Commitment Issues (also known as, My Big 2014 Commitment to Change)

I have dubbed 2014 to be the “Year of Commitment to Change.” Because, really, I’ve always had some sort of commitment issues. Not with my relationship with my husband or my friends or family, but with myself.

Years ago, I (albeit grudgingly, because I was diagnosed at 21, which should have be the height of “fun” time for me in college) made a commitment to myself to take care of my diabetes. When I was diagnosed, my doctor basically said there are 2 types of people with diabetes: those who live with it, and those who die from it.
I chose to be part of the former, and have taken numerous steps and changed my lifestyle dramatically over the past 19 years to make sure I was going to live, and live healthy, for as long as I possibly could. I’ve worked diligently to learn how to count carbs, take the right amounts of insulin, discover settings on my pump that help me avoid post-prandial spikes, acquired a CGM – the list goes on and on.

I go to my regular 3 month endocrinologist appointments like clockwork. I get my labwork reports. Everything looks pretty darn good, like it has for many years. My HbA1c is 6.1, and has been hanging out in the 6’s ever since I went on the pump in 2003. When I was pregnant, it even dipped into the 5’s.

At my last appointment, my endo and I had one of the most serious conversations we’ve had in years (the last one being in 2008, which was the “I’m trying to get pregnant” one, and I was reduced to tears because I felt it was never going to happen. But it did.) Our new-and-serious conversation revolved around my weight, which has steadily gone up since I was diagnosed with Type 1. I was a healthy weight back then at 21, I was an avid hiker, and loved to exercise. Fast forward almost 20 years…..a sedentary job, maturing into my 30s (and now, 40s), a bout of depression,  the roller coaster of hormones when trying to get pregnant, and then the pregnancy itself have helped me put on so much weight, I am now categorized as “morbidly obese.” Just saying that makes me cry.  I have explored the gamut of diets, exercise, changed how I eat, and definitely lost some weight along the way, but never enough to get down to a weight where my feet don’t constantly hurt, where I can sleep well at night, where I have enough energy to play with my daughter for hours, or where I can take up an exercise regimen without hurting myself in some way and losing track. I’ve been stuck in a rut of metabolic syndrome that has made gaining weight, despite my best diet-and-exercise efforts, far easier than losing weight. It’s discouraging, and my body is so very tired of constantly fighting some kind of pain from carrying around all this extra weight.

The me I want to be, again

A New Year’s picture of me, when I was at a healthy, manageable weight – before type 1 diabetes and metabolic syndrome had set in.
I want to be this again.

My endo says, “You are healthy, except for your weight. The medical issues, pains, etc that you have all revolve around your weight. Have you ever thought of having bariatric surgery? I wouldn’t recommend it for most of my type 1 patients. But you….I think you can do it. And I think you’ll see that as a tool, it will help you get to a place where you can manage your weight once again, and not get sucked back into the metabolic syndrome.”  For some background…my endo is a Type 2 himself. He had gastric sleeve surgery 1 year ago. I’ve seen the change in him – he looks, and tells me most importantly, he *feels* AMAZING now. He told me that he would refer me to his surgeon, he would go to the pre-op and post-op support meetings with me, and we could even do group personal training sessions with his personal trainer. He is on board to help and support me, which helps calm *some* of my fears about having an elective weight loss surgery as a Type 1 diabetic.

So….here comes the commitment part. If I want to do this, it’s going to require a LOT of commitment to changing, well, just about everything. I have to commit to a LOT more doctor visits over the next year. I have to commit to going to support group meetings. I have to commit to learning about how nutrition and digestion will change with the surgery. I have to commit to a non-impact exercise routine (to save me from injuries and so much foot pain) and know I will deal with blood sugar fluctuations as a result.  I have to commit to overhauling my diet and changing the way I consume food and drink. My diabetes management, that I’ve spent so much time perfecting, will drastically change – both before, and certainly after the surgery.

I have already tried to track down other Type 1’s who have had gastric sleeve surgery to ask them how they have managed, and if they have had any major complications or issues.  I have yet to find any. I feel like I’m navigating un-chartered territory here, and it’s scary. But, I’m even more scared of what my life will look like (or, if I will even be alive/healthy) in 20+ years if I can’t get rid of this extra, exhausting-and-debilitating weight. I’m sure there will be people in the DOC who are going to frown upon this choice I’m making…who think I *should* be able to lose 125+ pounds just by diet and exercise alone. Unless you have been THIS weight that I am, and struggled with all my injuries and aches, you have no idea how daunting it is, or how excruciatingly  painful. I need a dramatic change, I need it soon, and this is what I am going to do.

My first steps:

1. I am owning up to this commitment I am making – to take a risk that will change my life and my health for the better.

2. I am sending out feelers everywhere I know to find other Type 1s who have had gastric sleeve surgery. I’ve posted to a few bariatric surgery pages already, and found plenty of Type 2’s who have done it, but not a single Type 1. I’m hoping the DOC can reach out it’s arms and find someone within it’s ranks who has done this as a Type 1 and is willing to chat with me about it.

3. I’ve had my 1st consultation with the surgeon, and have scheduled nutrition counseling and a sleep study. Still to come: psychological evaluations, support group meetings, and various other tests and examinations to make sure my body is a good candidate for gastric sleeve surgery.

Even if I end up on this journey not knowing or being in contact with anyone else who’s done it that’s “like me,” I can at least document what’s going on through my blog, and I hope it will help someone else in the future. Wish me luck & strength, folks, and here’s to a Happy New Year for all of us!!

Diabetes Awareness Month Photo-a-Day 1 – Past

I knew November was Diabetes Awareness Month – see your DAM guide over on theperfectd.com – but I didn’t know about the cool “photo-a-day” idea until I saw it on Kerri’s sixuntilme.com post. She’s a creative cookie, that one.

Whew. You know I love pictures, so this is going to make coming up with blog posts this month a piece of cake (mmmm, sugar!)  I hope. Diabetes is an everyday thing for me and millions of others, and photos are certainly a good way to give glimpses into our lives with diabetes that you may otherwise not be able to see.

The topic for today is Diabetes – Past.

Check out that girl lounging on the crappy college-dumpster-found couch, it’s rigged-together slipcover already falling off. Chilling in front of that awesomely huge Prince and the New Power Generation poster, wearing a sweater from Maurice’s, rocking the Birkenstocks, newspapers open on the coffee table. It screams 1994.  My diagnosis year.

1994, you were so bad to me.I was oblivious to how diabetes would affect my life, really, when this picture was taken….the most unsettling thing in my 21 year old brain was that boyfriend whose apartment I was in at the time would break up with me soon after my diagnosis.  Not because I got sick, not because I gained weight  – trying to figure out the riddles of exchanges, when to eat, when to take more insulin – but because I was an emotional and dramatic 21 year old girl who still didn’t know the type of guy that was “good” for me, or what I was really searching for in life.

I’m glad now that he broke up with me. I’m glad I have the life I am living right now, even though diabetes is in it. It changed my life in more ways than I can count, and in more ways than I probably can still imagine, but it has been with me through truly maturing into an adult, finally learning what was “good” for me, and making me a better person in so many ways, that I hope to explore them in more detail through the Photo-a-Day posts this month.

Sweet New Threads

As I’ve mentioned before, I’ve become quite open about my diabetes in recent years, and have started wearing more diabetes-related apparel.

Got this *sweet*  new t-shirt in the mail today, that I had ordered through a TeeSpring fundraiser from Stick With It Sugar

Love it, Christina!

I’m already in love! Proceeds benefit JDRF, so it’s a win-win!! (FYI – I’m not sure if she is still selling the t-shirts…)

Thanks, Christina!

The t-shirt color is actually more a dark blue, not black – these pics were from my crappy cell phone. I was just too lazy today to haul out the big fancy camera.

Watch for me out and about around town – I’ve got the Electric Run 5k that I’ll be walking in tonight, and I think I’ll wear it there. Even though it’s a dark shirt,  I will be accessorizing with tons of glow in the dark bracelets, necklaces, sunglasses, etc, as well as toting around some LED flashing lights, so people SHOULD be able to see me regardless!

Test, Bolus, Eat, Repeat

A public service announcement for Type 1 diabetics from my daughter:

When I first got this t-shirt, she saw all the symbols on it, and asked me what they were, so of course, I told her and explained them, in the best way I could for a 2 year old to comprehend. Now, it’s just a game for her to say the words, but one day…she’ll really get what it means to me, and I hope she’ll realize the weight of those words on my daily life.

One of many awesome T-shirts from: http://type1diabetesmemes.spreadshirt.com/

One of many awesome T-shirts from: http://type1diabetesmemes.spreadshirt.com/ (photo credit for this goes to them as well)

For many years post-diagnosis, I never wanted the general populace to “know” I was different, and I hid all my diabetic accoutrements when I was out in public….when I was on MDIs and was eating at a restaurant, I would excuse myself from the table and discreetly go to the bathroom to take a shot or check my blood sugar. Once on the pump, I used to do the same thing (because it was housed in my bra, and digging around in your shirt at the dinner table is usually frowned-upon.)

But now? I’m wide open. I will whip out my pump or test my sugar anytime and anywhere. I don’t care. I’m like the honey badger in that respect.

I frequently wear t-shirts with obvious diabetes-related content in the hopes that someone will see me, realize I’m one of their peeps, and we’ll have a “diabetes in the wild” adventure. And every day, until there’s a cure, just like the t-shirt shows: I test, bolus, eat, repeat.

2 Years

It’s been 2 years today since that moment I can’t ever shake. The feelings and emotions are still so fresh. I was on a stretch of road I’ve ridden or driven hundreds of times over the past 20+ years. The drive between where I live currently, and my hometown, around 70 miles away. It was morning, the sun was behind us, shining into the back of the car window. I was in the back seat with my (then) 4 month old daughter, who was snoozing in her car seat, pacifier squeaking and bouncing away like Maggie from The Simpsons. I looked up into the rear view mirror and shared a glance with my husband, who was driving. I nodded that everything was OK, and smiled down at our daughter, relishing in her tiny little life, while looking ahead at the road that was leading us to the hospital in my hometown to see my Dad…where I didn’t know (but really, I did know) that he had already died earlier that morning.  In that one moment, I knew: my life had changed, again. Better start dealing with it.

Love you, Dad. Always.

My heart still aches, remembering this arrangement was only a step away from my Dad’s casket.

My Dad was so many things….Husband, Father, Grandfather. He was a jokester, a sports-lover, a salesman, and could strike up a conversation with anyone. He was also a Type 2 diabetic, and he had a ton of complications. Some were probably related to diabetes, but many were not.

In thinking of the last 2 years, I can’t help but wonder….is there anything he could have done better to take care of himself that would have given him 2 more years, or more, with us? I don’t want to sound selfish or unkind, but I get a little bitter thinking about all the “what if’s.” What if he had eaten better, what if he had lost weight, what if he had listened to me (and the multitude of doctors) and stopped smoking 30 years earlier….could he have been in our lives for longer? I could have given him so many more hugs, shared so many silly jokes, and asked him so many more questions. He could have seen his grand-daughter grow and flourish.

And then I apply those same concerns to myself as well, wondering….is that cupcake I just ate going to cause a high blood sugar that tacks onto the years of highs and lows that have taken such a toll on my body already? Is each high/low sugar taking away one minute, one hour, one day, one year more that I could have spent with my loved ones? I don’t know, and I really don’t want to think about it that way.

Appropriately, this morning was my 3 month checkup with the endocrinologist. Good news! My overall cholesterol is lower than it’s been in years (with HDL 67, LDL 106), my A1C is 6.4, and all my other blood-work numbers look great. I may not be perfect in my management of my health, but I’m trying. Despite any contradictions from the wizened sage Yoda, I’m trying (and I guess, technically doing things that actually add up to the trying) really hard, and I think that is the most I can ask of myself, or expect from anyone else. I am trying my best to be here and be healthy for as long as possible, and I hope the people who love me can recognize that.

I love you, Dad

The last time my daughter saw my Dad. The smiles on both of their faces are priceless.

Where’s My CGM?

I know, it’s Monday. We had a busy weekend filled with lots of fun, so I can’t complain. But really, how asleep was I this morning that I had no idea where my CGM was for several hours (it usually lives beside my bed at night, and in my pocket during the day), or how it got to the place where I found it:

I hope it can handle the cold.The only thing I can guess is that, as I was preparing breakfast for my daughter and myself, I got distracted while checking to see what my sugar was, and put the CGM into the fridge instead of what was in my other hand. My sugar was fine – a happy 104 when I woke up, so I can’t blame a low – but I hadn’t had any coffee, so we’ll use that as as excuse. Where’s the oddest place that you have found your CGM (or other diabetes-related tool?)

Diabetapedia and Check-in Day

In looking up a reference URL to link here for DOC (Diabetes Online Community), I came across said link to Diabetapedia.com – am I just slow on the uptake of finding this? How long has this been around? Have any of you guys submitted information to it? And does anyone else think they are kind of stealing Kerri’s tagline? I’m not sure how I feel about this…..I really like the idea of a diabetes-wikipedia-type site, but I guess I am a little suspicious when anything is sponsored/run by “big pharma.” There always seems to be a (not-so) secret agenda of them getting money and marketing from it, and regardless of who provides the information, there’s always something in the back of my mind that questions their motivations and the data that’s given because I feel they have their own agenda behind providing it.  I must noodle on this a bit more.

Switching gears (because I’m a bit off-kilter this morning after enjoying too much Stark Raving wine this weekend), how often is it that we let others in the DOC know that we read what they post, understand where they are coming from, and give them that little piece of moral support that can help them learn a new diabetes tip, or motivate them out of a bad case of diabetes burnout? Probably not often enough! So, today, if you’re reading this blog, please post a comment – even if it’s just a “check!” to say you’re here and you read this.  Chris at A Consequence of Hypoglycemia had this idea, and I’m participating today as well (as soon as I have time enough to read all the blogs I need to.)

Another switching of gears….we got some much needed relief from the heat yesterday at the misty-water-zone area at the Durham Museum of Life & Science. We took Penny there for the 1st time since she’s become a truly aware little person (the time we went when she was 8 months doesn’t count, since all she did that visit was sit in the stroller, sip milk, cry, poop and pee in a diaper, and nap. Oh, how life has changed!)
Kids in the MistFunny with my buddy Seth!One cool kid.