This post is a mix of general life questions, but also about my diabetes.
I’ve currently reached what somewhat of a crossroads in my life. Firstly, in regards to my diabetes; For the past 17 or so years of living with this condition I would say I’ve been approaching my control with somewhat of a complacent attitude. That’s not to say I have never tried, but rather I never really looked into how to achieve better control. In fact, until recently I thought that I was a very well controlled Type 1 Diabetic. Being diagnosed at the age of 7, in 1998, like many young children with diabetes, my A1cs for the preceding 10 years were by no means ideal. Having recently requested a list of these, I discovered them to be ranging from 7 to the high 9s throughout this period. Since I was 18, or roughly since I finished secondary school, my A1cs have ranged in between the lower 6s to the mid 7s, numbers that my diabetes care team were always very pleased with. In fact, I rarely ever had a checkup where they would say here is what you can do better, as they thought I was controlling my condition extremely well. I thought I was controlling my condition quite well, and would often come home quite proud of how I was managing to keep good control, without letting diabetes limit my life. I don’t know whether it was a failure on my behalf, on my doctor’s or a combination, but reflecting on the past I can’t say I even really knew what the ‘ideal’ blood sugar reading was. I knew I wanted to stay under 10 mmol/ml, but certainly if I was around 7-8 mmol/ml I didn’t see that as a negative.
I was always quite happy with this approach, from what I’d been told I was controlling my diabetes very well. I had never let it interrupt my life, and as such have and continue to live a very full life. In my later teens and early twenties I was often out at bars once or twice a month, drinking too much beer with my friends, like many I spent my early twenties in an undergraduate degree, I’ve spent quite a bit of my early twenties travelling, despite my diabetes, and in my mind I still kept good control. Retrospectively, I realise this control was probably not as good as I had thought.
Things started to change for me around this time last year when a begun to experience a number of alarming symptoms. Firstly, I started getting pins and needles, numbness, tingling and burning in both my feet and my left hand. Both my endocrinologist, a number of general practitioner’s and a number of other health professionals seriously doubted this was diabetic neuropathy, for a number of reasons but largely because I have had such well controlled diabetes, at least for the past 8 years. On top of this, I also begun experiencing chest pain in the left of my chest. Again this was never properly diagnosed as anything, but was quite alarming.
Around the same time, I also had a yearly checkup at my optometrist where he found a small dot of lipid at the back of one of my eyes, early signs of non-proliferative retinopathy. According to my optometrist, nothing to worry about as it stands. Further to this, I also begun to experience some notable gastric discomfort. Stomach aches, vomiting sometimes in the middle of the night, all symptoms that seemed to point to mild Gastroparesis.
The following months became I began to struggle with my own mental health. I felt depressed, I felt angry that I had made decisions that may have impacted my life negatively, but I also felt scared. I was, for the first time possibly since my diagnosis, scared for my future. I was uncertain of what might happen, and for the first time ever I started asking whether diabetes would and should limit what I can do.
It was at this point that I really decided I needed to be far more engaged with more control. Since then, I have adopted a low-carbohydrate diet and have spent far more time scrutinising and working towards better blood glucose control. In the last year I have managed to reduce my standard deviation and A1c dramatically. My last 3 A1cs being in between 5.3-5.6 and my standard deviations being around 1.2-1.3 across 90 days of blood sugar readings. Since these improvements my chest pain, tingling and numbness in my left hand and feet, and even gastric discomfort seems to have either disapeared or drastically improved, only very occasionally rearing its ugly head.
This really leads me to where I am currently.
I have for awhile been working for a software company. But have reached a point in my life where I am ready to move on to new things professionally. Partially due to my experiences, particularly recently, but more in general, and partially due to my genuine interest in the area I have started contemplating the prospect of applying for a position in a Graduate Medicine (MD) degree. Due to my recent experiences though, I have become concerned and have started questioning whether this is possible, or smart. Not due to my own capacities as a human being, but solely because of my diabetes. I know there are some MDs floating around on this forum, and I know there are other people who work in high paced, stressful jobs so I would love to hear from anyone who can share their own experiences.
I also understand that each person is an individual, so it is almost impossible to alleviate my fears. More than anything I just needed to post about this, somewhere that people who may actually be able to empathise with my concerns can read it.
I really have developed great concerns that I will have to resign myself to a job I dislike, simply because it provides good conditions for me to control my diabetes. I am scared if I go down the path of Medicine, that the stress and anxiety will make my bloods sugars impossible to control, that the night shifts will impact me, that all the hard work I’ve put in over the last year and a bit will be lost. I am scared that the minor complications I’ve started to experience will get worse because of this. I have managed such strict control now due to my adherence to my diet, I am scared I would not be able to put the time and effort into eating that I need to now to keep my bloods sugars good, I am scared I would have to many hypos whilst trying to work in fragile environments.
I had, never in the past asked myself the question of whether I should take my diabetes into consideration when making my life decisions. I went backpacking for 6 months, I know now if I wanted perfect control of my diabetes technically that probably wasn’t the right decision, but it was in my opinion the right decision for me as a person. I am struggling now to find this medium between what I want as a person, and what I know is right for my diabetes. Should I even be taking that into consideration when thinking about my career?
I would also like to take the chance to say I love this forum, the time people put into responding to people, the amazing stories I’ve read, the acceptance everyone shows to each other regardless of their backgrounds and experiences with Diabetes. It’s great. So thank you all in advance.