Dealing with Diabetes

Tennis, With a Serve of Diabetes

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By far, my favourite thing about January is the tennis.

Two weeks ago I went to the Hopman Cup in Perth, one of the tennis tournaments traditionally held in the lead up to the Australian Open this week.

Having seen Andy Murray last year, there wasn’t a doubt in my mind as to who I wanted to see this year – Serena Williams. I was so damn excited to see her play. She is just such an entertaining player to watch. I love her expression and her attitude, which she doesn’t try to hide. I love seeing her come onto the court with a bandage on her leg, seemingly injured, and yet still thrash her opponent. And I love watching her talk down her performance after a killer win.

Needless to say, I was so damn excited to see her play that night.

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When I arrived home after work that day, my blood sugar was 10.4. Which was okay, considering I’d only had my lunch 2 hours ago.

I wasn’t particularly hungry, but I knew I’d be hungry later. Wanting to avoid junk food after all of my festive eating, I packed myself a Burgen Bread sandwich of leftover cutlets from the night before. Even though the Arena had a strict no food policy, I was pretty confident I’d be able to sneak it in. But hey, I could always milk my diabetes for all it was worth, if I had to.

I was still 10.4 as we were getting ready to leave, and I gave myself a generous correction of 2 units.

When we parked the car at the Arena, I dialled up my Lantus dose. It was a little earlier than normal, and I knew that I’d have an hour or so of overlapping insulin. But it would save me the hassle of doing it while I was in there. I knew that the game would be a long one, and I’d likely be eating less than I would at home. I dialled up 10 units, rather than the 11 or 12 that I gave the night prior, and left my pen in the glovebox.

Going past security was a piece of cake. I managed to sneak my sandwich and water bottle through, hidden safely underneath the pile of jackets. Apparently water must be uncapped, in case we decide to launch the cap (rather than the empty bottle) at the court.

Serena came onto court, and it was so damn exciting to see her. She had pulled out of her match the previous day as a precaution, and I was so worried that I wouldn’t get to see her play.

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Unfortunately after the first set, she had to forfeit the match as a precaution for her inflamed knee. It was disappointing, but an hour was still better than no Serena at all.

I was ready to eat that sandwich, and tested my blood sugar. 5.7. I finished it, and quickly went off to the bathroom to bolus 5 units before Lleyton Hewitt came out to play in the Men’s match.

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That night, I was trying so hard to be good. I turned down lollies. I turned down hot chips. I turned down more lollies. Until 8.32pm, when I went hypo.

Not exactly my ideal, carb counted hypo treatment, I really had to give it my best guess. I measured out a handful of lollies into my palm, and began to chew them down. Still feeling shaky and in doubt a few minutes later, I grabbed another handful.

When I headed back to the car at the end of a great night, I was a lovely 19.0. Insert your swear word of choice here.

I had tried so hard to be good that night, and yet one small error with the bolus for my sandwich mucked it up. Yeah, I was bloody annoyed with myself. But it happens. It’s always going to happen, because I’m only human.

But at the end of the day, it’s not the hypo that I’m going to remember about that night.

I’m going to remember one awesome night of tennis that I got to watch.

Diabetes Game Plan: 2016 Edition

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New year, new me.

Kidding! Don’t even get me started on those Facebook statuses…

Ever since I’ve had diabetes, my New Year’s resolution has obviously centred around (wait for it) diabetes. Eat well, get my blood sugar levels down, maintain a good hba1c result without too many hypos and exercise. Scrap that last one, who the hell am I kidding here!

If I’m being honest here, I feel that for the better part of the last five years, my diabetes management has sort of stayed the same. I’ve chalked up good hba1c results, but they’re extremely difficult to sustain inbetween endo visits. Making a dedicated effort that delivers those sustained results is also hard, especially when there are a million other things going on in life.

But I want to do better than okay with my diabetes. I’ve already been at it for five, going on six years. That fraction of my life with diabetes is slowly, but surely growing. I want to look after myself. I want to minimise my risk of future complications. I want to remain hypo aware. I want to remain independent, and in control of my diabetes. I want to live a long, and healthy life.

So instead of that overall improvement this year, I’m going to strive for stable overnight glucose levels.

Night times over the past few months have never been such hard work. I can’t remember the last night where I didn’t have to wake up at 1am, test and give a correction shot. My last full night’s sleep seems like a lifetime ago. And mornings where I have woken up in range without minimal effort overnight have been rare occurrences.

I also know that it’s been a long time since I’ve had a full, uninterrupted night’s sleep. It’s been a long time since I’ve woken up feeling refreshed. It’s been a long time since I’ve woken up feeling pleased with my morning number, and have that sentiment echo positively throughout my day.

So, perhaps this is an argument in favour of switching to the pump. However, until that decision is made next month, I still need to manage with Multiple Daily Injections.

So, in 2016, I’m making a resolution to focus on the back end of the day. Say, from 4pm to 10pm – the 6 hour window before I go to sleep for the night. In these 6 hours, I will focus on doing as much as I can to not spoil my overnight glucose levels. Staying away from high fat foods. Satisfying my desire to graze on junk food with something healthy. Being patient when testing and correcting after dinner.

I know that I can do this.

I hope that I will eventually return to a point where I have some confidence that my overnight glucose levels will remain stable.

I hope that I will be able to return to a point of getting a full, uninterrupted night’s sleep more often.

I hope that if I can get those overnight levels within range, I will have one third of a stellar a1c result up my sleeve and a lot more enthusiasm in my mornings.

Defeated In The Darkness

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I could feel the sweat dripping from my forehead. My favourite red checkered cotton pyjama pants were stuck to my thighs, drenched in sweat. My entire upper body was trembling. I felt like I’d woken up from a bad dream that still felt very real in the dark of my bedroom. I pulled off my blankets, which I usually hid underneath to stop myself from freezing in the air conditioning.

The red numbers 12.40 were glowing back at me in the dark of my bedroom early on this Thursday morning. I reached over to flick on the lamp beside my bed. I pulled back the cap on my tube of test strips, grabbed one and feverishly stuck it into my meter. I pricked my finger and navigated it over to the test strip. 2.1 mmol/L. Just the number I wanted to see at 12.40am on a Thursday morning.

I heaved myself up to reach for the bag of marshmallows on the bed head behind me. Too weak to support this upright state, I leant over to one side. My elbow rested on my pillow, supporting my upper body weight. Marshmallows were in hand.

I opened the zip lock bag and pulled the marshmallows, stuck together from the heat, apart. One, two, three, four, five. I mentally counted to myself as I placed them into my hand, knowing my hypo-muddled brain would lose count of how many I’d eaten midway through.

By the time I was down to that last one, I couldn’t even remember eating the other four. I collapsed back onto the bed, relieved as my head sank back onto the pillow. I felt absolutely exhausted, and too weak to move. I reached over for the remote to the air-con, dialling the temperature down a few degrees. I so badly wanted to close my eyes, but knew I had to stay awake and see this hypo through. I turned and faced my bedside lamp, hoping the bright light would keep my weary eyes distracted.

I’ve always felt very in control of my diabetes. Throughout the day, I’ll test as often as I want. Those tests produce numbers. Numbers that give me a sense of security. Numbers that keep me in the know while I’m riding the wave of an unpredictable disease.

But when night comes and my body switches off, I’m forced to give up all control.

Laying there in that moment, paralysed in front of the lamp, I couldn’t help but feel a little defeated by my diabetes.

I roused again at 2.24am, having dozed off in front of the lamp. I switched it off, rolled over and closed my eyes with a sigh of relief.

(And I’m only now realising why my shoulders were aching the following day!)

“How’s It All Going? Are You Managing It Alright?”

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“Could I talk to you for a minute?”

“Sure.”

“Let’s go over to the desk.”

“I’m going to see my diabetes specialist on the 3rd of February in the afternoon. I wanted to work until 12 and then take the rest of the day as sick leave. I’ve got a letter underneath my form here to say where I’ll be.”

I stood there, waiting. Confident that she would sign my leave form. Sub consciously thinking that this is the second time that I’ve requested leave for my diabetes since November. Knowing that she was pretty understanding. But still half expecting a comment. (And no, this was not the person who told me I Should Be Making My Appointments Outside of Work Hours).

“How’s it all going?”

“What?” I replied, stunned, and a little bit lost for words.

“Are you managing it alright?”

“Um. Yeah, okay, I guess. I can only do the best I can, I suppose. I’ve got the type of diabetes that isn’t caused from being unhealthy.”

“I know. It’s just that your insulin’s not there. My friend has a hard time with it, too.”

“It’s hard. But I’ve only had it for a couple of years. I’m lucky that I got it when I was 17. Some kids get it from a very young age.”

“Yeah, she got it when she was an adult, too.”

“I can only do the best I can” I repeated, almost trying to convince myself of that fact, rather than her.

“Cool. I’ll sign it and payroll can put it through for you.”

Sometimes people can surprise you. That little conversation was enough to make an ordinary day brighter. It’s never a simple question to answer, but it was enough to help me to remember why I do what I do.

Happy Monday!

May The Force of Low Blood Sugars Be With You

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Because I was on holidays, because the fridge was empty and because I’d been wanting one for several weeks, I had a Subway footlong Italian BMT sub for lunch last Wednesday. I dialled up 18 units of insulin, and I was rather pleased with the way the results were tracking in the hours that followed. I was 14.1 at 2.18pm, 8.7 at 3.09pm, 5.7 at 4.04pm and 7.6 at 5.15pm.

At the time of that last test result, I was getting ready to go and see Star Wars. Still feeling full from that Subway, I figured that I would skip dinner (sorry, Mum!). I gave my Lantus dose an hour and a half earlier than normal, and headed out the door. I parked the car at 5.59pm, and a quick test showed I was 5.1. I knew straight away that I was on a downward trend. Definitely a combination of overlapping Lantus doses and skipping dinner that night. Which I should have anticipated, given this just happened a few weeks ago.

We walked in, bought our tickets, and went to sit down in the theatre. I knew that I was hypo, and that I would need some sugar to last me through the movie. For a lack of personal space in the theatre (brother on my left, stranger on the right), I decided to go and test outside. I leaned over to my brother and asked him for my ticket.

A quick test outside the theatre confirmed that I was a borderline hypo 4.0. I headed over to the candy bar, where thankfully, the line was empty.

“Do you have any juice in the fridge?” I asked the attendant, squinting at the drinks fridge behind the counter. I returned to the theatre with a very overpriced bottle of orange juice, noting the 34g of carbs on the label.

I sat back in my seat, reluctant for a few moments to open that bottle of juice in front of the two people I was with who I hadn’t brought anything for. I decided I could excuse myself later, and skulled two thirds of the bottle.

Thankfully the guy on my right had moved down 2 seats, giving me some personal space to test again 15 minutes later. By this point, it was dark. I was relying on the bright scenes on screen in order to see what I was doing. My meter backlight told me I was 2.9, and I quickly skulled the rest of my juice.

Another 15 minutes later I was 7.4, and at last I could finally focus on the movie.

While the force of low blood sugar levels were with me that night, I was pretty proud of how I handled the situation. One year ago, I would have sat that hypo out in the theatre until I truly felt those low symptoms coming on. 

Today, I have the confidence to attend to a hypo in public right away.