Life in LADA land

Living Philippians 1:6 with type 1.5 diabetes

Thoughts on becoming a mentor

I attended a training session to become a mentor to another type 1 diabetic yesterday. The session was actually pretty fun.  Turns out it is pretty encouraging and very affirming to hang out with other diabetics who really GET what it takes to manage this disease.  The content of the training was good too, and presented well by all three of our trainers.  I was heartened to realize how much I really do know about dealing with diabetes, even though I have only been at it for three years now.  All that they presented about ways to spur another diabetic on to better control of their blood sugar was review for me. I admit, I needed to have some kind of confirmation that I really do know enough and have enough experience to mentor another diabetic, and probably someone who has had the disease way longer than me.

I do feel some insecurity about taking on this assignment.  I WANT to do it.  But self-doubt plagues me.  Will I ask the right questions?  Will I know when to refer them to get advice from their doc or CDE? Will they think I’m not entitled to talk with them about their diabetes since I’m a relative newbie to this disease?  Will I even be able to help them at all?

Then I think about what motivates me to go on day after day with unpredictable blood sugars even after being diligent about trying to manage them.  It’s the encouragement of those around me.  The “how’s it going today?” from someone who genuinely means it, a friend checking in to see how my bg responded to my morning swim, the texts back when I rant and rave about how much diabetes frustrates me.  I have only really talked with one other type 1 diabetic since I was diagnosed (other than the occasional conversation at our medical practice’s pump support meetings), and yet I have an amazing support system of family and friends who spur me on to stick with it despite the random nature of type 1.  My best and most faithful mentor is not a diabetic, but she ‘gets it’ better than anyone else I know.  And she cares.  So can I do that for someone else?  Yeah, probably.  It doesn’t necessarily take another type 1 diabetic to mentor me, but it IS nice to talk with others who live with it from time to time, as I learned at our training session yesterday.   So I can do that for someone else.

OK, I’m ready. Let’s get this going!

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Life is complicated

I’ve taken my title from a line in an email to a friend.  I was telling her about some thinking and praying I’ve been doing since Friday about my life and work and diabetes.  The three things are intertwined very tightly and lately, the diabetes part has been overshadowing the other two parts.  I feel like there have been more and more days when I have not been able to function well because of wildly swinging blood glucose levels.  This has made me realize that I really need to do something differently.  I can’t change the diabetes part. That’s here for good.  (That was another realization that hit me squarely between the eyes this week.  It didn’t feel good, either.) So something else has to give.

I love my job. I love the people I work with on the church staff. I have so much respect for them all. They are amazing people, who love God and the church and the people in our church.  They are smart and wise (not the same thing) and funny and serious when they need to be.  I love where we work – it’s beautiful in all seasons, but especially in the fall.  I love the families I get to serve in my job and the volunteers who make my ministry actually work and who are so generous with their time and talents.  So trying to look objectively at my job and figure out how to make changes in what I do is hard.  I do know I am not indispensable. I was gone on sabbatical with our family a few years back and they did just fine without me, thank you very much.  But I love what I do. All of it (well, most days). So ‘giving up’ parts of it will be hard for me.  Selfish, isn’t it?  Anyway, I spent most of Friday morning wrestling over this, praying, thinking, reading and writing and God has been very good at bringing me new perspective and resolve to make the needed changes.

Today, I have been thinking about what it is about diabetes that makes all of this necessary. There is the day to day management stuff, like keeping my pump full of insulin, testing, dosing, counting carbs, and making sure I have the supplies I need. That’s one part of the story. The other part is the brain power that this disease uses up.  I can’t do anything spontaneously anymore, really. I have to think through the diabetes ramifications of almost everything – meals, running errands, putting on some kind of ministry event, or even sitting quietly to read or study for a few hours. All of these things (really, everything in life) require me to calculate if my current blood glucose level is what it needs to be to carry out the task, or if I will need to eat something or dose with insulin to make sure I stay in a good range for whatever it is I’m doing.  For example, I can’t just work right up until I realize I’m starving, grab my lunch from the frig and eat. Ideally, I should test and dose 15-20 minutes before lunch so that the bump in blood sugar from lunch and the peak of insulin action match.  Another example –  I can’t seem to go to Sam’s Club without my blood sugar tanking.  It doesn’t matter what my bg is when I go in, it will plunge at some point so that pretty much every time I go through the line, I’m low.  These two examples are the biggies but almost everything I do requires some conscious thought as to how it will affect my blood sugar.  I realize not all diabetics probably go through such mental acrobatics as I do, and maybe it’s because I’m relatively new to all of this.  Or, perhaps it’s just my need as a closet control freak to do all that I can to make my bg behave as I want it to.  Whatever the reason, I use up a lot of thinking time (and energy) everyday thinking about diabetes, when I would rather be thinking about my job, my family or pretty much anything else.

So, change will happen.  I’m getting to the point of becoming excited to see what God is going to do. Who will He show me is right for the tasks?  How will my work and life change as a result of freeing up some time and energy?  Will diabetes take a back seat for a change?

I’m ready.  Let’s see what happens next………

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Moderation – in all things?

This is the post I was going to write before the really terrible, horrible, very bad Sunday a couple of weeks ago.  I am learning about moderation in diabetes, and in life maybe too.

The first lesson came after realizing that I was having to change out infusion sets* in between pump refills more times than I would like. For those of you out there who aren’t wearing insulin pumps, my Animas Ping holds about 200 units of insulin, which lasts me about 4-5 days. The other piece of information you should have is that the infusion sets are only supposed to last 2-3 days, so I stretch that beyond the limit most of the time. Unfortunately some of the time, the site where the infusion set is  attached to me doesn’t always work that long (something happens so that insulin no longer gets through, either the cannula is kinked, or blocked or some mysterious force just makes it stop working), so I have to put in a new one for a day or so until I change out the whole system.  The problem is that none of this stuff is cheap, so I really dislike having to use up more infusion sets than pump cartridges.  Also, there’s a symmetry issue that bugs me, having more boxes of infusion sets than cartridges but that’s my problem……  My always-wiser-than-me CDE  suggested that the way around this is to just put less insulin in my pump than the pump actually holds, say, 3 days worth instead of 4-5 days worth.  Huh. Why didn’t I think of that? It’s really better for me to do that, since leaving the infusion sets in longer than recommended isn’t really good for my skin. But it is hard for me to psych myself up to do this – not filling up the pump to full capacity feels like some kind of weird failure.  I know it’s the right thing to do and will save on insulin and supplies in the long run, but something in me just wants to FILL that cartridge up to the top.

Then there’s swimming.  I have been struggling for months with unpredictable blood glucose levels after swimming, despite having the same breakfast, dosing the same way with insulin and trying hard to do the same level of intensity as I swim. Some days I would drop really low, others I would soar into the 200s and stick there for a while.  In August and September, between travel and knee surgery, I had to miss quite a bit of swimming so when I started back up in mid-September, I had to gradually increase the length of time I swam back to where I had been. Funny thing happened. My blood glucose behaved better when i wasn’t swimming so long.  I have settled out at 30 minutes (instead of 35-40) and it seems to be helping make things more predictable after swimming. But again, it’s less than I COULD do.  I COULD swim for another 5 minutes, but doing so seems to take a toll on me that is inconvenient, to say the least.  By settling for less than my maximum capacity, my mornings improve greatly. You would think that would be a no-brainer to do, but I have to fight myself almost every morning to stop swimming at 30 minutes.

To be honest, I’m not sure what the lesson is for the rest of my life. I’m waiting for it to catch up to me, as I know it will.  I’m sure I have something to learn about moderation in areas other than managing diabetes. Stay tuned for updates and insights.

*An infusion set is the place where the pump meets my body – there’s a quarter-sized sticky patch with a plastic connection where the tubing from the pump attaches. Under the patch there is a very short plastic cannula that goes just under my skin and that’s how the insulin is delivered.  Pictures of an infusion set for the strangely curious are here.

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