Back On The Unicorn.

Back in the day, I had a fairly consistent workout routine in place that involved our Xbox Kinect and games like Dance Central (2 is my favorite, but 1 and 3 are pretty okay too) and Just Dance. I was able to stick with it because 1. no matter how crappy the weather might be, I could still enjoy what I was doing, 2. I didn't have to pack up a bunch of stuff or wear a backpack of some kind, 3. I didn't have to exercise in front of other people, and 4. did I mention it's dancing? 

It was fun, and I was good at it. I could genuinely say I liked it, and being consistent with exercise was a habit I had fallen out of, so this was kind of a big deal for me.

Then I got pregnant and working out became so uncomfortable (can't! ::pant:: breathe! ::gasp::) that I just gave up for a while. And then I had a c-section and sitting up, let alone, dancing, was a challenge for several weeks, so I had to take time to recover from that. And when I started to feel like a version of myself again I just put it off, because who wants to work out when you could snuggle a baby instead?

But one can only make that excuse and wear stretchy pants for so long - plus your kid can watch you work out from the safety and amusement of a nearby Pack 'n Play, so really, no excuses here - so I'm getting back on the unicorn/horse. I also know that regular exercise decreases my insulin requirements, and this "new normal" post-pregnancy but sans exercise is reminding me that I need to get back to it. (My "old" daily insulin total was about 75% of what I'm currently requiring.)

Last night was my first workout - one that would have been really easy pre-pregnancy; a 20-minute "easy start" preset list in Dance Central 2's "Fitness" option - and I did not like it. My body didn't move as quickly as I recalled; things jiggled that never did before; I felt sluggish and anything but nimble. I was uncomfortable the whole time. I felt like trying to dance in jar of peanut butter; my limbs slow to react and heavy with muscle memory loss. "But you've done this before!", I lamented. No matter; I was starting from below zero, all over again.

But I did it. I completed a workout, and I'll do it again until those feelings come back. I already feel better today (funny how that works...), and that helps remind me how important it is to make time for this each night.

Onward!

Post-Pregnancy Resolution.

In what comes as news to exactly no one, pregnancy messes with your body, big time. I've read so many pregnancy advice blogs that I can't even backtrack or credit where I obtained this philosophy, but I noticed that there seems to be a common, resounding theme that "it takes nine months to get that way, so expect it to take at least another nine months to get back".

Ever since my college days, I've struggled with weight - and shortly before becoming pregnant I had actually made some significant strides in a direction that pleased me. Many of the changes I made (like avoiding diet soda and exercising frequently) were well-timed, as I became pregnant shortly after adopting those new practices. But then my belly started to grow inversely to my lung capacity, and by the end of the second trimester I would become out of breath simply from climbing a flight of stairs, so exercise got put on the back burner. And really, aside from carrying that adorable, cooing 16-pound weight around with me, I haven't brought exercise back into the equation yet.

What seems most interesting to me is that pregnancy was maybe the first time in quite a while that I felt good about how I looked. The stretchy clothes probably helped, but to me, my body was finally doing what it was supposed to do and I didn't feel guilty or ashamed of what size I became. My size felt purposeful - perhaps the most significant difference - and pregnancy allowed me to feel a bit of the "normal" I'm not used to enjoying. Weight gain? Awesome! Stretchy clothing? You bet! People often remark on your body when you're pregnant (which, in itself, can be a good or bad thing), and for a change, I could accept those compliments as geniune and true. Why yes, I do look gorgeous today. My belly; I know! Isn't it great?

But once that little fluffy-tailed Rabbit left the premises, that purposefulness left with her. My stomach deflated like a tiger-striped balloon, if you will, and the process of regaining my abdominal strength after a c-section was hard, and continues to be.

I'm now five months post-pregnancy and wondering how in the world I'm going to get back anywhere close to where I was, health and body-wise. (Is it normal to take much longer than nine months to "get back"? Is there really even any "getting back", or just "getting close"?) The surgery left a part of my stomach right above the incision site numb to the touch; advice told me that feeling would come back, but it hasn't fully, and I'm wondering if it ever will. For days, and even weeks, after my surgery even sitting up out of bed was a struggle, as my stomach muscles sloooowly mended themselves - I had to press myself up with my arms to a sitting position, because my stomach couldn't help me do it.  Laying on my stomach feels uncomfortable still in a way that causes me to avoid doing it. Getting up from a sitting position on the floor is something to see (please don't watch, ever). Things just aren't back to where they should be, yet.

Part of me thinks this should be expected, and that I should be patient and forgiving of myself - you made a friggin' person, for crying out loud! But there's another part - the one who watches those around her seem to bounce back so quickly, the one who refuses to buy all new pants, but can't feel good about still having to wear some maternity clothes, the one who wonders, is this just how I'm going to look, now? - that's frustrated and knows that this extra weight and inactivity are contributing in some way to the lackluster results in my diabetes data, too.

I think I'm starting to feel what a few people experience as it relates to the DOC: they come in with a not-the-norm view, and they sometimes find that the sharing social media promotes becomes a negative instead of a positive - a reminder, each time they see a post, of how different they are, instead of hearing that "me too" that we all long for. Instead of feeling happy for my friends and their successes in bouncing back post-baby, I find myself feeling... resentful. It makes no sense, and I don't want to feel that way, but I seem to do so anyway.

And here's the rub: every time I see someone talk about what's working for them in terms of attaining a healthy weight, I feel myself push away. I feel almost angry that this is so hard for me when others seem to find it so easy, yet I don't seem open to new ideas on how to achieve anything there.

I may not yet know how resolution will develop here - getting things done for myself with baby in tow proves a challenge - but I know that it's a place I need to focus on, and soon. I can't afford to let the negativity mope around much longer.

Letting The Dust Settle.

I once heard someone note that when you have a baby, "your life just kind of explodes". I'd like to add to that thought and remark that when you have a baby AND you have diabetes, your life just kind of explodes but then all of those fragments proceed to land on their self-destruct buttons. Life post-baby seems to resemble some sort of Michael Bay-directed cinematic adventure (with the addition of an adorable infant).

The total takeover of mind, energy and heart that a child brings has been... intense. But after a few months, I'm feeling that we're adjusting okay to this new version of normal. Our mornings look a little different, and not just because we're up waaaay earlier now - there exists a whole new set of activities that run in tandem with ours in order to get another human ready for the day. But I'm finding that I don't even mind all that, because that first grin of the morning - the one where the dimple in her right cheek surfaces; where her eyes widen, then light up with recognition when we lock stares; where she kicks her legs jubilantly and, with clenched fists, swings her chubby arms around - sets the tone for everything else. No matter what else may happen throughout the day, this daily treat remains the highlight. The joy in that moment fills up my heart, and I continue to be astounded at how this perfect little person could have been made by me.

Sorry, I'm baby gushing. I do that now.

While I may be adjusting to the shift in schedules and priorities, my relationship with my health has become more tumultuous. Diabetes is running alongside me like the child, arms flailing with panic, whose school bus drove right by them but never slowed down: "Hey! HEY!!! Stop the bus! You forgot me!!" I see you, diabetes - I just don't have the time to come to a complete stop for you. Don't throw yourself in front of me, okay? And no angry calls from your parents.

Where I once might have seen patterns and predictability, I now just see a jumbled mess... but maybe it's not as bad as I think it is, because I'm comparing it to the super-intensive routine I had during pregnancy. I saw my endocrinologist a few weeks back and after studying my CGM and insulin pump downloads for a bit, the corners of her mouth began to turn up.

"You know...." she paused, shuffling papers twice, and then three times, looking back to double (and triple) check herself, still smirking. "I'm actually really happy with where you're at." The tone of her voice indicated that even she couldn't believe she was saying that.

Pause. "I'm sorry... you're what?"

Laughter. "I mean, with most new moms, the baby comes and diabetes goes out the window. But I can see that you're still testing. And you're bolusing! I mean you're not entering carbs most of the time, but you're remembering to take insulin... at all. I can be happy with that if you are."

Well, that was true. And when we checked my A1C, she and I were both pleasantly surprised when I clocked in at 6.5.

"If you're okay with it, I really don't think we should make any changes yet. Let's let the dust settle a bit more before we start changing things - you already have enough to adjust to right now."

I'm okay with it.

I think.

Revisit: There Is No Spoon.

After reflecting on the past few days' CGM graphs, I'm reminded of this post from 2011. Pregnancy is this exaggerated version of what living with diabetes has been like for me - with 100% less predictability, more exaggerated swings, and super stubborn blood sugars. While I want to achieve "perfect" numbers during this pregnancy so that we can avoid all of the stuff no one ever wants to deal with, I also have to remember that perfect doesn't exist in the real world.

But, perhaps, my best will still be good enough.

* * * * *

I'm not sure where it began.

It probably wasn't a singular moment or comment that began that ever-growing snowball. It likely was all of those little things, laid one by one on top of another; melting into a suffocating landslide of guilt and shame.

Probably, it was the college years when my A1C started climbing and I felt as though I was doing all I was able and willing to do at the time - but it was never anywhere close to good enough.

It could have been the many, many times where an endocrinologist visit ended in tears, because my answers were never the sort that could pass their test. It could have been the dread of those appointments eventually causing the pre-appointment build-up of apprehension, anxiety and just plain fear. (And then, beating myself up over canceling the appointment.)

It could have resulted from not getting to hear the experiences of other real-life patients - of not knowing one single soul on that college campus who also had type 1 diabetes. I didn't know anyone else there who was living this same routine of shoddy math, bodily defiance and food distortion that I was.

It could have been my almost certain belief that one day, because I could never "get it right", I'd inevitably lose my eyesight. Or kidneys. Or toes. Take your pick.

It could have been realizing that "good enough" might not actually be.

It was seeing the impossibly low goals that my doctor had for me, and wondering, "How on earth do people do this? How do they do this, and still live a life? How can they enjoy that life, when all they're apparently thinking and worrying about is what diabetes is doing to them?"

It was being absolutely convinced that every single other diabetic in the entire universe must have this figured out, except for me.

I was convinced that I was the only screw-up. The way my doctors reacted to my self-care only reinforced that belief - because the only reason they'd be so shocked and disappointed would be because I was their worst patient, right? Because everyone else was achieving these kinds of numbers? Isn't that what was happening?

It was partly because questions were phrased, "Why are you still high in the mornings?", and "You are low way too often; what are you doing to cause that?", and "Why didn't you do what I told you to?".

It was beating myself up over my failures, then resigning myself to futility.

It had never occurred to me that a "perfect" diabetic wasn't actually a real thing. My past experience had shown that the medical world (which was all I had at the time, as this was B.D.O.C.) tended to make it very clear that there is an acceptable range, and it's [here]. And if you can't get yourself there, it is because you aren't trying hard enough; you aren't disciplined enough; you aren't following their guidelines as you should be. The focus of blame tends to be on the patient's ability to self-manage, rather than the disease itself.

It's one of the greatest gifts that bonding with this community has given me. Though it took a while for this to really sink into the parts of my brain and heart that can truly believe something, I think I can finally start to believe that there is no "perfect". There is "try your best"; there is "learn from your mistakes"; and there is "never give up". There will be questions without answers. There will be numbers without logic.

There is no productive benefit to berating myself. There is no positive benefit to my health when I internalize what I perceive to be "failure".

I can choose to let the outcomes of my diabetes decisions define who I am and how I live my life, or I can choose to accept the reality that the only parts I can consistently control are how I feel and how I react.

I have begun to accept that there is no spoon.

Lessons Of Perseverance.

Nothing worthwhile comes easily. Work, continuous work and hard work, 

is the only way to accomplish results that last. 

- Hamilton Holt

(ONE OF MANY SIZES OF) SKINNY JEANS FINALLY FIT YOU GUYS.

Confidence comes not from always being right, but from not fearing to be wrong.

- Peter T. McIntyre

Nothing builds self-esteem and self-confidence like accomplishment.

- Thomas Carlyle

A life of rich fulfillment comes to those who are also thankful for the setbacks.

- Author Unknown

You need to be aware of what others are doing, applaud their efforts, acknowledge their successes, and encourage them in their pursuits. When we all help one another, everybody wins. 

- Jim Stovall

Why do we fall, sir? So that we might learn to pick ourselves up.

- Alfred Pennyworth

When the world says "Give up", hope whispers… "Try it one more time".

- Author Unknown

Ch-ch-ch-ch-changes.

Over the course of several months I've been making small but cumulative changes to things like what I eat, how much I eat, how much I exercise, and most importantly, how my mind frames all of those activities. This isn't an entirely comfortable post for me to write because it touches on some things that I'd rather keep locked away in my mind somewhere, but I'm charging ahead with some of it anyway because that's how I roll.

I don't think I want to get into specifics about everything I'm changing (partly for reasons I'll explain below)... but I'll mention a couple.

Busting A Move

Starting in February-ish, I made a renewed vow to get in the exercise I need. It seems to go in cycles for me - I'll be on a streak for a while (three to five workouts a week), and then something trips up my pattern and I go weeks - or months - without. I'm proud to say that, at least over the summer, I've been pretty consistent. That's kind of a big deal for me. 

What changed was that I finally found exercise I not only enjoy doing, but that I actually look forward to all day - and not only for its calorie-burning properties, but because it makes me feel good. I change it up occasionally with a walk outside or some time on the elliptical, but for the most part, it's a Dance Central 2 party in my basement every day after work. The exercise I'm doing is fun enough that it doesn't feel like work, most of the time - and if I'm horrible at it, the only creature who has to witness it is my dog. He doesn't mind.

That Pesky "Eating" Thing

Whatever it is about attending diabetes conferences - the change in routine, the running around, the excitement of seeing friends and doing something that excites me - they sure do seem to diminish my need for the whole food thing. Especially during that first week of July while in Florida for FFL, I discovered that I wasn't eating nearly as much as I was used to, and... nothing bad happened. I didn't feel as hungry as I typically had, and when I did want to eat, I wanted smarter choices (fruit, veggies, protein, and the least-processed forms of most of those). Huh. 

This began an experiment for me, which is is still running: can I eat smaller portions and still be "okay"? Can I eat just until I stop feeling hungry, instead of eating until I feel "full"? Can I distinguish the difference between eating to ease boredom and eating to ease true hunger? Can I cut stuff like diet soda almost completely out of the picture? Can I steer myself towards vegetables more often?

Can I view food mostly as fuel, and make choices based on that viewpoint?

So far, the answer is "yes". And, as much as I hate to admit it, I am feeling so much better lately.

And Here's Where Things Get Uncomfortable

(This is the part where I imagine that you say, "Why does she hate to admit that?") Well, it's a complicated answer. The short version is that I don't like being wrong, or having to admit that I can't eat/exercise/whatever like those around me and stay in the kind of shape I'm comfortable being in. My metabolism will bring me to - well, where I was at the start of this year, if I do nothing. And I don't like that place one bit.

I hesitate even talking about this part of it, because I don't want anyone else who may be in a similar situation to feel that they're doing something "wrong". I don't want anyone to say "But I'm larger than/shaped like she is...what is she trying to say?" I don't want to make anyone else feel bad about their own situation by talking about my own. 

But for me - I miss feeling "in shape". I've missed that feeling for a while now.

Anyway, my point here is that I'm making a concerted effort to do things that result in better health for me. From what I can tell by weigh-ins at my doctor appointments, how my clothes fit, how I feel while exerting myself, and how I feel overall - things are going well. I'm not going to talk numbers here, though. You won't find any weigh-ins, nor mentions of pounds lost.

Instead, you'll probably find me tweeting about successful workouts (and feeling pride in how not-out-of-breath I am during them) or how I feel. Because how I feel matters more to me than my pants fitting better - but I hope that one can continue to lead to the other.

Yesterday's 1.5 hour walk - and only one of us was ready to fall over at the end of it.
Stubby Corgi legs are not made for distance, it seems.

Would, Could... But Should?

"Would you, could you, have a treat?

Can you snack on something sweet?"

I could eat, I would eat

That little treat

But should I, would I

Eat that sweet?

I could eat them at every meal.

I could eat them with such zeal.

I could eat them day or night.

I could eat them out of spite.

I could eat them on the go.

I could eat them all - YOLO.

But I would not, should not

Eat all those treats;

All those sweets

Those tasty treats.

I know I can, I can eat that treat.

But should I invite that glycemic leap?

But I want it! It's yummy!

It would fit so well inside my tummy!

(But you don't need it, you dummy...)

Those treats are right there for the taking

Despite the insulin my pancreas isn't making.

Just a few buttons pressed; it's not painstaking

But the true cost - to that, I'm waking.

The "just one"s add up.

The "I could"s are expensive.

The "once in a while"s seem to travel in packs.

The urges are sudden; sneak attacks.

I can, I have, I won't, I could

Another story, that dastardly "should".

Learn and try and learn once more.

I will, I can, I have before.

After assessing the accumulation of this past weekend's consumption - cake at a graduation party, desserts at a family reunion, s'mores at a baby shower (yes, you read that right), ice cream on Monday... I've got some work to do.

Failing.

I want to show you what it isn't.

Failing doesn't try. Failing doesn't care. Failing gives up when things are at their most precarious; right before the suffocating weight of darkness gives way to that tiny sliver of light. Failing throws up its arms to indicate surrender; not with clenched fists to promise a renewed fight.

Failing is a lie that guilt feeds you.

Failing doesn't bother to respond, or care what happens next. Failing is giving up. Failing is refusing to try.

Failing is not determined by a number or test result.

Failing doesn't keep working to find a solution; get up at 2:00 am to check a blood sugar; show up for their doctor appointments.

Failing accepts defeat. Failing internalizes fear. Failing believes that fault only lies within itself.

Do you know how many times I, and so many others, see those same cruel results after our hard work? Do you know how many people are out there living healthy, happy and completely imperfect lives?

Failing is good, because it requires effort to fail. Failure can't happen without some sort of action. And in so many cases, failure upon failure happens before success does.

If that's what "failing" looks like, sign me up.

image credit

I'm Not Sick, But I'm Not Well.

It's tough to say where it started; I only know that it's here, now.

A need to force a smile. Joker's block. (That's like 'writer's block', but for humor, right?) A propensity to tear up at the small things (which, actually, is how I am all the time). More than one person asking lately, "Are you okay?", with me dismissing their concern.

I hesitate to call it depression - because I've felt that before, and what I'm feeling now both disseminates far less deeply and disappears far more quickly.  I'm thankful for my friends who share their experiences with depression, because it causes me to be more self-aware of my own state of things, and it helps me feel more okay about seeking help if that should be the case for me. (And this time, it really is me, not you guys.) But no, I don't think it's that. Not this time.

It's a general sense of "feeling down", and it's looming like a small raincloud over my head these past few weeks. Like Eeyore, but less endearing.

I'm working my way through it, day by day. Whether my mood actually becomes better or just becomes more manageable - I'm not sure.

And why? It has been a number of small things; things that when they occur don't seem like much, but when I zoom out to the big picture, I go "Oh. That. That's a lot of things. Makes sense now." (Apparently my internal monologue is full of staccato sentences.)

The difference here, and most of the reason I'm fairly certain this is more "being down" and not "being depressed", is that I am more equipped to work on these things. And - this being the big part - I don't let my stubbornness get in the way of deciding to act on those. I can recognize myself feeling this way about a particular aspect of life, and within a relatively short amount of time, I can say to myself "Okay, I can either continue to be mopey, or I can actually do something to improve my situation." I can identify tangible things I can do to help myself - for example, frustration with a current job could translate to brushing up the resumé and looking at what else is out there - instead of allowing myself to aimlessly wallow.

The part I've come to now is more difficult - dealing with the things I cannot effectively change. In the past week I've experienced loss of two sorts: an old friend, my age who had also had T1, passed away (not sure if that played into what happened or not), and I've gone through the emotional roller coaster with family as my sister-in-law first learned she was pregnant, and subsequently found she had miscarried. There are other situations as well.

I'm not sure what I'm really trying to say, other than to say that I'm here, and I'm waddling through a bit of stuff at the moment. Writing this also helps me mark down when I've felt this way - blogs are often an online journal, after all.

I'm reminding myself that I'm not powerless to work on some of it, and perhaps I just need to be a bit more patient with other aspects. And the rest? I'm not sure, but I'm doing what I can to deal with it in a healthy way.

(Post title nod to Harvey Danger.)

Giving Glooko A Go.

Have I ever told you guys that I never log anything, ever, when it comes to diabetes?

It wasn't always like this. As a child, my parents were very diligent about making sure we wrote down everything we were supposed to - food, blood sugars, insulin, exercise, you name it. But as I got older, I somehow lost the skills/motivation/energy/desire to do it. Logging is something I struggle with. (And not typing "Loggins" was something I struggled with just now. Typos are my danger zone?) I'll download my Dexcom data and insulin pump settings in a last-minute frenzy before doctor appointments, and that's about as far as I go.

The reason I'm telling you this is that I recently got to try out the mobile app (which is free) and corresponding cable (which can be purchased for around $40 in the U.S.; $50 in Canada) from Glooko, which are "simple tools for people with diabetes to download their meter to their iPhone or iPod touch" (wording taken from the original email they sent me). And it really is that easy - I downloaded the app on my phone, plugged in my purple UltraMini, and with a few touches of the screen, off we went.

Thanks for the heads up, dude.

History in list form...

...and in the traditional chart.

I do like the fact that Glooko is "plug and play" - hooray for no manual entry, because I would never bother with it if that was required - and when it's done downloading, I can email the logbook file to myself, my doctor, or whomever. The app is super easy to navigate, and I had options when it came to sharing my logbook:

I can't see any reason why I won't have logbook entries to take with me to the doctor now. I mean, really. This cable and app combination couldn't make it any more simple. And, there is a food database included in the newest version of the app - convenient, but I haven't played around with that feature much yet.

What I do wish is that 1. the app was available for Android phones, and 2. more glucose meters were compatible with it. (The good news is that Glooko is already aware of and is working on those "wish list" items, so hopefully we'll see more integration soon.) The list of currently compatible meters includes:

In my dreams, I'd be able to download from my Ping meter, the Verio and the UltraMini all into one glorious, colorful chart. And Kenny Loggins would be there, wistfully gazing into a pond, while a unicorn tries his best to photobomb us. (See? It all comes full circle.)

Disclosure: Glooko kindly offered to send me a free cable to try out, with the hope (but not the requirement) that I would share what I thought of it. They probably weren't expecting the unicorn tie-in, but that's how the cookie crumbles sometimes.

 UPDATE: I couldn't help myself:

Dancin'! Dancin'!

Ever since the beginning of the year, I've been meaning to find some different ways of getting my exercise on. Originally Aaron and I thought we'd give P90X a go, but when we realized what was actually involved (holy crap, are you kidding me?) we knew that wasn't a realistic program for us to start with. I then set my sights on something dance-based, because I knew I'd likely enjoy that more than anything else - and if you enjoy it, you're more likely to actually do it, right?

I had talked to a few people on Twitter who had done stuff like Zumba and TurboJam. I'm sure those programs are wonderful for some, but really, they just intimidated me. I mean, look at the blonde lady on the TurboJam site. She looks way too happy about working out. I don't trust her face.

Then my friend George wrote about getting a Kinect, and using Dance Central 2 for exercise. For one, George has good taste so I probably would have tried it based on his recommendation alone, but secondly, the trailer video he shared in his post made that game look SO FUN. Who doesn't want to shake it to some Montell Jordan or Missy Elliott?

Or Chingy. Five stars. NBD.

Long story made blogable, Aaron was able to find a Kinect and DC2 on that list that Craig has (we already had an XBox), and now our basement living room has become a dance floor. I did my first "real" workout with it yesterday, and I'm telling you - it didn't feel like 30 minutes! I actually had to double check the time because I didn't believe I'd been at it that long. I also love that unlike using the Wii for example, I don't have to hold a remote or stand on a board for it to give me feedback on how I'm doing.

So, for now - that's what I'm doing. What exercise do you all enjoy when it's too cold to venture outside?

I'm Not Great At This.

I rely on my CGM for insulin dosing decisions, and I wear those sensors until they sputter out. The ends of the adhesive get so frilly they start to resemble a tutu.

My A1C has risen each of the last 3 times it's been tested in the past year. Not dramatically, but steadily. It is not currently under 7%. I have mixed feelings about that.

I make food decisions that could stand to be improved. I order a cheeseburger when I should order a salad. With the exception of the past few days, I usually have a few diet sodas a day. (I've switched to coffee, iced tea and water for the time being.) I'm sitting here eating a spoonful of peanut butter with chocolate chips on it as I type this. Low carber, I am usually not.

I don't test as often as I used to, or as I "should". My testing frequency ebbs and flows, and right now, it's ebbing like a boss. I bribe myself with new (not originally intended to be) meter cases to get myself to test more often. (Sometimes, that works. Sometimes it doesn't.)

I reuse insulin pump tubing and cartridges. I fill cartridges from multiple insulin bottles and pens, because I don't want to waste the little bit that's left at the end.

 I don't log my numbers. At all.

There are nights where I don't take my thyroid meds and vitamins because I'm just too tired to mess with it. It literally would take me 30 seconds, but I don't do it. I can always remember my morning ones, but evening is a different story.

Exercise is... well, you can guess. I don't work out often - it's either that I don't have workout clothes clean (lame), or I'm already tired (hello, exercise and taking all of my meds would help this), or my blood sugar is already dropping (or too high, or planking, or or or...).

I often don't notice that I'm out of pump supplies until I try to do a set change, only to find that I've nothing left to change with. (This is where that "reusing" comes in.)

I learn the same lessons over and over... or, rather, I'm reminded of them. Sometimes I change my behavior, sometimes I do not. A lot of times I change, but it doesn't stick.

I don't have this all figured out. I don't have all of the answers. I'm not great at being "perfect" (whatever the heck THAT is).

I'm living with this the best way I can at any given moment.

There Is No Spoon.

I'm not sure where it began.

It probably wasn't a singular moment or comment that began that ever-growing snowball. It likely was all of those little things, laid one by one on top of another; melting into a suffocating landslide of guilt and shame.

Probably, it was the college years when my A1C started climbing and I felt as though I was doing all I was able and willing to do at the time - but it was never anywhere close to good enough.

It could have been the many, many times where an endocrinologist visit ended in tears, because my answers were never the sort that could pass their test. It could have been the dread of those appointments eventually causing the pre-appointment build-up of anxiety and just plain fear. (And then, beating myself up over canceling the appointment.)

It could have resulted from not getting to hear the experiences of other real-life patients - of not knowing one single soul on that college campus who also had type 1 diabetes. I didn't know anyone else there who was living this same routine of shoddy math, bodily defiance and food distortion that I was.

It could have been my almost certain belief that one day, because I could never "get it right", I'd inevitably lose my eyesight. Or kidneys. Or toes. Take your pick.

It could have been realizing that "good enough" might not actually be.

It was seeing the impossibly low goals that my doctor had for me, and wondering, "How on earth do people do this? How do they do this, and still live a life? How can they enjoy that life, when all they're apparently thinking and worrying about is what diabetes is doing to them?"

It was being absolutely convinced that every single other diabetic in the entire universe must have this figured out, except for me.

I was convinced that I was the only screw-up. The way my doctors reacted to my self-care only reinforced that belief - because the only reason they'd be so shocked and disappointed would be because I was their worst patient, right? Because everyone else was achieving these kinds of numbers? Isn't that what was happening?

It was partly because questions were phrased, "Why are you still high in the mornings?", and "You are low way too often; what are you doing to cause that?", and "Why didn't you do what I told you to?".

It was beating myself up over my failures, then resigning myself to futility.

It had never occurred to me that a "perfect" diabetic wasn't actually a real thing. My past experience had shown that the medical world (which was all I had at the time, as this was B.D.O.C.) tended to make it very clear that there is an acceptable range, and it's [here]. And if you can't get yourself there, it is because you aren't trying hard enough; you aren't disciplined enough; you aren't following their guidelines as you should be. The focus of blame tends to be on the patient's ability to self-manage, not on the disease itself.

It's one of the greatest gifts that bonding with this community has given me. Though it took a while for this to really sink into the parts of my brain and heart that can truly believe something, I think I can finally start to believe that there is no "perfect". There is "try your best"; there is "learn from your mistakes"; and there is "never give up". There will be questions without answers. There will be numbers without logic.

There is no productive benefit to berating myself. There is no positive benefit to my health when I internalize what I perceive to be "failure".

I can choose to let the outcomes of my diabetes decisions define who I am and how I live my life, or I can choose to accept the reality that the only parts I can consistently control are how I feel and how I react.

I have begun to accept that there is no spoon.

Screw You; I'm Awesome.

I was minding my own (and my dog's) business on the bike trail, which parallels a well-traveled road near my house. Billy and I had just thrown down three miles on that bright, sunshiney afternoon, and were on the homestretch when Billy decided he needed to stop and do a stretch of his own RIGHT THAT MINUTE AND IT COULDN'T WAIT.

The enabler in me had crouched down to pet him while he rested, when from the road, I heard:

"FATASS!"

Since no one else was on the bike trail at that moment, and I could therefore make no other logical conclusion than he had been regarding me, I looked up. What greeted my eyes was a teen-age male, holding a very large beverage with a Sonic logo on it, rolling by in his pick-up truck.

My first thought was, "Wow."

My second thought was, "Dude, screw you. I'm awesome."

That's the thing - here I was, being the one getting exercise, and he was the one spectating from a vehicle.

I was doing something - he was merely the critic. It reminded me of a favorite quote of mine; part of which in engraved on a tiny paper weight that a family member gave me many years ago.

"It is not the critic who counts: not the man who points out how the strong man stumbles or where the doer of deeds could have done better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood, who strives valiantly, who errs and comes up short again and again, because there is no effort without error or shortcoming, but who knows the great enthusiasms, the great devotions, who spends himself for a worthy cause; who, at the best, knows, in the end, the triumph of high achievement, and who, at the worst, if he fails, at least he fails while daring greatly, so that his place shall never be with those cold and timid souls who knew neither victory nor defeat." - Theodore Rosevelt; April 1910

Because that is what matters, in diabetes and in life. It matters that you're in the arena, and you're trying.

So screw them - you're awesome.

It's Going Around.

I wasn't planning to post anything today, but reading Kerri's post yesterday, and Scott's post today struck a nerve.  Their words echoed what I've been feeling for a while now, and I started looking a little harder at my own situation.  I realized that I'm not doing anyone any favors - especially not myself - by not talking about what's going on.

I've got a touch of the Diabetes Burnout, folks.

It's horrible timing, too, for me to not be testing as often - as I mentioned yesterday, I'm not consistently feeling low symptoms the way I used to.  I'm still wearing Jim all the time, so I think that somewhere in my mind, I'm softening it for myself:  "It could be worse."  The problem is, it could also be a lot better. 

I talked about getting back on the horse (or unicorn, if you prefer) a couple of weeks ago, and I had hoped that writing a blog post about it would be the accountability nudge I needed to ramp things back up.

"Seriously, Kim, I'm right here. 
Ready when you are. 
Aaaaaanytime now."

But it didn't work.  I'm still not "feeling it" when it comes to the super-attentive self-care I once had.  I'm still doing the necessities - taking insulin (though not usually 15 minutes before eating anymore - something changed, and now doing that makes me go low before eating), taking pills, and doing a fasting BG check.

Past that?  It's a bit of a jumble.  It's "Jim is probably right".  It's "I'll test in 10 minutes", but I space it off, and 10 minutes become a few hours.  It's "This looks like 65 carbs.  Yep."  It's "I'd rather eat something right now to head off this low, than take 20 seconds to pull out my pump and decrease my basal rate".  There is slackery of epic proportions going on here, and when I start to think about where I was a few months ago, and where I am now, it's a bit of a downer.

When you then throw in my wish to start a family sometime in the near future, it transitions from downer to "What the heck are you doing?".  Except that my response to that right now is:  "Meh."

I haven't had any ODST requests thrown my way lately, and I'm embarrassed to say that I'm a little glad for that.  How do you comfort, guide, or otherwise advise someone else who is struggling, when you can't even get your own sheet together?  (And by "sheet", I mean a logbook, of course.  Wait, no I don't.)

Then last night, while at dinner with friends, I mentioned wanting to have a party (and cake, dammit) for my 25-year diabetes anniversary coming up in April - to which I was met with blank stares.  No one seemed to get why I'd want to celebrate that, much less with cake.  I don't expect everyone to understand this whole diabetes thing, but it wasn't the response I expected.  The whole thing left me feeling a bit down.

I've got an appointment with my P.A. tomorrow (who plays the part of endocrinologist for me), and I'm hoping she has some ideas - because I'm all out.

Didn't See That One Coming.

"And what are you here to see the doctor for today?", the nurse asked; her eyes remaining on the three-inch-deep pile of paperwork that is my medical file. 

It's a question that gets asked at every visit, even though I'm always there for the same reason.  "Oh, just the usual diabetes check-up, you know?"  I watched her scribble a few things down, and then she asked what medication I'm taking, which I always have to struggle to not laugh at.  "Well, it should all be the same as the last time.  Do you want me to list them all again?"  She shook her head.  More scribbling.

She checked my blood pressure - 126 over 76 - and we talked about pregnancy (hers in the past, and the one I'm hopeful for in the future).  She drew some blood.  She wished me luck, and left the exam room.  I relaxed, and waited.

The wait was so long that I began to wonder if they'd forgotten I was in there.  I Facebooked, I Twittered, I checked my blog stats.  I browsed the forums on Juvenation.  I considered reading an issue of People, but decided against it.  (Magazines in medical offices have to be some of the most germy things out there.)

Eventually, the door swung open, and my P.A., "D", walked in, smiling like usual - except this time, there was a little something behind that smile.

"Hi Kim!  How are you?"  We exchanged pleasantries, but she knows me well, and got to the point she knew I was anxiously waiting for.

"You know we checked your A1C today, right?", D said, with a bit of teasing in her voice.

"Yep!  How'd I do?" 

"Guess."

Oh, this game.  We do this every time.  Like always, I had brought all of my "reports" - the Dexcom data, two weeks of logs I had downloaded from my pump and meter, and my pump settings.  Jim's memories of the past two months led me to believe that I might have actually broken the 6.5 line, and I went a little bit gutsy with my response.  "6.3?"

Her smile broke into a grin.  "Nope.  Guess again."

I turned my head slightly and squinted at her; disbelieving.  "6.2?"

"Nuh-uh.  Guess again."  Her grin grew even wider, as did my eyes.  "What?  Seriously?  Okay, I can't guess anymore.  You'll just have to tell me."

There seemed to be an inaudible drumroll.  Then....  "5.8!"

My jaw hung open, and the corners of my mouth slowly turned up into a goofy grin.  I started laughing.  I didn't know what to do - but she did.  D wheeled over and showed me the proof, right there on the lab report. 

All I could do then was let out a single "Huh", and then, "Are you sure that's right?  I mean, I figured I'd be lower than last time, but... wow.  Wow!"  She assured me that it was, indeed, correct.

I don't remember what we really talked about the rest of the appointment.  I was in too much of a daze - first shock, and then amazement, and then realization - that I'd finally achieved that impossible dream I had of an A1C under 6.  I still can't really believe it, even as I'm typing this.  I know she asked me if I was having a lot of lows (I asked, "Um, define 'a lot'?"  We determined I was doing okay.), and she wrote me some new prescriptions.  She told me that she was proud of me, and of all of the hard work I'm doing.

My head was swimming with thoughts, with one treading water a little bit better than the others:  that's a great baby-building number.

On her way out, she chuckled.  "Well, I think I can guess what you'll be blogging about tonight!" 

She knows me well.