated with managing her diabetes slowly revealed themselves from time to time. When Em first came to school with her insulin pump she told me it was her brand new cell phone. At recess, when a rowdy grade two accidentally pulled her pump tubing out from the infusion site, she stuck it back in and returned to our soccer game. In the first few years after her diagnosis, when she wasn't allowed to sleepover because her parents worried about night time hypoglycemia, we snuggled down in sleeping bags and talked at a mile-a-minute to do all of the important late-night secret telling before the clock struck 12 and her mom came to pick her up. In high school when we had a late lunch and Em needed to chow down on crackers in class to keep her blood sugars level, I followed suit and ended up with more crushed crackers on the front of my sweater than in my mouth. When we started going to the movies regularly we settled on the perfect combo of popcorn, chocolate and a diet coke. Neither of us really liked coke but drinking a diet option to cut carbs was worth the free refills on popcorn. When we went on bike rides or hikes, Em was always diligent about packing snacks in case her blood sugars dropped but this was a non-issue considering our mutual love of picnics.  Now, rather than dealing with the risks associated with alcohol consumption and diabetes, Em chooses not to drink- instead we mix ginger ale with every fruit juice known to man to make tropical beverages that we occasionally dress up with festive paper umbrellas.  

As Em's best friend I don't have a lot of responsibility in terms of her diabetes- she is the one who is testing, doing calculations and making sure that she has her health under control. All I really have to do is be flexible and understanding when we have to make adjustments, which is really the mandate of any friendship. We don't play dress-up or build forts as much as we used to, but I'm still the same curly-headed little imp and she's still my straight-haired, long-legged, best friend.    

My Little Brown Book

Though the notion of the “little black book” may seem archaic in today’s wireless world of Blackberrys and iPhones, I find something charming in the idea of a little book with neatly penned names and phone numbers lining the pages.  I do not own such a book, however charming it may be, as I do succumb to the wonders of wireless technology.  But I do have my own, albeit diabetic, form of a little black book. 

It’s a beautiful, brown leather book, with a ribbon to hold one’s page, approximately the same width and length as my tester, which I use as my daily blood sugar, insulin and carbohydrate log.  It had been a gift for me from a friend before I had diabetes, but I had never been sure what to use it for.  When I was diagnosed with diabetes I started using a standard spiral bound notebook to record my blood sugars, insulin dosages and carbohydrate intake as recommended by the doctor, in order to better control my diabetes.  I went through spells of using large notebooks, small ones, and not using one at all.  Regretfully, the latter stage lasted longer than it should have and directly correlated to an increase in my A1C levels.    

My doctor had recommended the log to better track blood sugar patterns and make appropriate basal or carb ratio changes, but this isn’t the number one reason I feel I need to use one.  Writing down my blood sugars and carb intake as they occur forces me to pay attention to the fact that yes, I am diabetic, and yes, that means I need to do all that fun stuff like monitoring my blood sugar levels, giving insulin and calculating carb intake.  As a result, I am more attentive to my diabetes when I’m using the log book than when I’m not.  This is why I’m a fan of a log book over the digital options that track insulin and blood sugars via a pump or tester, because although those can create some great graphs, they allow me to ignore my diabetes too easily. 

So despite my Blackberry, laptop, iPod, and all the other wireless wonders I indulge in, when it comes to logging my blood sugars, I’ll stick to my old fashioned log book, which constantly reminds me to pay attention. 

Summertime and the Livin' Is Easy

Finally the sun has blessed Westdale after what seemed like a month of cold, rainy November-esque weather in May!  Walking around town, it seemed that many people were taking advantage of the sunny weather to go for a walk or a bike ride and soak up some UV rays.  I have always loved summer and everything that it brings; sunny days at the beach, sandals, sweaty runs, ice cream, summer dresses, swimming, and the general good vibrations that seem to accompany the fair weather. 

As a diabetic, summer also brings some concerns.  I’ve always found that a surge of warm weather causes my blood sugars to run low.  I had been led to believe that this was related to the general increase in (particularly outdoor) activity that generally accompanies warm weather, but I’ve noticed that if the weather suddenly warms up on a day that I spend sitting and studying, my blood sugars will still run low, despite my lack of activity. Whatever the cause, it’s always something I have to watch out for, particularly when I’m planning on taking advantage of the weather to spend some active time outside.

Yesterday, inspired by the sun, I grabbed a pair of rollerblades and a friend and headed to a beautifully scenic, well-paved, lakeside path, where the cool breeze coming off the lake nicely complimented the heat.  I set a temporary basal rate to 0 units for 2 hours, about the same duration of time I expected to be rollerblading for.  We rollerbladed for about an hour to our destination- a cafe- at which point my blood sugar had already dropped to 3.5 mmol/L.  I ordered a large mango smoothie, and we sat around for about half an hour, enjoying the weather and the view.  Before heading back, I tested again only to discover I was still low (drats!).  I finished off a juice box (those are generally what I keep handy for hypoglycemia) and by the time we had rollerbladed back to the car, my blood sugars were in a normal range.  I considered it a pretty successful outing, as I managed to control my blood sugars, enjoy the good company and drink a delicious smoothie without my blood sugars dropping low enough to make me grumpy or sluggish.

Another nuisance of being a diabetic in the summer is the issue of how to hide a pump within one’s clothing when wearing shorts and t-shirts.  When I was younger, I usually used a black spandex “holster” (like a spy, cool, I know) for my pump that fit around my thigh and had a little pocket for the pump.  I still use that when I’m wearing nice, flowing dresses or skirts, but I quickly discovered that the pump holster was pretty obvious when wearing shorts or tight jeans.  I know a popular option is to wear the pump like a pager, in a clip on your waist, but I’ve never been a particular fan of this style because I find it gets in the way.  I always cursed the ease with which diabetic boys could hide their pumps, as their clothes were always loose fitting and well equipped with big pockets, unlike the typical tiny, tight clothing fashionable for girls.

My solution to my pump-placement problem came one day when I was sitting in my high school cafeteria and noticed a girl reach in to her shirt and pull out her cell phone.  Though I had always found the trend of girls storing their cell phones, keys, money, combs (really?!?) and other important items in their bra rather strange, I realized that a pump, which is only slightly bigger than a heavy duty Blackberry or iPhone, could also be stored in a bra.  Since that day, I’ve discovered ways to strategically place the pump in my bra so that it isn’t really obvious that it’s there, and it is now definitely the number one place I keep my pump.  The biggest drawback is that I still find it awkward to reach into my shirt and whip out my pump in public, so I often go to the washroom to do this, or tactically place a backpack or sweater so that what I’m doing is less evident. 

All the things about summer that I love -the shorts, the outdoor activities, the icecream- are just as enjoyable with my diabetes as they were without.  Summer with diabetes just means a bit more planning, especially on those long rollerblading trips, and a bit more innovation, especially with pump placement. 

Why I Aim for Average

I have always been a high-achiever.  As a kindergartener, I would rush to clean up my toys the fastest so that I would be the first sitting down for story time.  In grade three I played a leading role in the class play.  In grade five I cried when I didn’t receive 100% on a project that I felt was flawless.  In grade six, unknowingly battling a life changing disease, I trained hard enough to place in the school board’s cross country event. 

Within two months of this achievement, however, I began to deteriorate.  It began subtly, I didn’t have the same energy on the basketball court or the soccer field that I use to have.  Then I badly sprained my ankle in gym class, the first time I had ever suffered a severe injury despite years of contact sports.  I developed a very bad ear infection and became extremely lethargic.  I missed days and days of school as I became sicker and sicker- my appetite dropped, I developed dark circles under my eyes and I lost 7 pounds in 2 days, an alarming amount on anyone, but particularly noticeable on my skinny, athletic body.  Then one night the reason for my illness was discovered, and I was woken up and rushed to the hospital.  My blood sugar tests had come in at a whopping 47.3 mmol/L  and I was nearly comatose.  On the ride to the hospital, my mom sat in the back seat with me and told me that the doctor had said it was very likely I had diabetes.  As an eleven year old, I didn’t know what that meant or how it would affect my life, but I knew that I was scared. In the safety of my mother’s arms, I cried. But that high-achieving person inside me made me put on a brave face for the nurses, who exclaimed at how courageous and well behaved I was as they pricked my fingers and hooked me up to an IV, for my aunts and uncles that visited,  and later for my teachers and friends at school.             

I soon learned that living with diabetes was a daily struggle to be average.  There was no such thing as 10 out of 10 or 100%.  My aim was to stay between the average, non-diabetic blood glucose range of 5-7 mmol/L, which, as any diabetic knows, often feels like an impossible task.  I still excelled in the areas of my life that I had always excelled in: I was an honour roll student and went on to become valedictorian of my high school graduating class, I raced my way to a spot on a track team, played on numerous competitive basketball and soccer teams, participated in enough high school sports to win me senior athlete of the year, sang in choirs and played piano.  But all these things were now accompanied by the new challenges of my diabetes.  I learned that my race performance greatly decreased if I had high blood sugars the night before a race, that low blood sugars during test writing would result in a similarly lower mark, that my coordination on the basketball court would deteriorate if my blood sugars dropped, and that my fingers would stumble over each other if I played piano when hypoglycemic.  Discovering these challenges of diabetes was frustrating, and I often indulged feelings of self pity or anger.  But ignoring my diabetes wasn’t an option simply because it was impossible to do. Ignoring it led to my blood sugars soaring or dropping, which would not only affect my mood, but also my performance in every aspect of my life.  So I fumbled along, trying to make sense of the disease I had and trying to prevent it from defining me.

It’s still a struggle, but finally I’ve accepted that being average in my diabetes means the possibility for success in the rest of my life.  And that, in at least one aspect of my life, success is being average, or at least, is having that average, non-diabetic A1C level.   So with the hope that I may one day achieve this understated goal, I’ll keep aiming for average.