Life in LADA land

Living Philippians 1:6 with type 1.5 diabetes

The joys and snares of Thanksgiving

It has been a wonderful Thanksgiving – a memorable one, even.  We had Sarah home from Miami (the one in Florida, not the one up the road in Oxford, Ohio), shared a delicious Thanksgiving meal with the Woods and 3 international students from UC, enjoyed a great day of mini-concerts and reunions with old friends at a Cincinnati Children’s Choir fundraiser, and generally had some great family time.  What a blessing that I no longer take for granted!  But the weekend had its share of pitfalls too, all related to diabetes.  I really figured I would just abandon all hope of staying in range on Thanksgiving itself, and I met these very low expectations. I didn’t see a blood sugar number without the number 2 at the beginning for a long time that day, starting in the morning before I had ever even thought about eating anything with carbs in it! So I was psyched for that, and fine with the result.

It’s the times when I did the right things and still ended up high or low that really got to me (as usual). I’ll take the blame for the night when we all had pie at 10:00 pm and then I went to bed.  When Jiminy (my Dexcom continuous glucose monitor) woke me a few hours later buzzing HIGH, I knew exactly why.  It’s the other nights that have me stumped. Why, oh, why did I go high on the nights when I actually showed some self-discipline and didn’t eat the ever-present pie – waking up either in the middle of the night, or, when I was able to completely ignore Jiminy, in the morning with a BG over 200?  My brain is screaming “IT’S NOT FAIR” while the more rational part of me is whispering “It’s ok, it’s just a number, now deal with it”.  If you think that’s an easy conversation to have with yourself at 3 am or 7 am, you are sadly mistaken.

So then came Sunday morning. Yep, Sunday Spike with a vengeance.  Spiked actually before leaving for church, and stayed high for a while, then plummeted during worship (as always).  But, God provided words of wisdom from the sermon (Thanks Rich!) that provided great encouragement and perspective.  The text was 1 Peter 1:6-9.  Several points stood out to me and are worth mentioning at the end of a holiday like this one.

  • Trials show me that God’s sovereignty is at work in my life.  I have no idea why I “need” to have diabetes, but God knows that and is using it to accomplish some purpose in His kingdom and in my life.  I’m still waiting to find out what those things are, but I am content to trust in the meantime that this is true.  It’s a great comfort to me to know that there is a “point” to having diabetes. I think I would do a lot of wallowing in self-pity if I didn’t know this.
  • When the heat of trials comes, it shows who I really am. Which argument wins out at 2 am? The “IT’S NOT FAIR!”, or the “Keep calm and deal with the number”?  Will the heat affect me like the plant in the parable of the sower that grows up quickly and then withers just as quickly from the sun’s heat? Or will the heat of diabetes be the heat of refining, proving the genuineness of my faith?
  • Our culture tells us that the easy way is the best way.  I am encouraged to think that my happiness is found in ease and comfort. There is nothing easy or comfortable about diabetes.  Shots, highs, lows, keeping track of supplies, maintaining all the technology that keeps me going – none of this is easy or comfortable (though since the alternative is pretty horrifying, I’m thankful to do it all!). It’s easy to start feeling really sorry for myself and wonder why I can’t just live the life I had Before Diabetes.  One day changed my life. (I know it didn’t happen in one day, but the symptoms developed from one day to the next, and so my life changed very dramatically in one day.)  Scripture reminds me that the life of faith is not like this.  The life of faith is the life of the athlete, training rigorously, exerting self-discipline, denying myself those things that would interfere with my performance.  This pushes me to spend some time this afternoon uploading data from my pump and CGM and trying to figure out how to deal with these new overnight patterns, rather than simply getting frustrated and giving up.  (The phrase “your diabetes may vary” springs to mind. Not only is my diabetes not like anyone else’s, my diabetes isn’t the same this week as it was last week!)

So it has been an eventful holiday weekend.  I also “celebrated” my second Dia-versary on Thanksgiving.  Two years with this disease. This doesn’t sound like much to the thousands of type 1s out there who have had it for decades.  But when I think about how different my life is now, I am stunned.   I’d go back to life without diabetes in a heartbeat, if I could.  But, since apparently I can’t do that, I will continue to trust in God that His plan is best.  And I will pray that I continue to be teachable, even when the lessons are not what I would choose.  Happy belated Thanksgiving, everyone!

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Friday afternoon I got a steroid shot in my right hand for carpal tunnel syndrome.  I have to say, it has made a wonderful change in the symptoms I usually experience at night!  No more numb, tingling hands and arms that used to wake me up.  Surprisingly, though the shot was only in my right hand, it is relieving the symptoms in my left hand and arm as well. And an unexpected bonus – I feel like Superwoman!  I had a whole lot of work to do around the house this weekend to get ready for Thanksgiving, and yesterday I was unstoppable!  Even today I still feel like I could take on the world.

But, there’s another side to this story (isn’t there always?).  Steroids and diabetes are not good friends.  Steroids cause blood glucose to go up, through a couple of mechanisms – by stimulating the release of glucose from the liver and by decreasing sensitivity to glucose in tissues that use glucose, so that the glucose stays in the blood longer.  Steroids can send BG up into the 300 range or higher, something I really do NOT want to happen, as I feel really horrible when it’s even in the 200s for  a few hours.  And I really love this Superwoman syndrome, so I don’t want to spoil it with super-high BG!  So, my wise and patient diabetic educator warned me about this and advised me to raise my basal insulin rates by 25% to start, and to go up from there until things get back to some semblance of normal.  I started at +25% and found pretty soon that it takes an increase of at least 50% to keep my BG in range.  And this morning in church (because of course, the dreaded  Sunday Spike still plagues me) I turned it up to +80%.  Gradually today, I have lowered it back down to +50% and things seem pretty stable.  This weekend has been easy, since I have not had a real busy schedule.  Tomorrow will be interesting – swimming in the morning, then a busy work day after that.  I’m trying to figure out how to plan for all of that so that I don’t spend the day in a fog from either low or high BG.

I’ll say one thing for being diabetic. Life is never boring!

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My Diabetes Science Experiment, part zwei

It’s now been about two full months since I started alternating weight training with swimming.  I feel great and can tell that the workouts are having beneficial effects on my muscle tone.  However, I have to say, it is not getting any easier to manage my ever varying blood glucose from week to week.  Just when I think things have stabilized, they turn a corner and do something else.  “Your diabetes may vary” doesn’t just refer to the fact that my diabetes isn’t the same as someone else’s diabetes, but that my diabetes is never the same two days in a row!

I hesitate to say this, since next week might prove me wrong, but I do think I am beginning to see that the weight training has improved my overall sensitivity to insulin. When I first starting doing weights, I needed less insulin right away, but then it seemed to go back to the previous levels. I think I’m starting to see that my need for insulin is decreasing, especially the ratio of insulin to carbohydates at meals.  I am decreasing that ratio VERY slowly to  see if it helps the pattern I have been seeing over the past week or so of pretty low blood glucose levels during the day.

I have also found that it is much nicer to begin my workouts (whether swimming or weights) at a higher blood glucose than I am used to. The past few days I have woken up with BGs that don’t make me very happy (140 and up). But, my workouts have been amazing!  I swim stronger and faster, and can just shove those weights around like never before!  So perhaps I won’t be too quick to work at lowering those morning levels just yet.

So, on this World Diabetes Day, I sit in wonder of how much things have improved for diabetics since the discovery of insulin by Frederick Banting (whose birthday we commemorate today) and Charles Best in 1921.  I live a pretty normal life with a disease that used to be incurable and fatal.  I may obsess on how to regulate my blood sugar during and after exercising, and any other time, but at least I CAN regulate my blood sugar to some degree (see my previous post for the rest of this story!).  Thank you Banting and Best, and Animas Corporation and Dexcom and Lilly and all the rest, for working to make diabetes as manageable as it is today.  And keep looking for the cure!

And I’ll keep doing my diabetes science experiments.

By the way, zwei is two in German.  Just a blast from my past.

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