Last week, I introduced what I believe are the three categories of diabetes self-management — none at all, obsessive, and educating yourself to the point of living life the way you want to — and discussed the first two. I’ve been through the first two categories and have been living successfully with the last one for several years now.
Going through the first category was because I didn’t know anything about diabetes and didn’t believe Type 2 was the “bad” type. More specifically, about all I was told was to follow an American Diabetes Association exchange diet, which I referred to as the “white bread diet,” and given a long list of “no, don’t, can’t.” Don’t tell me “no, don’t, can’t.” I dig in my heels and say, “Watch me.” (Although today, I’d just have to dig in my heel.)
Why the second category? The obsessive one? I’ve thought about that a lot. Because obsessive just isn’t me. When I was diagnosed with Type 2 diabetes in 1986, my fasting level was 311 mg/dl. I must have had diabetes for a long time. By the time I got to an endocrinologist and saw a nurse educator and dietitian, my HbA1c was 17.4%. I had a thirst that couldn’t be satisfied and was either sleeping or running to the bathroom. I felt like crap. I was afraid to drive. I was barely making it through my days at work as, at that time, administrative assistant to our mayor.
One morning the mayor walked in, took one look at me, and told my assistant to take me to the emergency room. “If nothing’s wrong,” he said, “you’ll feel relieved. If something is wrong, you’ll get help.” That day, I got my first injection of insulin. I gave it to myself. Shortly after that, a friend told me about endocrinologists, gave me the phone number for the group her Type 1 daughter went to, and I made an appointment.
Once I began to feel better, I became obsessed. I never wanted to feel rotten again. I was energetic. My husband noted one day that my cheeks were pink. I wanted to go out. I wanted to dance. I wanted to do what, you know, married people do.
I was on a regimen of Regular and NPH, taken in specific doses at specific times and eating specific amounts of carbohydrate, again at specific times. My control was fantastic. “I’d kill for numbers like those!” a Type 1 friend told me.
“This is the way to go!” I told myself. And others. But I really wasn’t happy. I didn’t like watching the clock. I didn’t like trying to plan meals around 60 grams of carbohydrate, or snacks with 15 grams of carbs. I think I was manic. As somebody who normally reads several books at once, I couldn’t focus enough to follow a Reader’s Digest article.
I told my endocrinologist I wanted to go on a multiple-injection regimen. “But you’re a Type 2 in good control!” he exclaimed.
At the time, I couldn’t voice it to him, but later realized that having my diabetes in good control didn’t equate to being in good mental health control. In reality, I was extremely depressed.
I went farther. With the help of my diabetes education team, I began to learn more about how to fit diabetes into my life instead of having my life revolve around diabetes. (Admittedly, you can’t totally ignore caring for your diabetes at any time. But you can learn enough to put yourself on autopilot for the most part.) Bless Sonja, Amy, Sheila, Sandy, Gail, and all of the others who helped me learn!
My next step was to get an insulin pump. I’ve been pumping for…maybe 12 or 13 years now. Lemme see…I’m on my third pump now and I don’t automatically get a new one when my 4-year warranty is up. This one expires in December. It took me a while to get my endocrinologist to recommend one for me (“but you’re a Type 2…” I used to get that a lot!).
I read a book all the way through for the first time in two years or so. It was Like Water for Chocolate.
Today, I’m out of that cramped box labeled “diabetes” and spreading my wings. I make mistakes. I’m human. You may have noticed I tell you when I flub. I want you to know that you don’t need to be perfect. And you can’t be. Nobody can. But you do need to get yourself back on track instead of telling yourself, “I’ve failed so there’s no use trying again.”
Sometimes I eat the “wrong” things. But are they really “wrong?” Using your meter, learn how to eat the things you like. (Check when you take your first bite, then again two hours later.) Most of the time, I eat healthfully. Sometimes I don’t. (I’m more likely to tell you when I don’t.) I’m still trying to figure out an aerobic activity I can handle with my new circumstances (one leg doesn’t go all the way to the ground). I used to ride a bike every day. Will I be able to do that again? I hope so. Water exercises would be great, but there’s a problem. I can get into a pool. Heck, you can fall into a pool. Getting out is the problem.
But even with all of the things I do wrong, the one thing I do right is to keep my HbA1c in the lower 6th percentile most of the time. So maybe it’s not wrong after all? Maybe it’s just me handling my diabetes management in a way that’s right for me, making it a normal and natural part of my life. The first comment on last week’s blog indicated that the commenter and her husband are handling their diabetes management in ways that are different but right for each of them. Way to go!