Diabetes Burnout

Just Like Federer

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Earlier this month, I watched Roger Federer make his return to tennis after six months off at the Hopman Cup in Perth. At the time, I hardly would have expected him to make it to the Men’s Final of the Australian Open.

His last grand slam title was back in 2012, and he’s now well into his 30s. He was also matched against one of his greatest rivals, Rafael Nadal, against whom he did not have the odds of beating.

Yet last night, I was glued to the edge of my seat as I watched Federer break back his serve in the fifth set, and then earn a break of his own that saw him serve for the match.

It’s pretty remarkable to think that Roger Federer has been playing tennis for as long as I can remember. Although he hasn’t won a grand slam title since Wimbledon 2012, it hasn’t stopped him from continuing to play tennis.

I suppose the same can be said of Venus Williams, who scored runner up in the Women’s Final on Saturday night after a few quiet years. Mirjana Lucic Baroni, who made the Women’s Semi Finals for the first time since 1999! And Rafael Nadal, who is constantly prone to injury, but continues to persevere.

My diabetes management is feeling like a very endless task at the moment. In January, the victories feel like they have been outweighed by frustration. The motivation to diligently attend to self management tasks subsequently disappeared. The care factor has just not been there.

Yet watching some of these seasoned tennis players over the past two weeks has been so inspiring. For many of them, the victories have been far and few. Yet they continue to persevere. Their endurance never wavers. They are passionate, and enjoy what they do.

Unlike these guys, I can’t say that I am passionate about, or enjoy tending to a broken pancreas.

However just like Federer, I am confident that I will persevere to see the victories once again.

Taking a Break from My Insulin Pump

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I spent two weeks disconnected from my insulin pump last month. It was honestly the best decision I could have made for my diabetes management in the long run. Going back to the simplicity of injections gave me some much needed relief from the stress the pump was inflicting on me, as well as a lot of time to reflect on how I wanted to manage my diabetes going forward. With a much clearer head today, I will add some more to what I wrote about this pump break last month.


As we were heading into warmer weather and the festive season towards the end of last year, I was spending a lot more time being physically active. Watering the garden, Christmas shopping, setting up Christmas lights and activity around the house. Suddenly, a lot of what I had learned and experienced over the past few months from using an insulin pump had changed.

Being plugged into rapid acting insulin all the time felt exhausting. I was going low all the time. Even simple things, like watering the garden, would send my blood sugars spiralling downward. I felt like a single day without a hypo was rare. I often found myself eating my way out of impending hypos, and trying to predict what my blood sugar levels were going to do to me before leaving the house.

I felt really, really lost. I had very little confidence in my basal rates, or insulin to carb ratios. I had no idea whether it was my basal rates, or my insulin to carb ratios that were sending me low. I no longer felt safe leaving the house for half an hour without a meter and tonnes of skittles to fall back on. I’m pretty sure I had made the connection between physical activity and my lows, but I just felt far too overwhelmed at the thought of fine tuning everything once again.

I was nervously pacing up and down on a Friday night in December, deliberating over a site change or a Lantus injection. I was equally scared about going back to using Lantus, given how uneven and inconsistent it had been for me in the past. What finally got me over the line was telling myself that insulin pumping was no longer working for me. I knew that it was the source of all of this frustration, and that I didn’t need to use it if I didn’t want to.

The days that followed were quite honestly the happiest I’d felt in several weeks. The freedom from that annoying chunk of a pump, and the relief from not having to stress about basal insulin sending me low from a short walk. I was honestly so happy at the time, I was convinced that this might be the way forward for me. I was so relieved, I kept telling myself how much better injections were compared to the last few weeks I’d had on the insulin pump.

I went from having days like this.


To having days like this.


I anticipated I’d probably only last a few days without my pump. But injections were going surprisingly well for me. Everytime I stared at my pump, I just knew that I didn’t feel ready to hook back onto it. At the one week mark, I even stashed it in a drawer because I didn’t want to look at it.

My pump break gave me some much needed time to clear my head. I plugged back in for a few days over Christmas, because I knew that I would need the temporary basal rates and extended boluses to help me cruise through all of the food. I was fully prepared to take it off again after Christmas, but quite honestly I haven’t felt any desire to do so since.

I’ve been setting temporary basal rates around physical activity, and they seemed to do the trick from the get go with minimal hiccups. I’ve been setting a -30% temporary basal rate before I get into the car to go to the shops, and switching my insulin delivery to “off” for half an hour if I go for a short walk around the block in the afternoon. I think I’ve had about 2 or 3 hypos in the New Year, which is not only a big relief, but tells me that I must be doing something right. 

If it weren’t for Christmas, I’m not sure whether I would still call myself an insulin pumper today. In those two weeks, I was absolutely fine with the possibility of going back to injections permanently if that was what worked best for me. 

At the moment, things are travelling well with the pump. Things are making sense once again, and I honestly have not felt any desire to be without it since Christmas. 

Could this change again down the track? Who knows? This is diabetes, after all…

What I have learned, however, is that I absolutely will not hesitate to take a pump break if the need arises again.

My diabetes, my rules…

Staycation

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I am often asked when my next holiday will be, or if I have any travel plans in the pipeline. As much as I do love going on a holiday, they are equally exhausting by the time I return home. AND they cost money.

I’m not the kind of person who goes on a holiday to sit on the beach. I can easily do that at home. I want to go somewhere that I can explore and sightsee and be a tourist. But that is exhausting in itself. So ideally I’d love an extra week up my sleeve when I return home just to sleep in and catch up with life. But with a full time job, no lotto wins and only four weeks of annual leave, it rarely happens.

Throw diabetes into the mix of work and life, and after a while it feels like you’re just pulling it along, struggling to keep up. It’s monotonous. It’s always there. It never ceases to throw curveballs my way. 

Towards the end of last year, I definitely drew back a fair bit from my blog and from social media. I was feeling a lot of frustration towards my pump, which I’ll write more about soon. I felt like I was venting my diabetes frustrations all the time, without anything of value to say. 

I had a lot of other things going on at home and at work, leaving me with little enthusiasm for much else. It had been ages since I’d binge watched a good TV drama, or even gone to the beach. But I was exhausted.

So, after working through most of December, I decided to take a much needed Staycation. You know, being able to sleep in, make breakfast at 10am, go to the beach, binge on a good TV drama at midday, go to the shops without being in a hurry, stay up late into the night and recharge the batteries. 

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It began with all of this seemingly endless time stretched out in front of me, and before I knew it I was wondering how it could be over so soon. I guess that’s a good thing…

Staycations are awesome. They’re cheap. They’re a good way to charge up the batteries quickly. And they kind of let me catch up to diabetes a little, so that I’m not lagging behind for too long.

The What-ifs of the Festive Season

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It’s that time of the year. Food, festivities, end of year exhaustion, and the promise of a fresh start come January 1. Add to that a nasty throat infection that I’m only just getting over, and the unpredictable glucose levels that have come with it.

This is a time of year where I have traditionally cruised along with my diabetes management, pushing all of my “priorities” back to January 1. It’s during this time, as I’m cruising along, that the diabetes what-ifs begin to cross my mind.

What if I had eaten less junk this year?

What if I had been motivated to count my carbs, and weigh my food more often?

What if I had been able to keep my blood sugar levels stable through the night more often?

What if I was able to log my readings and doses and look for trends more often?

What if I’m never able to get this right?

These feelings of guilt cross my mind moreso during the festive season, when I’m likely to be found ho-ing into plates of leftover desert in the days after Christmas and reflecting on the year gone.

This year, I do feel massively lighter. I still feel exhausted, but it’s more of a normal person exhaustion than diabetes exhaustion. It’s weirdly refreshing. It’s been a good year for my diabetes. I have made some impressive strides in my management. I’m in a place that I thought was impossible this time last year.

No, things are not perfect. There are still highs. There are still lows. And I’d be lying if I said that there aren’t still some what-ifs crossing my mind this year. I think we all feel that there is always more that we could do for our diabetes.

So, I’m challenging myself not to think about the what-ifs over the next couple of weeks. I’m really just looking forward to putting my feet up this festive season, and appreciating all of the things I have been able to accomplish in 2016. Diabetes, and otherwise.

I’ll likely be dialling up big doses of insulin, and using temporary basal rates on my insulin pump to help me cruise through the Christmas eating a little easier. I’ll be monitoring my blood sugar a little more often, but the focus will be more on enjoying myself than the numbers themselves.

If you’d like to spare a thought for those who don’t have the luxury of insulin this Christmas, consider making a donation to T1International or Spare a Rose. Both organisations advocate for, and provide insulin to people with diabetes in need all over the world.

While many Offices and workplaces have the luxury of a break over Christmas and New Years, spare a thought for those in industries such as hospitality, retail and health care who sacrifice time with their loved ones to serve us during the festive season.

Finally, dear readers. Merry Christmas. Thanks for reading Type 1 Writes this year. Wishing you a very happy, and safe festive season. See you in 2017!

– Frank

I Don’t Have the Answers

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I’m not burned out. But I’d be lying if I said I haven’t been frustrated when I haven’t been able get things right.

For years, I’ve dreamed of the day where I’d finally get things in check. Where I would run decent blood sugars and feel somewhat in control of this condition. It would always be tomorrow. Tomorrow would turn into next week. Next week would become the first of the month. Then, New Years would be just round the corner…

I started using an insulin pump, and suddenly those dreams actually felt a little more attainable to me than they were on injections. Things were improving. I definitely felt more confidence, and control in my actions around my diabetes. My levels weren’t peaking so high, so often. I wasn’t making wild guesses. I was motivated to take more measured approaches. I was motivated to experiment. I was finally getting things right.

However the more I got things right, the more I kept expecting of myself.

When I couldn’t get things right, I got frustrated. I blamed myself. I rebounded with junk food. I felt increasingly guilty and found myself thinking more and more about the long term consequences of my blood sugar control.

After four weeks of FreeStyle Libre monitoring recently, I felt confidence in going back to fingersticks after fine tuning my morning routine. After near perfect graphs on the Libre, suddenly I was getting high readings after breakfast. Suddenly I had no idea, or confidence in where my blood sugar levels were sitting anymore.

Was it just a bad week? Stress? Lack of sleep? Food? Change in activity levels?

Who the hell knows. Thankfully, things eventually returned to normal.

I look back at some of the posts I’ve written recently, and I can see how hungry I am for answers. For some sort of solution. Expecting that there’s some magic way to get diabetes down pat, once and for all.

Let me clue you in on something. There isn’t. Everything affects diabetes. Anything and everything. It’s impossible to achieve perfection all the time.

Sure, I will continue to work at my diabetes. I will continue to share what works, and what doesn’t work for me and my diabetes.

But I don’t have all of the answers to managing diabetes. And I’m learning to be okay with that.

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