How do I say this? Where do I begin? How do I admit to myself that I am the problem? It's difficult...
I was diagnosed with Type 1 Diabetes on March 1, 2009 at the age of 20. Between July 1, 2009 and November 2010, I spent 4 visits and stays in ICU for DKA. Each time making a solid vow to myself to do better... to treat my body and soul right and take care of myself. Each time I have failed.
I am a successful professional manager in high stress venues. I am consistently contracted to perform nearly impossible management transition tasks that only a fool would take on. I am capable of managing multi-billion dollar budgets and high-volume stressful situations and people, but I cannot, for the life of me, take the time to manage myself and my Type 1 diabetes. My last a1c result (4/20/2012) crash landed at 11.5, the worst number yet.
I do not see an Endo anymore since I lost my insurance, but I do take time to visit a local FNP that specializes in Type 1 Diabetes (he is one himself.) And my diabetes management is not a reflection of him... simply my gross attempts of taking care of myself.
I take Lantus and Novolog and I get the "general gist" of what I am supposed to do. I understand numbers and know the formulas... I just can't force myself to do right... to eat correctly, or even do the simplest thing.... take the freaking Lantus before bed.
I need help.. Motivation. Am I the only loser who will not force himself to save his own life?
I can't keep living this way. I can't keep looking at the nurse when she shows me the meter that says "313" and I say, "That's a low for me!"
Desperately needing help,
The nasty thing about Diabetes is that it will punch into your face harder and harder until you are following the rules. You can not escape and resistance is futile. Self destructive behaviour is known in many shades and colors. Please seek help of a professional therapist and treat and respect him like your coach - like you want to be respected while managing millions of assets. There is one funamental truth you are about to discover: your health is fundamental for your physical and mental well being. No money or achievement is worth to loose much of your life expectancy. You can have 99% of a healthy human life in terms of life expectancy. When your current state of brain fog has passed you will find it much easier to life with D. It will become an integral part of yourself. Just seek help to accept your faith. Otherwise you will inflict great damage with your current state of poor control. You can not revert but only slow down many complications. Choose wisely and act because as usual life does not wait for you to come to terms with yourself...
It's hardest the first couple years after you are diagnosed. There is an overwhelming amount of information you need to learn, you have to make over your entire life-style, and answer the same questions from well meaning friends & family over & over. Not to mention, you don't really SEE the damage you are doing to your body with high/ low sugars immediately so you can almost convince yourself that you are not doing damage at all! It makes living in denial much easier.
If I were to guess, I would say that you have the knowledge to make small changes to your diet, insulin, and life-style but choose not to because when you DO try & the numbers are still high, you feel like you failed. If the choices are: Try & fail or Don't try & fail, you figure, "Why try?" Am I right? That was my attitude for the longest time. I wish I could tell you what snapped in me, but something did & I decided that I wasn't going to live & die for this disease! I started being mindful of what I ate, I started checking my sugars before each meal, and I started not just checking in with my doctor, but actually talking to her. Things are not perfect, they never will be. But I have accepted that a bad blood sugar does not mean I failed. It simply means I need to take action to correct a medical issue. My suggestion to you is, make small changes & set realistic goals with your doctor. Then, treat those goals like you do your work deadlines. Failure is not an option. You can do this!!!
I'm proud of you for coming here. This is a first step towards dealing with this. When I was diagnosed, I went through a grieving process. I would not be surprised if you have similar feelings. I found Elizabeth Kübler-Ross's The Five Stages of Grief really helpful in understanding some of the feelings I had
And finally Acceptance
I think many of us go through these various steps in different ways. I know that I initially thought I could just take a pill change my diet for a little while and my diabetes would just "go away." In hindsight, that was totally stupid, but that was my D'Nial.
In the end, you are going to have to look yourself in the mirror and admit the truth. You have diabetes and will always have diabetes. And if you don't make your own self care a priority your health will suffer and you will be gone way before your time. Don't think that you are a failure or a loser just because you have difficult with this. We all have trouble with this. Steve Jobs, by his own admission put off treating his cancer for 9 months and shunning conventional medicine, clearly in D'Nial. Smart and successful people can still distort reality, Jobs was accused of this. This distortion is perhaps what enables us to achieve things that others would consider impossible. But it can bite us if we aren't careful.
This doesn't make you a loser, just human.
It is time to look in that mirror and do some real self reflection. We are always here. We won't judge you. We will help you in any way we can. But in the end, change will come from within.
I was kind of all over the place until I started pumping a few years ago. Not so much A1C-wise but, OTOH, I was stoned out of my gourd on insulin a lot more than would probably be considered healthy.
When I decided to get a pump (long story, on my page, I won't bore you here...), I started hanging around online, learned about "Think Like a Pancreas" and read that and the lightbulb went on. Even if "313 is a low for me", it may not be a huge amount "off" in terms of the volume of insulin and some work might 1) get the numbers in line 2) help you realize that you can kick ■■■ at diabetes like you do at management transition tasks. I figured "I'll check it (the book) out as it's only $10 if it sucks" but I found it really engaging and read it in like a day and a half.
Just as the CEOs who hire you finally admit they've got a problem, sounds like you're there. It takes time. Don't beat yourself over the head. Take very tiny steps. Figure out how much insulin is needed to bring yourself down in a fasting situation, over a 3 hour period. If you've been running in the 300s, however, only bring yourself down to 175-150. Now take 7 grams of each kind of carb, one every 3 hours, and see, with a pen and book in hand, how far up you go when you eat just that much. Try a cereal, a pasta, a piece of bread or a half piece if that's what's 7 grams. The fruits will spike you so don't do them til you have the other things in tow. Once you find out how far up each puts you, you can figure out how much of that insulin is needed for a 15 gram amount. And you can do the same with 3 oz protein so you see how long it takes for it to change into glucose.
And after you've researched yourself, slowly, you can begin building a table of how much of each kind of food you can eat and how much insulin will bring down your blood glucose in every case. As I say, it takes patience. It also changes your view of food. Best wishes! Treat yourself as a piece of research in progress.
After a couple weeks or a month I give you permission to lower yourself to 110. :)
It sounds like you already have the basic building blocks for managing diabetes if you just apply the skills you employ successfully in you job. Setting goals, managing time and breaking up a big project into small but achievable steps is how I've learned to manage my diabetes - just like you do with your job.
First concentrate on the basics, set achievable goals, set aside time to do it and monitor your progress. Take things one meal at a time - monitoring blood glucose, tailoring meals and then checking your glucose afterward. Instead of beating yourself up when you don't achieve a goal, learn what went wrong, decide on how to improve the outcome and try again. Keep these accumulated lessons in mind with every meal and event. Over time you will learn more about how your body, i.e. blood glucose reacts to your insulin dose and food intake. As these lessons accumulate, if you apply them intelligently your glucose will start trending down to more acceptable levels. You will achieve your BG goals with greater regularity. Don't worry so much about your A1C at first - as you get better and better at lowering your before and after meal glucose levels, the A1C will take care of yourself.
When it comes to remembering your Lantus injection and meals + boluses, make an appointment with yourself. Treat it with the same resolve and seriousness you would for an appointment with a client. Take your professional traits for diligence and dependability and consider your health as another client you must serve with dedication and professionalism.
I hope it works out for you.
You're taking the first step (admitting that you have a problem). And now you need to take the next step. It's all about baby steps.
1. We have all been there. I doubt there is is a single one of us living with T1D who hasn't gotten into this rut. Rest assured that many of us have been there and many of us are able to get it. But it takes work.
2. Pick one thing about your D-care (or lack of D-care) that you want to change. Maybe it's testing when you wake up, or testing before a meal. Pick that one thing and start doing it. Just do that one thing and don't worry about changing anything else immediately. Do that one new thing for two weeks and then, once you have that mastered, pick another single thing you want to change or do better at. And then another...and then another. You know what to do. You just have to do it.
3. Remember that T1D is still relatively new for you. It's not yet a lifestyle as it is for those of us who have been managing it since childhood. I personally think that makes things harder because you had this life and then something new got thrown into it. You have to seriously look at your life (your job, social life, work, etc) and eliminate or change the things that are making D-management harder. If, for example, your friendships or work life revolve around people or activities that have a negative impact on your D-management, well, you need to evaluate whether those things should still be a part of your life. This is hard, but necessary because if you don't purge the bad things in your life, you won't have much of a life 5 or 10 years from now.
You can make the changes, but you have to do it. There are no short cuts, no easy answers. It is not your fault that you're in this situation, but diabetes isn't going away, so you either learn how to live with it and manage it or you keep doing what you're doing. And the path you're on is not a good one, but you already know that.
Belly laughter... MATT... Look my diabetic brother. We your diabetic elders, your peers GET IT. Its not motivation that is the issue. Its not time either. The issue is success, plain and simple.
The way you worded your question answers itself I think.
All you need IMHO is some numbers that don't hand you your own rear-end, time after time? If you can get that... or a pattern that you can wrap your brain around, you can understand the cause and effect, you will be good to go. If you do not, diabetes, like life in general will eventually come back and bite you in the butt, BIG TIME for ignoring that shark in the tank you've been swimming with. Its not magic.
Where do you want to start?
What you eat? What you shoot? What kind of testing are you willing to do? It will take some time to get the data to make deep & necessary changes, but that would be the same with work too right? For right now you have to cope with the fire right in front of you.
What diabetic habits do you have? What patterns would we find if we followed you with a secret pin camera for a couple days?
You've got tons of great advice on here already, so I am gonna take a different approach in my post ;) You say that you are proud of your professional acheivements and are successful. High BG can impair your abilty to concentrate and work effectively. Imagine how much MORE you can accomplish if your sugars ran closer to range!?!! You can do this! Good on you for redirecting and trying again.
I think everyone hit it dead on the head here. I'm failing because I am simply afraid of failing...
I am going to start blogging my journey. This documentation process may help. Thank you all.
hey Matt, thanks for posting. I'd like to add that beefing up your logging is a good idea for getting back to better control. and don't think of your numbers as "good" or "bad" but as information. writing down what's going on with bgs, insulin, food intake, and perhaps exercise and stress can also help your health professionals spot trends and be able to make suggestions.
I was reminded of another member here, who wrote this post, and I think some of the many responses were really really good
I agree with what Jen said above...if you want your brain to be in peak form for your demanding job, get your blood sugar as close to normal as you can. You'll find that where you are now is like being in a fog compared to when they are in the more normal range. Your thought processes will become faster, reaction times will improve, etc.
Do you know that kids in school can be excused from tests when their blood sugars are that far off (for example, over 220 ? )? They will be allowed to take the test when it is closer to normal range because mental performance is so affected.
If your job is more important to you than your health - make that the motivating factor - your job performance will improve.
This post and the replies hit home hard!
A real community feeling <3 Matt, all the responses are there, I have not much to add. Only that I was in your situation only a year ago and I have been T1D for more than 8 years. I am there too, slowly getting out of D'nial-anger-grief, down to 8.3% now, trying to do what everyone suggested, including seeing an awesome therapist :)
Why bother? Because you CAN do better, you CAN feel better physically and emotionally, it DOES make a difference! why bother taking a shower? why bother brushing your teeth? Treat it as any other daily routine and work on getting rid of the guilt, with time you won't be forgetting your Lantus before bed, and that is a step towards the right direction. Mine is sitting either in my bedside table or by my toothbrush; I may still forget to do it but now is once every 2-3 months instead of ever other night.
You will, or you won't. It is all up to you--and a support network of friends, family, other ds (here is great.)
I was diagnosed in 1962. Had a baby (not in 62!! There were no glucose monitors at the time) and never paid much attention until I was 40-45. On a whim, had an A1C, and it was bad--not 11.5, but in the 8-9 range. I got terrified. I basicly stopped eating much of anything, found a good endo, and lost 65 pounds. My only side affect is some pretty heavy retinopathy. I thought mine was bad, but after some recent posts on this, I had problems, but not like some.
I have been struggling lately--big life changes, I guess.
My point is that we all struggle and deal, as best we can. Is stress a factor? Food choices? Exercise?
In today's world, 313 would freak me out. In my past pre-meter world, who knows?
Do you have insurance now? If not, have you considered a new job that has health coverage? That would really provide the ability to use the latest tools--they get better every day. There are so many things out there--pumps, CGM, even therapy.
Good luck and let us know when the community can help.
I was diagnosed at almost the same age as You. I was 21. Back then there were fewer treatment options and testing was difficult at best.
I think You are just in denial of the reality of diabetes. When I was 21 I would drink and eat to my hearts content and just bolused large ammounts of insulin afterward. My a1c was never as high as yours, but I'm sure my control was not much better.
If often didn't work very well and I found myself getting sick. Super low to super high.
First I learned to eat and drink whatever I wanted and how much insulin to take with it.
Then after a while I started to back off. After the reality set in.
25 years later I still hate having to think about it.
I have a pump and a CGM now. Actually I think I take care of myself much better now because my pump constantly nags me. If I were at 300 I would get a nudge every 5 min until I got it back in line.
It is what works for me. Allow yourself your process but remember if you have landed in the hospital already from DKA , the next time might be the last.
I think it took me a good 2 years to get into a health state of mind and good groove with the reality of the rest of my life.
You can get there too,