Lazy Diabetesing / Survival Mode

Two weeks ago we, as a family, welcomed my little girl into our lives. Having seen my unwavering efforts to keep blood sugar hikes and spikes at bay during pregnancy, I was whole-heartedly congratulated on a job well done by my family members (aka, 'the help').  Inside, I congratulated myself too. It was a slog, but I did it.

Throughout pregnancy, my aim was to keep my diabetes as balanced as possible, without becoming a massive control freak and giving birth to one stressed-out neurotic little kiddo. But after 9 months with an HbA1c in the low 6s, healthy squishy bits and a full term pregnancy, it felt like the challenge (war?) had been won. Two weeks on, it has dawned on me that the challenge (war?) is only just starting. 

Immediately after she was born, I smugly looked at my CGM trend thinking how very much I had 'this'. My nice steady line with occasional above 10 mmol spike painted the picture of a mother absolutely nailing post-birth blood sugars. Two weeks on, and even my CGM trend arrow is trying to show me where I went wrong. 

My once 'never away from my side' receiver now shows a sorry trend of gaps and spikes. The gaps telling the story of it having been left in another room, far from anywhere conceivably useful. The spikes sharing its tale of alarms smothered into silence at the bottom of a nappy changing bag - often rummaged around in, but never for the CGM. The weathered tally gear case shows its age, and the precious upper and lower alarm limits set beautifully at 4 and 7.5mmol (target numbers for pregnancy) now stand at 4 and 13mmol, because I had to turn off the alarms which have been the electronic nag in my life since February 2015. The battery uncharged for the third time in this week. A sorry tale it tells. 

Am I lazy diabetesing? Well, no. Right now I'm adjusting to a new normal beyond anything I could have imagined. My kid is amazing, but in a world where only last night Jamie and I celebrated sleeping in the same bed for the first time in two weeks, there is no room for diabetes 'perfection', if there even is such a thing. If there is, it probably holidays with the 'compliant diabetic' and the 'optimal control' gang. 

Right now I'm living day-to-day, in survival mode. And while I thank my situation daily to be able to use a pump and CGM, right now, as I learn tricks of the trade for getting dressed AND having a shower in one day through a fog of sleep deprivation and survival naps, my diabetes has to just tick by on autopilot. My pump means I always have insulin when I leave the house, and my Dexcom is the safetynet of blood sugar mayhem. Anything in between 'way too high' and 'plummeting like fuck' is pretty much OK. 

The time will come when I have the headspace to basal test between breastfeeds, and prepare blood sugar friendly foods between vomitted-on outfit changes. For now, I'll stick with survival mode 

And on we must go. 

An ode to the Olympics

Two years ago when I started to have regular fun and games (see also: swearing and rage) with kinked cannulas, I made the decision to try out the Medtronic steel cannulas.  Rather than being most people's nightmare because of the idea that you might feel them under the skin (you can't), it took just a couple of weeks of before I made the switch on a permanent basis.

I loved the fact that as they are removed after just two days and were so much more narrow than the Teflon needles, there was always much less scar tissue left after it was removed.  And the purple marks people talked about seeing after removing the Teflon needles seemed like a thing of the distant past, to me.

Perhaps the issue is just that in order to use my steels I have been using my abdomen for every cannula, but I feel like I'm starting to resemble the Olympic rings.  Right?

With an inkling over the last few weeks that burnout may be approaching (**rips off own pump and goes to hide in garden shed for a day with a pint of ice cream**), I've put in a sharpish order for some inset IIs (Teflon needles that could park themselves on my back or arm).  

Why?  Because as PWDs who have choice (even if that choice is limited) over the tools we use to manage our diabetes, and it is my prerogative (and sometimes a survival technique) to shake things up and change my form of attack.

For a long time I didn't mind using my abdomen for cannulas.  It worked for me and the lack of kinky (oo-er) issues kept me kicking the crap out of diabetes without a second thought.  But it's OK to reach an impasse and say, "This isn't working out, anymore" and make changes that will help you feel ready to take on another day with diabetes. Diabetes paraphernalia is something unavoidable that we have to live with as PWDs, so we might as well make that paraphernalia work for us.

Have you changed your paraphernalia to make it work for you?

Rocks, bottoms and food-shaped shadows

As I stood on the scales this morning taking on board the eight pound telling off my scales were giving me for the choices I've been making recently, I realised something: I am losing control.  My diabetes management lately has not exactly been something to write home about.  I've been using my CGM as a disaster safety net, rather than the pre-emptive strike it can be.  I have a lump on my abdomen that I'm fairly sure is a nasty piece of scar tissue from overuse of that area for cannulas, but I have been too apathetic to stop using the area, let alone get it checked out by someone who knows more than Dr Google. The carbs I used to cut out because they led to bouts of mountainous blood sugar landscape are back with a vengeance, and my reaction to the peaks and troughs that inevitably follow is decidedly... meh.  Worst of all, the pounds I had lost in the last 18 months using the tools Animas gave a group of people at their sports weekend, are all but regained.  And I am too tired to care.

Burnout is back.

I don't generally talk about my issues with food widely because my 14 stone out-of-shape and old-before-its-time physique does that for me.  It's not exactly rocket science to know that I overeat and make poor choices. I've always known my relationship with food was... awkward... and I've known for many years that my choices can not only be bad, at their worst they are damaging.  It goes nowhere near the realms of anorexia or diabulimia, for that I am blessed.  But my battle to lose weight because of my inability to exercise self-control around food - far beyond that of any normal person - and my tendency to use food both as a comfort and a weapon, has become much more pronounced in recent weeks. I find myself so compelled to eat a certain type of food, that I will leave the house at ridiculous times of day and night to get whatever that food might be.  And I won't eat one of them; I eat four. I eat in secret sometimes and kick myself so hard when I do, because I am the only one I am fooling.

I know where it comes from. I remember times when I was a kid where I was so, so hungry, but my BGs weren't behaving themselves, so I had to wait.  And wait.  And wait.  My diabetic chocolate (before the world realised what a conspiracy that really is) was measured two squares at a time, and I had to go and run around outside for an hour if I wanted to eat them.  I could never just enjoy them for enjoyment's sake.  At other times my parents would need to feed my snacks and meals when I was half asleep, because yet again my blood sugars demanded so. I know how sorry they must have been and how sad this restriction must have made them.  I've had 'are you allowed that?' and 'you can't eat that!' so many times in my life that I use food as a channel dor my frustrations, my anger, my sadness and even  my successes. When I lose control, I LOSE control. And that's where I am now, and have been for several weeks: Out of control.

Diabetes stole from me a normal relationship with food.

But I'm not a silent partner in this and for the most part I am well aware of the issues I have, I see them and I can keep them at bay. At any time I am probably only one bad choice away from being on the evening news as firefighters take apart the side of my house to remove me by crane, but I can manage just enough self-control to stop myself most of the time. I know this, so I try to make efforts to fight the devil on my shoulder and go for option A, rather than sink to option B.

I know that something has to change if I'm going to raise myself out of the current funky state of affairs.  I get it.  I've been here before, and I will be here again.  That is the nature of managing a chronic illness that needs 24/7 attention. But with the changes that I plan to make will come better BG control; as a side of that I will feel interested again; on the back of that, the burnout will abate.  That's how it works, you see.

So how do I move forward?  We've done this before, right?

There are so many ways that years of teaching myself how to sock burnout in the mouth has shown me.  For starters, I have re-invigorated my refrigerator with mounds of delicious, healthy, low-carb foods, ones that I know help my BGs behave less like the adolescent faff-fest they've been lately.  I am writing what I am eating in my My Fitness Pal account so that I can see just how much 'a couple of cakes' really is, calorie, carb and conscience wise.  I have an agreement with my family members that every night after work, we go for a walk.  It's only a two mile loop around the village where I live, but it is a perfect 30-minute walk with hills and slopes to keep the heart rate chirping along. The pains in my legs are still lurking thanks to having regained some weight ('some', ha!), so for now walking is the best I can manage.  And I am going to go for some thorough basal testing to use the incredible CGM tool we made the commitment to buy this year.  Because using it as a safetynet while I put crisp packets in my face practically whole and three at a time, is ludicrous.

This is how I do it.  With determination, and with friends.  But it's not easy.  You know my 'secret' now, and you will know if you see me and can tell that I've gained some weight, that maybe now is a bad time.  But if you want to join me in hitting this diabetes shit out of the park, find me on My Fitness Pal at annamac1982.

Do you struggle with food yourself?  Then maybe see you there...