Life in LADA land

Living Philippians 1:6 with type 1.5 diabetes

Blood sugar fairy tale

Apparently the blood sugar fairy – or demon, more likely – attacked last night.  My CGM line looks like a roller coaster.  I went to bed at about 75 (not a good idea), went up and down all night, and I woke up at 165. The only thing I can figure out is that someone was feeding me cookies all night. Darn. Sure wish I had been awake to enjoy them.  Just when I think I have things completely under control, stuff like this happens. And just to confirm it, while grocery shopping this morning, I must have hit about 50 (Dexcom said 70) and got really sweaty and shaky, right in the middle of the cereal aisle.  Jolly Rancher to the rescue!

I read something this week about the fact that we are never in control of our diabetes, we are just in charge. That really makes sense to me.  On days like today, I know very well I’ll never be in control.  So it is encouraging to think that at least I can be in charge.  That means I don’t have to get all upset when my blood sugars go in unexpected directions, as if it were my fault.  Instead, I take charge and do something about it.  Presto, no guilt! Well, almost no guilt.  OK, sometimes no guilt.  It’s hard not to take a BG reading of 250 personally. But I’m working on it.

All of this makes me profoundly grateful that God is in control of my life, not me. This has been a rough week at our church, with the sudden death of a member, and a sudden serious illness of another. This is just made worse by the fact that it seems like we have a lot of folks dealing with serious illnesses already.   At times like this, I am reminded that God is indeed in control, and all of this is in His hands, according to His timing, for His purpose. I don’t understand the whys, but the more I learn about the character of God, the more I am able to trust Him for the answers I don’t have.

This has also put my own struggles with diabetes in perspective. Even on my worst days, life is good, and full of blessings.  I am thankful for the technology that makes the management of this disease so much easier. Even when my Dexcom wakes me several times in the night to warn me I’m low (or high).  I am thankful for Dr. Hazen and for Betty, my diabetes educator, who encourage and coach me through the ins and outs of diabetes, and listen to my whining when I’m feeling sorry for myself. I’m thankful for great insurance that makes it possible for me to get the medication I need. I’m thankful for people in the DOC who can make me laugh about diabetes. Mostly I’m thankful to God for creating me the way He did, diabetes and all, knowing that He has a plan for me, and is providing the help I need to bring Him glory in and through the challenge of diabetes.

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Sunday morning blues

For months I have struggled with my blood glucose levels on weekend mornings.  Sunday is a work day for me (since I am a Children’s Director at my church), and I don’t swim on Saturdays or Sundays.  My BG always soars really out of control on Sunday mornings, and even on Saturdays, though not as high.  This has been really frustrating, to say the least. I have not been able to make it through a worship service for over a month now without having to leave because I feel like I’m going to be sick, or fall over, or I just can’t concentrate and participate because my head is so foggy and thick. I was beginning to think my desire to worship had taken a nosedive, and that made me feel even worse. I love worship – the music, singing great hymns and songs, the time of confession, praying for those in our congregation, learning from God’s Word. But mostly I love being in the presence of God and spending an hour and a half  or so with others who love Him thinking about Him, praising Him, praying, and hopefully, honoring Him.  To think that perhaps I was losing the desire to do that has left me feeling really empty.  But this morning, I finally managed to keep my BG under control (more about that later), and worship was wonderful and fresh and full of meaning.  I am so encouraged by that.  It looks like it wasn’t that my desire to worship was impaired, it’s just that when my body is really out of whack, my physical ability to worship suffers. This is a great relief to me.  To lose the love of worshiping God was something I didn’t really want to think about.

So this weekend has seen a real turn-around in my BGs in the mornings.  Honestly, it’s pretty simple.  It just takes more insulin than I had been using.  Wow, brilliant.   I don’t know why I have been so slow to increase my doses for meals, or my basal rates (the continuous small amounts of insulin that the pump delivers all day long) to cover these wild increases.  All it takes is a 20-30% increase in the basal rate to keep things normal on Saturday and Sunday mornings.  Why did it take me so long to figure this out? I think it’s rooted in pride. I don’t really want to admit that I might need more insulin. It’s like admitting some kind of weakness. Well, duh, yeah, there is a weakness! My pancreas doesn’t work!  But my pride wouldn’t let me change my insulin:carbohydrate ratio for meals, or to raise my basals, because I have some strange need to get by on as little insulin as possible.  Once I broke through that barrier, things really evened out – not just on weekends, but all the time.

It has been a good weekend.  “And do not be grieved, for the joy of the LORD is your strength.” (Nehemiah 8:10)  I’m happy to say that the joy of the Lord is indeed my strength, for the days when things go well, and for the days when they don’t.

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Exercising Humility

Exercise. I love it. I hate it. I started because I heard that regular exercise would help bring my blood glucose under better control and help maintain insulin sensitivity. Now I’m hooked because I know I feel better.  But it is does come with frustrations.

For the most part, I am pretty motivated to swim 5 days a week, and it isn’t all that hard to get myself there most mornings.  I have to drop my son off at school at about 7, so I just head for the pool after that.  I have found that tying my exercise routine to something else that HAS  to happen makes it easier for me to stick to.  And now, there is a small group of us who swim at the same time and have become friends, so there’s actually some accountability there. (In other words, I’m afraid they will give me a hard time if I don’t show up!)

But I struggle with unpredictability in my blood glucose (BG) levels after swimming.  For several weeks,  my post-swim BG would drop pretty low, which really cut into my mornings at work. So I’d eat something to counter that, and my BG would then soar really high, making me feel even worse.  Frustrating, to say the least. Turns out, this happened when I increased the intensity of my swimming, in anticipation of getting my continuous glucose monitor. (The sensor for the CGM is only cleared for 30 minutes in 3 feet of water – I had been swimming for 35-40 minutes, so I increased the intensity of my workout to make up for only being able to swim for 30 minutes.)  Once I got the CGM,  I discovered a surprise that explained my problem.  It turns out that strenuous exercise causes BG to actually go UP (after initially dropping during the workout) for a couple of hours after exercising.  That explained why my BGs were going so high – my eating a snack was just making it worse.  But just like everything else with diabetes,  it’s rare that the same thing will happen two days in a row.  Turns out that my job is to see where I am when I start swimming, and predict how my swim will impact the next few hours. These days I seem to be getting it right more often than wrong, but there’s no formula that works every day.

And there’s the rub! Dealing with diabetes is not a perfect science. It’s an art, a science, and a crap shoot, all rolled into one.  I have no illusions that what I do today to deal with my BG after swimming (or for a meal, or for any other reason) will work tomorrow, even if I have the same breakfast, do the same workout and do the same things after swimming.  I’m basically a scientist by training and I want things to turn out the same every time I do them. That is probably the most frustrating thing about this disease for me. And so of course, it is the point at which God is most stretching me.  I don’t know completely what God is going to teach me about this, but so far I do know that I have to let go of my desire to always be right, which I’m not when it comes to controlling my blood glucose. I need to be able to look at the glucose meter and see the number not as condemnation, but as information.  And then, to take the information and act on it, not to judge myself based on whether or not the number is “good” or “bad”.  But, see, that requires humility, and that’s hard.

The application to real life is hard to face, and even harder to do. When someone comes to me with a problem, or disagrees with something I have done, my gut reaction is to defend myself, and to automatically think that the other person is wrong and that obviously, I know better.  The more godly response is to take the information, assess it honestly without judging either the other person or myself, and act on the information without resentment and with grace. Humility does not come quickly to me, in dealing with errant blood sugar, or in dealing graciously with others. And so, I keep trying, and praying, and working out what God keeps putting in front of me. And claiming the truth of Philippians 1:6, that He who began a good work in me will complete it in the day of Christ Jesus.

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