Tuesday, October 29, 2013

Sweet Mama Drama

Sometimes I struggle with my role as a mom that juggles multiple autoimmune disease states. Type 1 diabetes poses glucose a swings that can affect my mood, ability to drive safely, carry on a conversation and just function as a parent. My sweet, brilliant 6 year old is so bright he is able to pick up on the cues for both his mom and dad's "diabeebees" lows. He is able to notify the other parent to these changes, and is quite hip to diabetes lingo and can accurately describe how too much insulin in the blood means you must eat or drink sugar to bring the blood back up to feel better. How many 1st graders should have to explain the pathophysiology behind hypoglycemia? It breaks my little heart, but also makes it beam with pride. My 3 year old will jump right in and ask to have his glucose tested. He loves blood and guts and actually enjoys the ritual. I'm sure in some ways this should be worrisome, but for the time being, we will just let him be a little weirdo and partake in the activities.

My greatest fear is that my children will develop my disease. That I have passed this on to them. That they will grow up having to test, inject, worry about complications, feel the angst of a low glucose, the nagging fatigue and grossness of a high, the never ending Endo visits. When they ask for a drink of water or accidentally wet the bed, my pulse quickens and I immediately scream in my head "ITS HERE, LORD, ITS HERE...DIABETES..GET THE METER AND CALL THE ENDO"....which means screaming for my husband in the next room, and then he tells me I'm a psycho and that my kids are just thirsty because it's Texas and 170 degrees outside in August and they pissed the bed because I let them drink a quart of Gatorade before bed because I'm an excellent mother and they looked like they over exerted themselves at peewee flag football. This whole living with a pragmatic Dr thing sometimes is annoying and I often wonder if I should slap him around so that he knows that I'm actually the boss. No?

Dr. C and I actually consulted with a genetic counselor prior to conceiving the heathens to asses the risk of passing on our diabetes, and the risk was very low. We also have the boys enrolled in the Diabetes TrialNet (http://www.diabetestrialnet.org) and for the past 2 years their blood work has remained negative for antibodies. Does this mean they will never develop type 1? Maybe. Could they ever? Maybe. Who better to care for them, is the way we have always looked at it. But still, the fear is real. 

Being a parent with diabetes, a different type of "PWD", is difficult. Hats off to the d-moms and dads out there. I salute all of your hard work. I admire you more than you know. But we work hard too. There are days where I go hours without having looked at my CGM because I become so preoccupied with work, life, kids, who peed on the floor, who colored on the wall, who painted their nails, why are their transformers in the freezer and why is the dog locked in the closet...?
Life can runaway from you, but the diabetes is always there. It's hard to explain to a 3 year old why mommy can't share her juice with him right that moment, or why mommy has to pull the car over to test and eat a snack on the way to pick up Bubba. 

And hats off to those of us that created a life inside of us with diabetes. Glucose can fragment DNA from the moment of conception. The risk of birth defects is much higher amongst women with type 1 because of hyperglycemia, which is why it is recommended our A1c is <6% prior to conception. Yeah, ok doc. I'll get right no top of that! Super easy! Pfffffft!! Pregnancy is turning your body into one large walking hormone attached to a pump of hormones and all you want is to eat food and fuel the monster and don't get in my effing way. The end result is so majorly worth it, though. So bravo, Mommas with diabetes!

What's your take on being a parent with diabetes or pregnant with diabetes??

Wednesday, August 14, 2013

Gone to the dogs

As many of you may already know, I work closely with a service dog organization that specilaizes in training diabetes alert dogs (DADs). These animals are amazing and mind blowing all at the same time. They are trained to detect low and high glucoses in their handler with type 1. They are trained using saliva samples, and the first time I witnessed a DAD-in-training alert, I wept. Like tears. From my eyes. Yeah.

Bringing these dogs into my home for training purposes has been a blast. Each dog has its own unique personality, likes, dislikes and channel preferences on my DirecTV. Learning each in and out of the many dogs in the pipeline has proved to be both hilarious and frustrating. WHY WONT YOU JUST DOOOOO WHAT THAT OTHER DOG DIDDDD!?!?
Stuff like that. But each dog I have hosted in my home has "live alerted" me to a dropping glucose. Some before my Dexcom, even. The nose knows.

So, this organization I work with approached me a while back about having my own dog, that is with me all the time. They would also want to utilize this dog as a "demo dog" when we travel to spread the good word about DADs. This was pretty exciting to me, as you all know, I LOVE PUPPIES. So we looked at the upcoming planned litters, and then we waited. Mojo was born on Wednesday, May the 1st. He is a handsome yellow Labrador Retriever. His registered name will be: "Chillbrooks BL Mojo Cosmic Storm". Now...I know what youre thinking...that I'm on an acid trip. But really, I just took his breeding line, and parts of his mom & dad's names and tried to put them together.

Mojo will join my family in September, when he is about 5 months old. He began obedience training at around 9 weeks of age. His little brain is like a sponge, and he's progressing well! I can't wait for him to meet my boys and family and patients and friends and neighbors....can you tell I am excited??!

With that excitement, though, comes apprehension. Yeah, I've had service dogs with me before, but never for any great length of time. And they haven't been mine. They haven't been a dog meant to service me with MY disability. That's been a bit of a hard pill to swallow. Knowing that the general public may view my owning a service dog as admitting that my diability requires assistance. Hmmmph. I always strive to be so upbeat and independent, and encourage my patients to do the same! Will they view me as weak? Will people wonder if there is something MORE wrong with me, something they can't see? What if I want to go have drinks with my friends, does Mojo come with? Does Mojo care that I have a glass or 4 of wine? Will people wonder why someone with a service dog is talking loudly with her friends while eating dessert??

And then I feel guilty. I am extremely blessed to be as healthy as I am when it comes to my diabetes. Some families may not be so fortunate, some families may not have the funds for a service animal, some may not know how to ask for fundraising and grant info. So they go without. Some remain silent. So I'm going to take my handsome man, strut around with him proudly, and spend exorbitant amounts of time talking to individuals and families about how these service dogs work IN ADDITION to my insulin pump and Dexcom G4 Platinum CGM. So, here I am, about ready to yank up my big girl panties and change my life completely. Follow me here. And follow Mojo on Facebook at "Mojo, The diabetes alert dog".

Come on, September!

Wednesday, July 17, 2013

That time my thyroid hated me...

After I calfed my first kid, in 2007, I became completely run down, exhausted, hair falling out and a raging lunatic. I would cry at the drop of a hat, and felt like my newborn son hated me. My endocrinologist, encouraged me to get blood work done. Pffftttt. Stupid Dr...what does he know, plus, the thought of taking my newborn son into a lab with me around ALL THE GERMS was just out of the question. So my psychosis moved onwards, and I continued to spiral downwards. My face became puffy, my anxiety and depression seemed to be out of control, and I was gaining weight, despite hardly ever eating + breast feeding.

At this point my endocrinologist, who also happens to be my baby daddy, laid down the law. I WOULD get my labs done, I WOULD take the baby in public, and NO he would not catch Ebola from accompanying me. Hmmmph. Asshole. I did it anyways. Had my blood drawn, had them send the results to Dr. C. Whatever. Everything was going to be normal. I just KNEW it. Because I'm me. And I know. Better than a physician. Duh.

My hubby brought my blood results home. Something had popped up. Oh. Humph. I was severely hypothyroid. Suffering from a condition called "Postpartum thyroiditis". This occurs when a pregnancy triggers your immune system to attack your thyroid. Hashimoto's Thyroiditis was the cause. I could barely pronounce this. Holy Guacamole.

Dr. C promptly started me on Synthroid. I was now one of "them". One of those crazy women muttering about her thyroid and how it was the cause of ALL BAD THINGS EVER. Worst part? It was going to take 4-6 weeks for my medication to kick in. 'Scuse me?? Ummm hi, Mr. Endocrinologist....I'm your wife...I need INSTANT GRATIFICATION. Fix me. Now. I'm not just "some patient". He was all "sorry bout ya" and told me to keep taking my drugs. I sobbed. I now had to take this tiny pill every morning. On an empty stomach, nothing else. I THEN had to wait 30 minutes before administering coffee or food into my mouth. ERMAHGAWD. He was killing me. This was terrible. This was worse than my diabetes in my mind. This was A PILL. Aghhhhhhhh!!!!

Fast forward 5 years. I have good months and bad months. There are days {ahem, sometimes weeks} where I forget my medication. I have a LIFE ya know, thyroid. Dumb. But then I get run down, my face and joints get puffy. Then I cry at the drop of a hat and start feeling stabby towards ALL THINGS. And I can't shit for days, and all I want to do is nap. Usually the Endo knows when things are off. Better than me. Sometimes I think he should become a thyroid expert or something.

My hair has never been the same. It's more brittle and can fall out in gobs. My nails break more easily. My temper can go from zero to WATCH YOSELF, FOOL in a matter of seconds. The weight gain. OHHHHH the weight gain. Really, Endo Gods? You couldn't have just left my waistline alone? This is hard enough as it is! I try to check my levels every 3-4 months, or more often if I'm feeling off. But sometimes it's like, well....is this diabetes? RA? Thyroid? Syphilis? Brain tumor? How am I supposed to know!? I've been on pretty much all doses of thyroid medication. From 50 to 300 mcg. There have been days I take a week's worth because its been that long since I've taken it. My memory? What memory. The sick joke is that you can't remember the last time you HAD a memory when you have thyroid disease.

Recently I began following a popular thyroid disease support site. It has a super hip name and is endorsed by a B list celebrity. Hmmm.. Cool. I can dig it. They claim that the only way to take your thyroid meds is if it's "natural", AKA dessicated {dried pork jerky} pig thyroid ground up and put into pills. In endocrinology we are taught that this stuff is the devil. That it's inconsistent and all over the place and that most Drs don't even Rx it correctly. So of course, I forced my husband to give this to me. He said I would be sorry. I told him he was a nay sayer, just like all of THEM out there. So I started it. This pill I had to take TWICE a day, once being at lunch. Ohhhhhhh shit. It just got real up in hurrrrr. I can barely remember to EAT at lunch, let alone REMEMBER TO REPLACE A HORMONE IN MY BODY.
1 month goes by. My trainer is seeing I'm struggling working out, I'm going to sleep at 7pm and my face turns round, like a mutha effin moon. Endo sayssssss: check your damn labs. Verdict? Most awfulist thyroid levels of all time. Ohhh. Oops. So yeah...about that pig jerky I've been taking....not real sure it's working that great for me. So now he has me back on Synthroid {synthetic thyroid hormone} and a dose of Nature-Throid in the AM and at lunch. After a week I'm feeling a bit better, but would still like to be asleep. Like right now. Like in bed writing this with my eyes closed. Please.

All of my thyroid patients out there I know can relate to this. You're not alone! Even the wife of a board certified Endo struggles with this. Like a LOT. So know the signs and symptoms of hypo {low} and hyper {high} thyroid.
As seen here: http://thyroid.org/wp-content/uploads/patients/brochures/Hypo_brochure.pdf

Annnnnnnd here: http://thyroid.org/wp-content/uploads/patients/brochures/Hyper_brochure.pdf

And know that your primary care doctor may be following a lab's guidelines for what a "normal" thyroid level should be. 60% of our thyroid patients were told at one point or another, that their levels were normal. When they were un-normal. And whack. So do your due diligence when getting checked out and push for more than just a "TSH" test {which is most Dr's idea of "checking" your "thyroid", even though TSH is made by the "pituitary gland"}. And if you have diabetes, your chances are increasingly elevated for developing thyroid disease. Have a blood relative with autoimmune disease? Increases YOUR risk for autoimmune thyroid disease {Hashimoto's & Grave's}. I tell my parents that they genetically screwed me.

Oh...and for all of you that take thyroid replacement, make sure you're taking it CORRECTLY. First thing in the morning, on an empty stomach, with a sip of water, nothing to eat or drink for 30 minutes and at LEAST 4 hours apart from vitamins. Iron and calcium will actually bind to the thyroid hormone = you won't get your dose. Many patients are NEVER told how to do this. Which sucks for everyone involved! DON'T BECOME A STATISTIC. Wait...now I sound like an after-school ABC family movie. But for real, y'all...be educated.

So that's all I got about thyroid. Can you tell I hate it? And it hates me? Yep...me too.

Thursday, June 13, 2013

That time I went into kidney failure....

Recently I became fed up. I've gained this weight from having kids, being lazy and my RA medications...and it just sucks. So I wanted to try something both fun and challenging. I'm sure many of you have heard of CrossFit, as had I. A legit CrossFit gym had recently opened near mi casa...so I decided to try it out! The first week was free, so I had nothing to lose. Or so I thought.... {dum dum DUMMMMMMM}

My first workout was on a Monday. The prescribed workout was 100 pull ups, 100 push ups, 100 squats and 100 sit ups. Well, there was no way in HELL that MY body was going to be able to do THAT on my first day, so we modified the workout {WOD: Angie...for those of you in the know}. I ended up doing 35 of each, and although I was drenched in sweat and stringing curse words together like a sailor, I got through it all. Pre-workout BG: 94 mg/dL, post: 86 mg/dL, and I removed my pump during the actual workout, and drank water before, during and after. I dropped low later that night, which I promptly over treated with juice and then almond butter & honey...jussssst to make sure I didn't die. As soon as I came home from the gym I was immediately sore in all of the muscles I had just abused. Triceps, abs, quads...all were killing me. I upped my hydration, hit the Magnesium & L-glutamine...and a little Advil so I didn't feel like I was dying. Trainers told me to def come back the following day, that working out again would help with the soreness. Sure, ok...seemed legit..plus I loved the community feel of the gym and workouts, and how positive everyone was. Crossfit was also super appealing to me because of the connection with the Paleo diet, which Dr. C and I have dabbled with and prescribed in our clinic for the past year or so.

2nd day work out consisted of weights...jerks, lifts..and I did some modifications with a 35lb kettle bell. Again, not easy, but I never felt like I was over doing it. BG stayed ~90 again, and I also hydrated. Next day I felt pretty sore, but pushed through and did a run. Which I completed. Again with good sugars and {what I thought was} adequate hydration.

Thursday I took totally off. I was sore. I had also noticed that I was UP 10 lbs since Monday. That was a bit unnerving. I had puffiness around my eyes, in my fingers, my tummy and my ankles. Hmmmmmm. So I reached out to FaceBook....which warned me of a certain condition that I was familiar with because of my nursing background. But, again, STILL didn't feel bad...was still ok in my eyes. My sports medicine Dr suggested getting some blood work done when I came in the following day to see patients in my practice. So I did. About an hour later I get a call from the hospital's stat lab informing me that my muscle breakdown level, a "CK" or "CPK" level, was more than their machine could measure...and that they would be sending my blood to another hospital. Hmmmph. My liver enzymes were also more than quadruple what they normally are, and my creatinine {blood kidney test} was double what it normally runs. SHIT. At this point I'm getting upset. My triceps and quads had also begun to abnormally swell, and my skin in those areas became super tight. FML. Dr. C called over to the hospital, and at that point their machine was also having difficulty running my CK level, but they were guessing it was around 20,000. Ruh Roh. Normal is 60-400.

So by now, Dr. C and I have consulted with my sports med Dr {Hey, Dr. D!!! Love ya!} and an internal medicine doc in our practice. Both were recommending a trip to the hospital for IV fluids. Dr. Google was scaring the crap out of me. When you hear things like "renal failure" and you've had diabetes for 20+ years, you tend to get nervous. So I drove myself to the hospital, Dr. C followed....I turned up the music, LOUD...and cried, because I was scared, y'all.

I get into the ER and my blood pressure is abnormally high. Hmmmph. And my weight is up 15 lbs from Monday {it's now only Friday}...ERMAHGAWD. I get shown to a room, and a physician looks over my blood work. I started hearing things like "acute renal failure" and "rhabdomyolysis". At this point I'm sobbing, and feeling like I'm going to faint. I was given no choice in the matter, I was being admitted to the hospital for intensive IV fluid management and monitoring. WHOA. Seriously, I've been in the hospital for baby-having stuff and for DKA when I was 16. I used to work in a hospital. I KNOW what goes on there, I KNOW how sick the patients can be. I was fuh-rrreaking.

Fast forward. 4 days of intensive IV fluids. Peeing gallons of water and protein out almost hourly. My CK level at admission was around 25,000, and that indicated that my muscles were swelling and dying, and as they are breaking down, releasing proteins. These proteins then are being caught up by the filters in my kidneys, which overloaded them. The ER doc said to think of my kidneys like a swimming pool after a super crazy summer party: my pool filter is now clogged with hair and the pool is getting murky. Uhhhhhhhhhh.
Thankfully I have zero kidney involvement when it comes to my type 1 diabetes. My kidneys took it all in stride and immediately began to improve and heal. I was told I wasn't allowed to leave until my CK levels came down to below 1,000...remember, normal is 60-400. On Monday, my level came back at 4,300...and I whined and complained enough that I was allowed to come home and rest for a few days before returning to work. I was also told no exercise for 1-2 weeks. Y'all. This shit was craaaaaay craaaaay, and I NEVER EVEN FELT THAT BAD.

Dealing with my diabetes in the hospital was easy. After the Dr on call "placed" me on a "sliding scale" with "regular insulin", I informed all Drs that NO ONE was to even THINK about the management of my sugars, insulin or diet. Do you think that stopped them from ordering a "diabetic diet"? Or prescribing bed time snacks of sugar free pudding and cheese to "prevent hypoglycemia"? Bless it. That's all I have to say. My highest sugar there was 136 mg/dL. Funny how basal/bolus Novolog with carb counting works. Like a Champ. Pffffffft.

So now I'm home. Feeling a bit weak, having muscle cramps, and still spending hours of my day peeing. I gained a total of 18 lbs in 7 days from the fluids and swelling. Mofo 18 pounds. My face is round and puffy and I look 5 months preggo. I'm ready for this to be over!

I have spoken with the gym owners and trainers at great length. They have been awesome, and have a prescribed plan just for me, catered to my delicate, flower like self. I am in no way blaming them for what happened, as it was just a random ass shit storm that occurred in my body. I'm also not afraid to work out again. I'm sad that I have to take so much time off, but alas, my body has to heal!

I was also under the assumption that marathon runners, persons taking cholesterol lowering medications and those that experience crush injuries were the ones that were diagnosed with rhabdo. It never occurred to me that I was at risk. Going from my un-gym like status, under hydrated and working out at 5:30 in the hot as Texas heat...I set myself up for the perfect storm of bodily dysfunction.

So now, here I am...a few days after discharge. And I still feel like ass. My muscles are cramping, I'm tired and have only peed off 4-5 lbs of that fluid. My arms and legs are still
a little swollen, so I am hoping all of this will improve in days to come.

How do you prevent rhabdomyolysis? First of all, again, my diabetes status had zero to do with it. It was more like, hey...you haven't lifted weights in 3 years? How about you take it easy instead of going all Chuck Norris style.
-immediate muscle soreness after a workout
-increasing muscle weakness
-red, rust or tea colored pee {I never had this} {you're welcome}
-muscle swelling
-new workout routine you're not accustomed to....and you just ADR {ain't doin right}
-generalized edema
I was lucky I had peeps to ask what the fudge to do. I could have easily ignored my symptoms and blown them off...then done some major ass damage to my kidneys. That ain't cool. So, being an educator, I'm sharing my story with my public. In hopes that you share it with yours. {as in DO IT, or I will beat you}.

Thanks for all of the love, support, thoughts, prayers, food, texts and emails...I'm a blessed lady!


Tuesday, May 21, 2013

The 'Betes, 101 {Guest Post}

Hey, party people...please welcome my guest poster, none-other than the super famous {well, at least in the DOC} D-Dad with DADs: Frank Wisenski, who blogs over at Blackdogsrule.com
. Please welcome him with sugary, bitchy love!!!

Hi everybody! Welcome to diabetes 101, day 1. Today's topic? Things that can affect blood sugar in a 10 year old girl, that makes managing diabetes so tough, and prevents us from knowing "normal", or having our diabetes (or our children's diabetes) "in control"

1. Food
2. no food
3. drinks
4. exercise
5. no exercise
6. math tests
7. pop quizzes
8. your best friend just got a new "insert cool thing here"
9. cleaning your room
10. horseback riding
11. hormones
12. growing
13. heat
14. cold
15. puppies
16. mom and dad miscalculating carb counts
17. miscalculated carb counts printed on food packaging
18. waking up in the morning
19. not wanting to go to bed at night
20. butterflies
21. going to Costco
22. excitement
23. Disneyland
24. anything school related
25. little brothers
26. when dad says "have you finished your homework?"
27. not washing hands
28. eating more than 1 "free" snack
29. Thursdays
30. playing outside
31. playing inside
32. not playing outside
33. rainy days
34. sunny days
35. Mondays
36. hot showers
37. pizza
38. bananas
39. blue shirts
40. birthday presents
41. Halloween candy
42. going to Nana's house
43. walking down the hall
44. reading a book
45. orange socks
46. car rides
47. crying
48. eating the same lunch today as yesterday
49. laughing
50. kittens
51. breathing
52. stopping to smell the roses
53. Computer games
54. Sunsets

You see, here's the funny thing about diabetes. EVERYTHING can affect blood sugar. Or it won't. Maybe it will. It did last Tuesday. Today? Nope.

They say the definition of insanity is doing the same thing over and over and expecting different results.

The thing about type 1 diabetes that drives us insane? It's doing the same thing over and over and GETTING those different results

Comment below and keep the list going! What affects YOUR sugar????



Monday, April 22, 2013

Gotta have faith

Faith....in humanity...and in the general public has been challenged here as of late. The tragedies that have transpired over the last week have been heart breaking and gut wrenching, completely senseless and make me ache for those so closely affected.

The trust I have in the public has also been challenged in a "people of Walmart" kind of way, too. My new gig as a clinical trainer for a diabetes alert dog service organization has put me somewhat in the spotlight in my small community. Having a gorgeous dog or puppy, in a vest, as my constant companion has invited some interesting interactions while visiting different establishments.
"Is that your seeing eye dog???" As I'm holding my latte, a new bathing suit and bottle of vitamins at Target.
"Is your DOG diabetic!?" Yep, he also wears a tiny insulin pump.
"If I pet your dog, will it bite me??" Indeed, that's why I brought him here.
"Why can't your dog tell me if I have diabetes?" I'm pretty sure that giant Big Red you're drinking with your gut hanging out tells me you have diabetes.
"Paying that much for a service dog is why our country is in a financial crisis" -_-

Don't get me wrong, any opportunity I have to educate people about diabetes alert dogs is a good thing. But please just consider asking generalized questions.....instead of jumping to conclusions and saying asinine things that in no way make sense, or that possibly offend others.
It very much goes along with the stupid shit that people say about type 1:
"Did your mom feed you too much candy as a kid?"
"You/your kid will grow out of that, right??"
"My grandmother had diabetes, and had her leg cut off, and then she died a horrible death..." {thanks for your story of hope and encouragement, asshat}
"My 17 year old cat has diabetes....you should look at the diet plan I have her on"
"You know...if you ate more kale and came to see my chiropractor, you could totally get off of insulin all together" {yeahhhhh, my chiropractor is definitely on the forefront of type 1 diabetes cure treatments...right, Karly???}
The list goes on and on, and I know each and every one of you has anecdotes of your own. It is ALWAYS my first instinct to be an asshole to these people, but then I take a deep breath, bite down on that Xanax I was hiding in my cheek, and know that God wants me to use my powers for GOOD. Educate. Tell them you're less than 5% of the diabetic population. Tell them that nothing will get you off of insulin, short of a transplant. And tell them that while you're super sorry about their grandmother/cat/aunt/rotted off toe, that you're doing great and hope for a better, healthier future.

Please approach me if I have a dog. I'd love to share the good word of DADs and their super powers. Ask thoughtful questions, rub their chin and admire their awesoemness. Just don't say idiotic things, or I will straight up call you out on my blog!
Ahhhhhh, the power of social media.

Please feel free to share YOUR unfortunate diabetical interactions, below...we all need a good laugh.

Sunday, March 3, 2013

Life sentence

Being diagnosed with a chronic disease can be devastating. Whether you're a toddler, tween, teen or almost adult, it can rock your world. Knowing the statistics. Listening to the news, the billions of dollars spent on others with your same disease state. Constantly being screened for potential complications and issues. Having your feet stripped down and examined by the Dr...I think it's just plain humiliating. I mean, sometimes I just can't make it to get a dang pedicure, mmmmk, doc!?

But what happens when you're faced with yet ANOTHER diagnosis. Another blood test that rocks your entire existence. Being told you must take yet another life saving medication just to function daily. Sometimes it's almost too much to bare. But wait...oh wait...life isn't finished with you. Your immune system is in a full on revolt, and launches a destructive war against yet one more bodily system. Why is this happening? Why did I get chosen to bare the burden of this auto-immune hell???

Truth is, once you're diagnosed with one autoimmune disease, you're very much predisposed to others. It's like a genetic lottery. Will your number be picked? And again? What about one more time? Disease grouping is common when we look at autoimmune diagnoses. Crappy part is, all of these disease states are relatively rare, and barely measure as a blip on the public health radar. There are multiple specialists associated with each diagnosis, which means more cash spent on copays, medications and treatments. T1 diabetes has brought most of us here, but how many of you also share your life with an additional AI disease? Rheumatoid Arthritis, Lupus, Hashimoto's Thyroiditis, Graves' Disease, Addison's, Vitiligo, Celiac Disease, Crohn's, Ulcerative Colitis....and these are just the more common.

I personally struggle with my hand basket of random autoimmune issues. Type 1 since the age of 9, Hashimoto's not long after the birth of my first son, Celiac Disease not too far behind that one, and the suckiest by FAR: a rare hybrid of Rheumatoid Arthritis and Ankylosing Spondylitis. I struggle with anti-inflammatories and immunosuppressants trying to treat the pain while also attempting to slow down the damage being done to my body. It ain't fun.

Some days are easier than others. But something as simple as a cold my kids brings home can send me to the hospital..where they want to shoot me full of steroids..which affects my 'betes. So, I feel like this delicate juggling act can disrupt with the tiniest of interferences. There are days I can barely get out of bed, or nights that I sleep for 12 hours straight. It has affected my ability to be the kind of mother to my sons that I wish I could be. That guilt then manifests into a crippling fear that I have passed along my crappy genes to these guys. Yeah he got my amazing dimples and winning personality, but will he also have to face these struggles and burdens as I have? It takes my breath away at times. The only thing that helps is to sneak my fingers to interlace with theirs while they sleep. And listen to their breathing, and know that I am not in control of these things, and all I can do is take this life one day at a time. The advances made in medicine over the last 20 years have been amazing, and I so look forward to what the future holds for me, my husband, my kick ass kids and my patients.

Know the signs and symptoms of other autoimmune disorders. Early detection and treatment is key, just like with T1. We, at the endo's office, routinely screen you for many of the common issues...you may not even realize it. And if you find yourself a sudden collector of suckage, much like myself, seek out the love and support of others! My life and health have been enriched by the thought and care of my husband, friends and family. They can't understand what I'm going through, but they sure know how to make me laugh and which foods make me poop my pants and which aggravate my joint pain. I am beyond a lucky girl.

This week I celebrate my 30th year on this planet, and I am enriched and humbled by all of you, so thank you for your kind words, support and accolades. Being here, now, is pretty damn awesome.