Voices of Type 1 Diabetes

I came across this article today, Voices of Type 1 Diabetes: Doing My Best Each and Every Day written by the International Diabetes Federation, intended to profile the stories of type 1 diabetics from around the world. I always enjoy reading stories about other type 1 diabetics, but I was particularly taken aback by the story of the 24 year old Indian woman, who's history and attitude toward diabetes has an incredible likeness to my own. In particular:

"I was diagnosed with type 1 diabetes when I was 12 years old. I was in 7th grade, and before diabetes, I was a happy go-lucky girl. I was active, and did well in school and sports. After my diagnosis, I took my diet very seriously but in truth, I hated the painful injections I was required to take each day. I worked hard on overcoming social fears, keeping appointments with my doctor, checking blood sugars regularly and eating well. Fortunately, when I graduated from university and began working, I understood the importance of informing friends, and office co-workers about my condition, especially about the risk of hypoglycemia and what happens to me during low blood sugar episodes. I dislike pity and my co-workers understood this about my nature and supported me."

I was diagnosed with type 1 diabetes at 11 years of age, in 6th grade, and was similarly an active, high achiever (for more on my own story, see Why I Aim for Average). It has also taken me a relatively long time (through high school and university) to overcome my own pride when it comes to diabetes, and to more openly inform my colleagues and friends.    

Living with a chronic condition sometimes feel very isolating, and at times it is frustrating to think that nobody quite understands the intricate, and often subtle, daily struggles of living with type 1 diabetes, both physical and emotional. This article was a small reminder that no matter what you're experiencing, and no matter how it makes you feel, you are never alone in your experiences in this big ol' world. 

A Dream Come True

The week after my adventures with Big Hair, Big Science, I received life changing news. It is with so much excitement, anticipation and passion that I am proud to say that I was accepted to medical school in Canada. The program I was accepted to is a three year program, that runs for 12 months of the year (with only about 9 weeks of vacation in total across all three years!), so in three years time I will be an M.D. I still cannot grasp the reality of this incredible life change.

My path towards medicine began at a fairly young age, when I was diagnosed with type 1 diabetes. I was very ill when I was diagnosed and spent a few days in the hospital, and throughout my stay I always felt rather comfortable at a hospital, perhaps a strange thing for an eleven year old to feel. It’s not that I loved being there or loved being a newly diagnosed diabetic, but I never felt frightened by the hospital, only curious of the noises and sights and sounds. I did not make a big fuss when administering my first needles, or pricking my finger to test my blood sugars. However it was only after my release from the hospital, when the true sorrows and triumphs of living with a chronic illness began, that I discovered my passion for physiology. When my blood sugars were high or low, I had an immediate physical reaction, and I was always curious to find out exactly what was happening inside my body. On the outside I might be shaking, or sweating or feeling grumpy, but I always wondered what was happening at the cellular level?

It took me awhile to place this interest and curiosity in my diabetes into the context of a possible future profession.  But one morning when I was in grade 11, I had a revelation. I would be a sports medicine doctor. It seemed the perfect profession for me, as it combined by passion for athletics with my interest in physiology and my desire to help others.

When I arrived at university, my determination to pursue medicine wavered. Surrounded by intelligent, wonderful, high-achieving individuals in my program, I questioned my own ability to get in to medical school. Something I grappled with continuously over the four years of my undergraduate degree was the notion of what makes a good physician? Each medical school has a slightly different preference in who is accepted, and it always left me wondering, which was the right preference? And who has the right to decide what qualities make a good physician? I still have yet to answer these questions, but I think perhaps, in the broad and varied field of medicine, there is no single set of qualities that are needed to be a good physician, because the field calls for a variety of people with different ambitions, skills, emotions and backgrounds. Yet my own questions about the medical field left me wondering if it was the right field for me. In my senior years in university, I worked at a health policy hub and received an undergraduate fellowship (which is what landed me in Geneva, interning at the WHO for the summer), and I toyed with the idea of pursuing a career in the field of health policy over medicine. But I realized that the long hours of reading and researching, and the lack of individual, one-on-one human contact with others did not satisfy me. I have not completely abandoned the idea of continuing in the field of health policy in some capacity, but I know that for the time being, studying medicine is exactly what I want to be doing.

It has been exactly a month since I found out I was accepted to medical school, and I am not sure I have really grasped the reality of it. Having a dream come true that I have been wanting and grappling with for years is a surreal experience. I am sure once I am back in Canada and settling into my new place, buying my textbooks and preparing for a challenging and rewarding three years of intense schooling, it’ll feel more real, but for now it is an overwhelming little thought in my head that can elicit happiness, excitement, nervousness, relief and determination, all at once.

Have you ever had a dream come true?

Doctor Syntax: The Doctor's Dream By Artist Thomas Rowlandson, English 1756 - 1827

Hope for a Cure

Thursday was the International Diabetes Federation’s international Hope for a Cure day. They ran an initiative in which you write HOPE on your hand if you or someone you love has been affected by diabetes.

It was a very difficult day for me. The thing about living with type 1 diabetes is that it is ubiquitous in my life. There’s no break from it, there’s no time when I’m not dealing with it in some form. I’m literally chained to my insulin pump, which is only disconnected when playing sports or swimming, my tester and a juice box follow me everywhere I go and any time my blood sugar is high or low I can physically feel the effects of the disease on my body.

When you live with a disease that is so pervasive in your life, hoping for a cure isn’t something you can do on a daily basis because it will tear you apart. There are no words to describe how much I want- no, need- a cure, and I wouldn’t stay sane if I thought about it all the time. I know any type 1 diabetic reading this right now feels the exact same. But anyone who suffers any sort of life-changing disease knows the feeling. Hope isn’t something that can be felt on a daily basis. Hope is something that is felt when you’re at the end of your rope, when you just cannot deal with the disease anymore and you feel helpless. That’s when you hope for a cure, hope for a second chance at health, because it’s the only emotion that can see you through those really tough times.

Having a Hope for a Cure day brought up all those tough emotions that I associate with hope at a time when I hadn’t been feeling them. As humans, we naturally like to feel we have control over our lives, and I think that’s why I find the helplessness of living with an auto-immune disorder so upsetting. Nothing I can do can change the fact I am a type 1 diabetic, and so, when there’s nothing left that can be done, the only thing in my power left to do is hope.

My Diabetes Success Story

This post is written as a response to the International Diabetes Federation's tweet: “We have the power to change. What is YOUR #diabetes success story? Let us know how you intend to carry on the success into 2012”.

My diabetes success story does not begin with success. It takes place 3 years ago, during my first semester of my first year of university, when I was struggling to balance the newness of university academic, extracurricular and social activities with all the usual inconveniences of life with type 1 diabetes. This story may not begin with success, but it does end with it.

Exam season of first year university is a stressful time. Personally, I found myself very stressed about my chemistry exam, as it was the course I found the most difficult, and my mark was consequently not as high as I would have liked, so I really had to ace the exam to get the mark I wanted. After long days of studying, I finally felt prepared for this beast of an exam, and the morning of the exam I ate a big bowl of Mini Wheats cereal (for comic relief, click the link), something I don’t usually have for breakfast because I do not find it very filling.  As a result of this highly sugary breakfast, my blood sugar an hour before the exam was sky high, and I felt terrible and thirsty. In my agitated state, nervous about the exam and feeling groggy from hyperglycemia, I over-bolused.

Flash forward to mid-exam, and the mixture of the sugary cereal carbs, that flashed through my system far faster than they should have, combined with my over-bolusing for a post-meal hyperglycemia, meant my blood sugars were low and dropping fast.  But because this was one of my first university exams ever, and because my mind was unclear due to hypoglycaemia, I didn’t immediately call on one of the invigilators to ask to go to my bag and test my blood sugars.  Instead I sat in my seat, attempting questions that seemed impossible to my sugar-deprived mind, and I believe at some point I must have momentarily blacked out (Note: I have never passed out from hypoglycaemia, although twice in my life, this being one of those times, I have blacked out, while still moving and functioning as normal to those around me, though I simply don’t remember time passing), because next thing I knew there was only an hour left in the three hour exam and I was barely half done.

I finally beckoned the invigilator and got some juice into my system, but by the time my blood sugar was up enough to function properly, I didn’t have enough time to do all the questions on the exam properly and I rushed through quite a few multiple choice questions in the end.

I did poorly on the exam, which was extremely upsetting given the amount of preparation I had done, and the potential I had going in to that exam to succeed, which was all wasted because of my low blood sugar.  I was furious. Furious at myself for allowing my blood sugar control to be so poor, furious at Mini Wheats for being such a terrible breakfast choice, and furious at diabetes for interfering with my life.

But I channelled that anger. I decided that from that day forward, I would not allow poor blood sugars affect an exam.  I strategized. I experimented with different breakfasts (peanut butter toast, oatmeal, eggs, etc.) to see which offered the most stable blood sugar control and minimized the effects of the Dawn Phenomenon (in case you’re wondering, oatmeal was the winning breakfast choice in the end).  I planned.  I made sure I always had juice and crackers in my bag before exams, and made a plan to test multiple times before exams (3 hours before, 2 hours before, 1 hour before, 30min before and 5 mins before) to track my blood sugar pattern.  I prepared for the worst by ingraining in my head that the moment I felt low during an exam, I would immediately summon the invigilator and test my blood sugars, to maximize the time that my blood sugars were normal.    

Now, 23 exams later, I can honestly say that my diabetes has not affected my success on any of my exams since that fateful chemistry exam.  Though this story does not begin with success, I can certainly say it ends with success.  Success that will continue throughout 2012 and that will see me through the rest of my undergrad career, and throughout whichever post-grad opportunities I pursue.    

“Our greatest glory is not in never falling, but in rising every time we fall.” -Confucius

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.