Monday, November 21, 2016

diaOCD


 I sat in my office today looking at the brand new Medtronic 630G insulin pump boxes and supplies spread out on my conference table. 
My patient sat their with apprehension painted on his face. He has been diabetic for the last 10 years, 9 of them wearing a pump similar to the Medtronic Revel still attached to him.
"Is it totally different? Like will I ...have to relearn everything..?". His question was more than valid. This new pump suddenly looked strikingly dissimilar to his current pancreas.
Of course it was different, even if the basic ideology was the same. And this struck fear in my patient. Change often strikes fear in a type 1 diabetic. We have daily routines and rituals that we develop and form. We choose our medications, devices and supplies and then cling to their normalcy as fixtures in our activities of diabetical daily life.



The sound of panic in voices as the call my clinic because of their formulary changes. "But I've been on Humalog for 15 years, how could they possibly expect me to use Novolog??."
Whether it be a new meter, type of test strip, a pump or new lancet device, anything new and unfamiliar causes a type 1 to have a nervous tic. We have our Rain Man routines, and when that is threatened, when we can't buy our underwear at K-Mart, we fret. 

I can tell someone via text how to change pump settings, step by step. I have worn each one long enough that each key stroke is ingrained in my diabetic brain. When my ex, Dr.  C, and I first began dating, he used Humalog, whereas I used Novolog. Our butter compartment in the fridge was suddenly like a throw down between the Crips and the Bloods. His Accu-Chek drum strips mingling with my One Touch Ultras on the floor, like a scene from Westside Story. Each one of us steadfast that OUR way and OUR products were THE best and THE way to go.



Change is scary. Especially when we are talking about a chronic disease that requires daily, almost hourly attention. Rely on your endo team, CDE, pump rep and fellow members of the DOC when faced with decisions regarding change. They are all wonderful wealths of knowledge and experience. The goods, bads and the uglies.

Thursday, September 8, 2016

Dating: diabetes edition


So we already covered the fact that divorce SUCKS. You have to split your diabetes stock pile, you can't rely on your diabetic spouse to have backup insulin/finger poker/test strips when you run out, and you no longer have the comfort zone of that person knowing every inch of your diabetic body. Where do you like to give your shots? Which fingers do you prefer to prick for blood samples? Which long acting insulins do you hate, and which brand of tape do you like for your Dexcom. You don't have a Dia-buddy to help you put your Dexcom in hard to reach places, or fix the tape when it starts to peel up. You don't have someone that can just glance in your direction and instantly "know" that your sugar is low and that you need candy or juice. All of those luxuries that come with a long term relationship while having diabetes slowly spin down the drain and are gone forever. I don't know about you, but I don't just trust anyone to jab a needle into my skin or to get my GrifGrip tape perfectly smooth and in the correct spot.

Dating with type 1 hasn't necessarily been challenging, but I get a LOT of questions. What's that on your arm? Are you bionic? Is that a microchip? Are you actually on house arrest? Are you allowed to eat sugar? Will your kids get it? Will you have this forever? Why do you take insulin when you're high but not when you're low? My buddy's brother was 800 when he was diagnosed and now eats whatever he wants and take shots for it, why can't you do that? Why don't you have one of those dogs? *during a low* Should I call your ex? Do I need to call 911?
OMG YOU GUYS ARE AMAZING FOR CARING BUT JESUS PLEASE JUST CHILL THE EFF OUT. I got this. For 24 years. Without y'all. Let me share on my own. And for the love of all that is holy, don't tap on my Dexcom transmitter. I will literally cut you. With a knife.

On a date a couple months ago I really needed help placing a GrifGrip so I asked my date, a fire fighter, to assist me. I figured he's also a paramedic, he's got this. Omg. I had to go home and rip it off it was crooked and wrinkled and pleated. FAIL. And sexy time? Holy crap. Talk about embarrassing. "wow, you're like..really sweaty..are you turned on..?" *BEEEEP BEEEEP BEEEEP* uhhh no Casanova, my sugar is 55, now hand over my Smarties.

In my college days I kept it under wraps. Didn't tell the dude unless we made it past 3-4 dates. Would test before I left the house and do my shots in the bathroom (I know, ick). And I didn't have to fret or angst about all of this. Because I do worry. Do they see me as damaged goods? Because as a divorcee single mom, I already feel tainted enough, without adding the chronic lifelong and altering disease on top of it! Is it a turn off? Do they see my Dexcom and say "ew, I can't even"?

I don't know that I would ever date or marry another type 1, though. Being the spouse of a type 1 was hard work. The constant worry and anxiety. Making sure snacks and low treatments were always available. Having all of his prescriptions readily available, and pump supplies at the house. Not only was I keeping up with my own diabetes, but his too. And for me, personally, I think it caused a lot of resentment. Let someone worry about ME, let someone grab MY insulin out of the fridge or run by HEB for alcohol swabs. I think for once that would be amazingly sweet. Let someone else worry about keeping fruit snacks or Gatorade around in case I drop low (which I do!). Everyone wants to feel loved and cared for, even the care takers.

So that's all I got, really. Tinder & Bumble are some scary places to meet people...the variety is insane, and the unique attributes of each contender can be quite entertaining. I share some of these over at my private diabetes group Team Diabadass...if you're type 1 and have a raunchy sense of humor, we'd love to have you! 

Friday, January 8, 2016

Divorcing diabetes




Chances are, you know someone who's either going through a divorce, been divorced or is a product of a divorced household. Fact of the matter is, 30-40% of all marriages end in divorce, which is actually an all time low for our nation. But you can barely blink without being surrounded by celebrities marrying and divorcing for various reasons: monetary, adultery, differing schedules or one partner's dislike of the newest Beyonce track. Divorce is everywhere.

That being said, why does it still feel so taboo? Why do I still feel like a failure? Why do I hesitate to admit I am knee deep into a divorce, why do I fret about asking for help? The institute of marriage is held extremely sacred to some, and these people likely have great marriages and think we should too. They want to share their "secret" and want to convince you that this isn't the path God wants for you. They kind of make you feel like a loser. Then there are the ones that point fingers and play the blame game. "Well had you not done such and such, maybe he would have stayed with you"....yeah well..umm NO. We tried. We fell in love while I was a nurse in his budding endocrine clinic and I was fresh out of nursing school. He was 10 years older and one of the smartest men I had ever met. I admired how he approached patient care and advocated for education. He wanted a family, he was a smart ass and he thought I was beautiful and funny. So we got married. Yes there were red flags here and there, but nothing a baby or two couldn't fix, right? What about a few marriage counselors? Writing each other letters mapping out our feelings? Yeah. We fought the good fight. We tried. And now we want to give the other the chance to be happy in the future.

Fast forward 10 years. We have built  a wonderfully amazing pediatric and adult private endocrine clinic. We have thousands of patients that feel like family. Patients whom I share my personal cell phone number with because I truly want them to know they can call if they ever need us. These people truly care for me and the good Dr and our two awesome sons. Through social media many feel like they know my boys and get to share in their daily funnies and goofy smiles.
We are choosing a path less taken by continuing to run our practices and clinic together, even in the wake of deciding to dissolve our almost 10 year marriage. So far, so good. By being able to place the utmost importance on our children and patients we've been able to form a united front and stop being so...so...pissed off at one another!

Not saying I still don't break down and cry sometimes while I'm driving and hear a song that played at our wedding, or when our boys ask why we don't do things as a foursome anymore. It's sad. It sucks. There's no way around making a divorce a fun thing for anyone. Looking at houses, organizing finances, discussing custody agreements...it's anxiety producing. It drives my sugar up. Keeps me from sleeping. Don't even get me started on dating. Sometimes I wish I could take my health issues to him the way I used to so freely. And I catch myself. He's not my best friend and partner anymore. I have to allow him to heal and move on, the way he's allowing me to. We have to learn what our new normal is.

Thank you to everyone that checks on me and the boys. Thank you for your prayers and support. This new season of our life is a stressful one, and we are taking it day by day...and having an amazing family, friends that are to die for and little boys that make laughing so hard hurt is certainly helpful.