Facing the Challange

I've had type one diabetes as long as I can remember. My A1C's have been consistently in the 8%s most my life. It's been tolerable for the past 18 years. Although, it's resulted in occasional blurry vision and mild to moderate depression at times. And I know it'll catch up with me.

Thoughts of motherhood have become more and more frequent lately, and I know it's time for me to look this challenge in the face. It's time to take ownership regardless of whether of not I think I deserve diabetes, and I can no longer deny diet and exercise as a crucial part of management.

My biggest struggle is finding the middle ground between obsessive management--which leads to instant perceived failure--and healthy management. Most of my life this far, I've listened to the story in my head that tells me "I can't manage it, so why bother." Now, I know it's not true, and I recognize that if I keep telling myself that I'll keep perceiving failure.

As of a couple days ago, I actually called my amazing team of doctors for help. The most amazing advice was, "stop testing every hour, you will drive your self crazy." (I didn't expect THAT kind of advice) But, it's working. I found THIS wonderful website, and have read many stories of folks with similar experiences. And, I know the physical and mental benefits of yoga are helpful too.

I've decided not to let my diabetes take control, but be a passenger in the car. As a good chauffeur, I'll be attentive to my passenger and make adjustments in my driving.

I cried in my fiance's arms yesterday, "I don't want this. I don't want this." But, today I know that looking my fear in the face, and taking on the challenge with patience and diligence will enrich my life and give me confidence.

I'd love some folks to share their stories of this moment of facing the challenge, deciding to take ownership of it, and what the view from the farther up the mountain is like.

I would say that the view is encouraging. I was only diagnosed in Oct of 2010, but my best guess is that I have had this for at least 10 years. I already had pretty bad retinopathy and PN at diagnosis, so the challenge smacked me hard on day one. Luckily I found this site and began to learn everything I could. I did everything I could to bring my BG to normal levels as it was my only hope in stopping and reversing the damage done. I did this very quickly, too quickly I suppose. My problems got much worse before they began to improve. I have been able to maintain an A1c of 5.5 for over a year by being careful and vigilant. I don't get obsessed with my management. Obsessing is not something I do well at all. I approach it like driving. I define the lines and try to stay between them,, not worrying if I am not always exactly in the middle. If I stray somewhat I try to make a careful adjustment so as not to over correct (think of driving on ice). Along the way I gain experience and knowledge that make my vehicle (body) easier to keep on the road. So you see, setting and striving for optimistic goals does not have to set you up for failure. You just need to look at the bigger picture and have realistic expectations for yourself.

Congrats on facing the challenge, and it is a challenge every day. I have had T1 for 37+ years and for many of them I was pretty much like you. A1C's in the 7's to 8's basically just on cruise control. I did get into obsessive management when I was pregnant 22 years ago and that resulted in a 5 pound 1/2 ounce baby boy who is the love of my life and is away in college. After pregnancy it was easy to slip back in to cruise control. But I have also had some life threatening hypos and last November I finally to get some help and make a choice to take better care of myself. I talked to my internist, sat down with the CDE and dietician and started to make better choices. Since then my control while not perfect is certainly much better. My last A1C was 6.1% and that was not by obsessive management it was just being more consistent. No one ever "wants this" but we have it and basically have a choice, either take care of it or die young. Personally I have far too much to live for to let "this" kill me. Good luck to you. Although, to be honest luck has nothing to do with it.

Thank you. Thank you. Thank you. Randy and Clare, these are very encouraging stories. I like the "driving on ice" analogy, and realistic expectations are key. Clare, I am interested in how you managed your diabetes with pregnancy. Do you have any resources you could pass along or parts of your experience you wouldn't mind sharing?

I feel your pain. I often struggle with the tendency to either be absolutely crazy obsessive or apathetic. It’s a balancing act for sure. One thing I’ve learned to accept is that life is cyclical. There will be times I can be diligent and the A+ diabetes manager, and there’s times when I have to slack, if only for my mental sanity. I have found exercise to be a huge motivator and management tool for me. Even if I’m slacking with the carb counting and testing, I can usually get halfway to decent management simply by exercising as much as possible.

Remember that it’s impossible to do everything perfect ALL the time. We here all get that. I just wish endos did too.

I am pretty obsessive but I don't look at numbers that aren't where I want them to be as "failures" as much as "data" to use to make changes. Once you get your numbers where you want, you can find new challenges but numbers can be quite a handful!

My story, which maybe everyone is sick of, is that in 2004, I was overweight, 37, had had diabetes since 1984 and figured I needed to get in shape. Either very late that year or in early 05, our friends were over for dinner and I was like "I need to exercise, I can't wait for Spring so I can go walking or maybe bike riding..." and my friend suggested I try the Tae Kwon Do class she taught. I signed up. It was *very* intimidating at first ("25 pushups, are you nuts!") but it was interesting and the teachers were good at pushing me and we stuck with it. After a while, I started walking, going maybe 2-3 miles around the neighborhood on Saturdays to touch on that too. The whole "belt" thing was a very useful motivator, you'd have a finite set of new things, practice them a lot and then on to a new challenge. By 2007, I felt like I needed to try to improve myself more and signed up for the "instructor program", flat fee, not cheap but the place I was at was cheaper than other places in town charged for the same thing and you could go to class as much as you wanted. The head instructor could tell immediately I needed 1) more work and 2) a lot more work but, between those classes and the other classes I stuck with it. We were doing 50 pushups to get warmed up before class and I was doing things I was like "I'll NEVER do that" when I saw them when I started.

At the same time, my BG was really nutso. I was eating less but had never heard of carb counting, was resistant to modern insulin and my A1C had drifted up from the high 5s/ 6s to 7s which, understandably alarmed my doc. One of my work buddies said "you should talk to my wife, she has a pump, it's great!" so we had dinner and she pretty much sold me on it in like 5 minutes. I talked to the doc almost immediately and got the ball rolling to get a pump. It made a HUGE difference and probably helped me get organized about things for the first time ever and things have fallen in place since then. Before the black belt test, I knew I'd need to run and, Dec. 08 an ice storm and holidays shut down the academy so I took the clothes off the treadmill and ran 4 miles the first time out! The test was in May and I kept at that on my few off days and also at lunch so I was working out, doing TKD 5-6 nights/ week and lifting and running on the treadmill at lunch. Testing 17x/ day at the peak. My BG fell into line and I passed the test, but had to move b/c my office closed right before the test! It was very tumultuous for me but MrsAcidRock is great and we survived and the area we moved to is great for running so I've kept up with that.

Pregnancy was no picnic, in fact it was probably the hardest thing I have ever attempted. When every thing you put in your mouth effects your growing fetus, it was daunting. I had 2 critical lows that put me in the hospital but thanfully Mark managed to survive both of them as did I. My first suggestion if you are considering pregnancy is visit a maternal/fetal medicine doctor who specializes in diabetes and pregnancy. My doc was a life saver on more than 1 occasion and we got to be good friends as well. I got pregnant on April fools day and spent a week in the hospital getting my blood sugar regulated in May. If I had done that before hand I would not have had to spend a week in the hospital. But over all it just took a lot more checking my bs and making sure it wasn't going high or low. It probably would be a bit easier today with CGMS systems and pumps. Although pumps were available back then, I never considered them because I did not want to be attached to anything. I am now however considering an Omnipod system because it is tubeless. But there are no easy outs, you just have to keep at it and do the best you can.

I took ownership about four years ago after having T1 for 20 years. I finally got sick and tired of feeling sick and tired all the time. I wouldn't go so far as to say that I am at the "top of the mountain" by any means, but I'm much higher up than I was before. Things are much better and I can actually see a future. If I had continued on the way I was before "on cruise control", I would be dead by now. Or, I would have had something catastrophic happen to me which would have forced a change. As it is, I do have some permanent vision damage which is being controlled by a very good retina specialist. I hope the complications stop right there. I don't want anymore of them. Best of luck with affecting a change in your life. BTW...I went through three pregnancies with D. One baby was lost as a still birth but the other two babies survived and are now 18 and 20 years old--healthy and thriving. Pregnancy is hard with Diabetes, but if you want it and are willing to work hard for it, you can have a successful one and a healthy baby.