Where we left off: It has been almost seven years since I agreed to start managing my diabetes at my now-husband’s request, and I wish I could say I was terrified; I realized what I feared was that sense of failure and inadequacy; and I got over it. Unfortunately, the emotional struggles of diabetes, like the physical struggles, are about consistency, dedication, and methodology, rather than One Big Change that Fixes Everything. (Read Part 1 and Part 2)
I view the last seven years then as a slow upward slope. Zooming in, there are many ups and downs, but on the whole, I grow, I learn, I improve, both in terms of medical control and emotional maturity. About five years ago, I started with the pump– and if you don’t have one, fight tooth and nail to get one. I measure myself with absurd frequency– twenty to thirty times a day– which I know isn’t great, and I know Kaiser hates, but I recognize is necessary to get deltas and point-in-time measurements that allow me to predict where my blood sugar is going, rather than just record where it has been. The big news for me in the past few weeks is that there is a good chance I will shortly get my hands on a continuous glucose monitoring sensor, for more consistent monitoring and the salvation of my poor fingers.
These improvements, though, are only half the story. The other half is the gradual self-acceptance, and the gradual recognition of the fact that, Yes, I am a diabetic, and that is neither a death sentence nor a non-issue.
Achieving a balance between these two extremes is not easy for me; I tend to run all hot or all cold, ready to throw out everything as lost to diabetes, or to deny diabetes has any role in my life at all. To fight this tendency, I have recently started to keep track of the wise advice and internal realizations that make the daily task of living with diabetes less of a burden and more of a simple, and acceptable, fact of life. So far, this is what I know:
1. This is not impossible. Diabetes is a chronic but treatable illness. My control will not be perfect, and it need not be perfect, but it should be pretty damn good.
2. It might seem more emotionally easy if blood sugar measurements were completely random and unpredictable, but truth be told,they are not. Dealing with diabetes is not like trying to read the tea leaves of my body; this is a science, and there are a series of inputs and outputs that can be monitored using blood sugar levels. I won’t always know all the inputs, especially when they are hormonal or psychologically induced, but I will often know the most important inputs, like what I am eating, my activity level, and how much insulin I am taking. Watch the input, acknowledge the input, and the blood sugar output becomes much more predictable and comprehensible.
3. Sometimes, the output is not what I want– hyperglycemia, hypoglycemia, or even just-fine-glycemia-but-I-still-feel-awful. This does not mean I have failed, and it also does not mean I should close my eyes, cover my ears, and claim I couldn’t possibly have seen it coming. This is a science; for me, it helps to use the vocabulary of science. I am not “high,” “out of control”– I am hyperglycemic. Once I extract the emotional element, analyzing what went wrong becomes easier, and I can record what I see either mentally or in writing for my reference next time around. Usually, the problem is a matter of being off on one of the inputs: I didn’t bolus enough for a meal, or I misjudged the caloric content of the food I ate. These are not failings of wit or value, and these are problems I can comprehend and repair.
4. Yes, I am a diabetic, and No, I can’t eat that. As much as I want to be Like Everyone Else, I have to admit my body is different. It has different needs and different limits. I cannot be ashamed of that, and it does not help my curious hosts or my worried friends if I try to pretend nothing is wrong. If I can’t eat with everyone because I had to eat half an hour earlier, so be it; better to do what I know is right for my body, and enjoy everyone’s company later on, than to allow my blood sugar to get lower and lower while I wait for a delayed dinner. And I would love to have some of that monochromatic cheesy pasta mixture that you made, but its elements are indistinguishable, and I don’t think I can adequately predict how my blood sugar would react. Trust me, it’s not you; it’s me. And dear waitress, I’m sorry to ask again, but are you sure this is Diet Coke? You see, I’m a diabetic, and the difference between Diet and Regular is more than just a taste preference for me, so if you could just make sure, I would really, really appreciate it.
This list will grow, and I imagine you, reading it, have much to add or subtract. I would love your advice, as this is a learning process I have still only just begun. This, though– this letter and these paragraphs– are a big step for me. This is me reaching out to you, and the collective wisdom of experience, to say, Hi.
I should get a little rainbow badge with a robot pancreas on it: Yes, I am a Diabetic. Loud and Proud. It’s nice to meet you.