Work it!

While I’m not in school during the summer and winter, I spend a lot of time working at a discount department store near my house. I started last summer, and was thrilled to have a job with steady hours to keep me busy. Managing diabetes while working upwards of 30 hours a week some weeks, however, is a challenge all its own. Being on my feet for several hours at a time and walking around the store carrying large piles of clothes definitely causes my blood sugar to drop. I do my best to prevent this by having a snack before my shift, or adjusting my insulin rates…but we all know how unpredictable diabetes can be. Sometimes it works, sometimes my blood sugar goes up to 250, and sometimes I’m stuck trying to make change while my hands shake and my blood sugar is 60. Because my hours vary every week, it’s difficult to establish a routine, and I usually keep a very close eye on my CGM to catch any impending lows or highs.

When I was hired, I informed each of my managers and direct supervisors that I had diabetes, and had approval to carry around my supplies in a fanny pack (I keep it with me, but try to avoid wearing it as much as possible- it’s not really my style), but didn’t make a big deal out of it unless someone asked. I did my best to avoid checking my blood sugar while I was working, in order to avoid awkward questions, and because I was afraid someone would reprimand me for not doing my job. This definitely resulted in some less-than-stellar blood sugar readings, but I was just too anxious to put myself first.

When I returned to work this past Christmas, I was forced to acknowledge my diabetes during my shifts. I had gone off the pump and was taking Lantus, and needed to ask my supervisor for a quick break to deliver my injection. She was very understanding, and I was immensely relieved. This incident left me feeling a lot more comfortable dealing with my diabetes at work, and I even started checking my blood sugar when I felt that I needed to, instead of waiting for my break.

I’ve had a lot of positive experiences with my coworkers and diabetes since then, and most of them stem from times when I’ve run into problems with my blood sugar at work. My first day starting back on the pump this past May, I dealt with very high, and then rapidly dropping blood sugars after accidentally giving myself too much insulin. My coworkers were very concerned, offering to get me granola bars to treat my low, and asking if I would be okay to drive myself home. My first supervisor informed me that she was hypoglycemic, and had spare glucose tabs in her locker. Many people have shown an interest in my CGM, and I’ve fielded a lot of questions about how it works, and what I have to do every day to keep myself healthy. Recently, my pump gave me an error alarm that required me to change my cartridge and tubing immediately, and my supervisor let me go right away, telling me to take as much time as I needed. I even had a great conversation with a customer one day after she told me “I like your insulin pump!”

That’s not to say everyone has handled the knowledge of my diabetes as I’d hoped. Many of the people I work with are older, and I’ve heard many stories about spouses, parents and friends with type 2 diabetes. I do appreciate these people trying to understand how I manage my disease, but type 1 and type 2 are so different that their expectations of what I eat and how I take my insulin don’t really match up to what I actually do. I’ve heard plenty of less-than-polite comments- “Why can’t she help out? She’s not doing anything!” (I had a low blood sugar) “Oh…but you’re not fat!” (It still amazes me that people will actually say that- rude!), “Do you have bad diabetes?” (last I checked, all the types are bad), and a rather hostile conversation with someone who discovered my fanny pack and told me that “associates aren’t allowed to have ANYTHING with them on the sales floor, don’t you have a locker?” That last one had me scared to go back to work for a week.

And of course, there have been some standout moments, like when I was told that fanny packs are coming back in style (maybe I SHOULD look for a more stylish one?), and when someone told me “I thought diabetics couldn’t eat fruit?” (but…fruit is good for you? I’m still confused on this one.)

I have to take this space to give a HUGE thank you to my sometimes-supervisor, coworker, and friend Correnna. A few weeks after I started my job last summer, she recognized my pump asked if I had diabetes, revealing that she has another close friend with type 1. Since then, she has been my ally in explaining what happens when my blood sugar is low or high, convincing people that I can eat candy, and defending me when people make rude or misinformed comments. When my blood sugar is low, all I have to do is let her know, and I’m free to immediately sit down and have a juice box. She even convinced management to give a fan to the cashiers because my blood sugar spikes when it gets too warm. (The other cashiers are grateful for this too.)

We spent a whole shift ranting about CrossFit’s ignorance back in June when their insulting tweet about diabetes and Coca Cola went public. That was a fun day. Diabetes brought us together, but we’ve bonded over so many other things too. I’m lucky to work with her, and I hope everyone with diabetes finds a coworker or friend like Correnna who understands what we live with so well.

I’ll have a temporary reprieve from my job now that I’m returning to school for the semester- but Christmas is just around the corner!

Advertisements

Dia-Skills

I don’t know about anyone else, but if my diabetes is anything, it’s inconsistent. My blood sugar patterns have baffled my doctors (and me) for years; I’m simply not a “by the book” diabetic! Whether it’s an oddly high or low basal rate that just seems to work for me, or a more isolated event (“why is my blood sugar 313?!), I can count on weird things happening on a regular basis.

My diabetes technology (glucose meter, insulin pump, and continuous glucose monitor) can cause the same amount of frustration when things don’t work as I would expect. Who else has had the awful experience of a pump site ripping out when the tubing gets caught on a doorknob, or worse, someone’s backpack as they’re walking away from you? This happened to me once in a dining hall at school; I was mortified as I chased after the person trying to detach myself from their backpack, but I wasn’t able to untangle it before my site came out. “Yeah, my pancreas was basically just ripped from my body…but I’m totally fine.”

I’ve dealt with meters that have been GROSSLY inaccurate (thank goodness for my CGM being a reference, and saving me from making dangerous mistakes in treating my blood sugar), pump alarms just as I’m about to clock in to work, and infusion sets that kink at impossible angles. These life interruptions are unbelievably frustrating, but I’ve learned a lot from them during my fourteen years with diabetes.

Namely, I don’t panic when these kinds of things happen.

Sure, discovering that your blood sugar is 460, or getting a defective cartridge alarm at work, is stressful. But the reality is that those kinds of problems can’t be solved immediately. You change the infusion set, give yourself a correction bolus, and then wait. That’s all you can do. There’s no sense in working yourself up over something that wasn’t even your fault to begin with- it’s not like we plan for these things to happen!

I’ve also learned to think through potential causes and solutions if I get stuck in a less-than-ideal situation, diabetes related or not. Don’t get me wrong, my first instinct is still to freak out- but after the initial few seconds of shock wears off, I start trying to figure out why exactly my blood sugar is so high (does my basal need to be increased? Is it the warm weather? It could be literally anything!), and what I can do to solve and prevent the problem. This reaction has served me well in all sorts of situations, from pump failures to road detours, even class enrollment time.

Living with diabetes makes you good at a lot of things; simple math, explaining T1 to other people, and figuring out how many carbs are in something just by looking at it. But so many of the skills we learn are applicable to other areas of our lives: being prepared, staying calm in an emergency, and learning to deal with health insurance at a younger age than most (as a public health major, this one has been especially helpful). Diabetes is a total pain in the butt, but I think all of us can identify at least one thing it’s taught us that’s had a positive impact on our lives, whether it’s getting over a fear of needles, having a greater awareness of your general health, or knowing that you’re never alone in whatever struggles you face.

Learning to live

What amazes me most about starting my senior year of college in a few weeks isn’t how quickly the time has gone by. It’s how much my life, and life plan, have changed. When I began my freshman year in 2012, I was majoring in communication disorders. I was going to graduate a semester early, get my master’s degree in speech therapy, and get a job working with children. I knew what my strengths were (and weren’t), who I wanted to marry- you name it, and I probably had some sort of plan for it. I should mention that I also had tons and tons of anxiety, especially social anxiety. I was terrified of being in any unfamiliar situation that required me to interact with other people. There were some nights my freshman year when I would eat cereal and chips from the vending machine for dinner. I just couldn’t get past my anxiety and leave my dorm. At the end of the year, to say that I was relieved to move out and go home was an understatement. I pushed the fact that in only 3 short months, I’d be preparing to move back, to the back of my mind. I worked at a new froyo place in town, hung out with my boyfriend, and took yoga classes at a local studio. As July gave way to August, the familiar feelings of anxiety began to set in, and I knew something needed to change. I was shutting down new opportunities, and putting myself down in the process- all because of anxiety and its resulting self-descriptors. I wasn’t good at lab sciences. I could never get an internship far away from home. There was no way I could balance having a job and taking classes at the same time. I couldn’t manage my diabetes well. I couldn’t make new friends. And the thought of a future that was any different from how I planned it was something I couldn’t even think about. I had gone into “identity foreclosure,” as I learned in my adolescent psychology class. And the identity I had foreclosed on was one in which my strengths weren’t that strong, my confidence wasn’t too high, and one that absolutely had to stay the same. Not for long. I discovered my school’s public health major, and switched into it immediately; it was perfect for me. After taking the core classes, I had so much freedom of choice for the rest of my credits- and I could tailor my class schedule to whatever interested me. I joined not one, but TWO clubs, one of which I am now the president of. In April, I applied to become a peer advisor (which involved a LOT of interacting with people I didn’t know) for my new major the following year- and was offered a position, despite my worries that the other applicants were much more qualified than I was. During the summer between sophomore and junior years, I started a new job at a local department store- and it brought back my anxiety in a tidal wave. The shifts were long, the store was huge, and I was terrified that I would do something wrong and be fired. Living with this constant fear was exhausting, and I felt an odd sense of relief when the summer ended and it was time to go back to school. But the relief didn’t last long. Junior year arrived, and I was stressed to the max. My parents left after move-in day, and I felt so alone. And literally paralyzed with anxiety. The thought of leaving my room at all filled me with immense dread. There was no way I could get through a whole school year like that. So I called my school’s counseling service, and started bimonthly appointments with a great counselor. Along the way,I realized I just wasn’t happy- being anxious was serving me absolutely no purpose. What’s the worst that would happen if I tried something new? I ended my two and a half year relationship that was, admittedly, making me more stressed than happy. I hung out with friends more, and realized I’d been neglecting friendships for my relationship (a mistake I will not make again). I tried a hip-hop dance class at the gym, and loved it. (I’m not half bad, in my opinion. Who knew?) I replaced my grey and black wardrobe with bright colors and patterns. I tried makeup. I went to a college party. I got a job as a research assistant, and balanced that on top of classes, club meetings, peer advising, and consistently going to the gym. When I got home for the summer, I accepted extra shifts left and right at work (my bank account thanks me for this). I enrolled in an ONLINE class in BIOLOGY of all things, and just finished my last assignment with a fantastic average. I have my sights set on nursing school (with all of that hard science) so that I can work with kids with diabetes one day. I’m getting ready to move into my first apartment with one of my best friends in a few weeks. And NONE of this was in my life plan up until a few months ago. The moral of the story? Don’t plan out your life too carefully. Having plans is great, but so is exploring. That’s what being a young adult is all about. Knowing exactly what you want to do and who you want to be in your life at 18 is great, but don’t be scared of change- it’s an adventure. Your future never has to be set in stone. My freshman self saw college as a means to an end: I’ve learned since then that college and young adulthood are a period of self-discovery, and that staying exactly the same may not be such a great thing after all. Learning how to live your life, be flexible, try new things, adapt to change- all of these are great skills that I came very close to missing out on. Best of all, I’ve gained a lot of confidence from this whole process. I’m actually excited to move into my apartment and go back to school, for once. I give myself a lot of credit for managing a chronic disease every day, and managing to do everything I do. I’m not afraid to like the music, or the clothes, or activities that I like. If I’m faced with a challenge, I know I can do my best- and that my best is good enough. Just because it’s scary, doesn’t mean you can’t do it.

Stop the Ride, I Want to Get Off

Hands up if your CGM ever looks like this.

IMG_0102

A 24-hour display that looks this extreme is pretty rare for me. But we all know that these things happen, sometimes without much of an explanation. There are so many factors, from meals and exercise to stress and the weather, that affect blood sugar that it’s impossible to account for them all. It’s easy to get frustrated and upset (especially when lack of sleep is involved)- and that’s okay. We live on the constant roller coaster that is diabetes, day in and day out, with no breaks. It’s only natural that sometimes we feel like screaming, crying, or throwing our meters out the window.

Yesterday seemed to be the perfect storm of events to create that lovely mountain range. I had inserted a new sensor that morning, and I’ve found that during the first 24-36 hours of a sensor session, it tends to get a little over-excited when my blood sugar rises or falls. (The most memorable and extreme incidence of this occurred a few months ago, when my receiver claimed I was 380 a half hour after eating a banana to treat a low. Like, no. Go get your head on straight, Dexcom.) Some of the lows and highs might have been a little exaggerated, but the trends were definitely correct.

When the two hour start-up period ended, and I could finally see my numbers being displayed, I noticed that my blood sugar seemed to be falling from a steep high. I thought this was odd- I had just changed my breakfast insulin-to-carb ratio to ensure that I got more insulin to prevent that high. Additionally, I delivered my insulin 20 minutes before I ate breakfast, to give the insulin time to kick in before I ate. This should have prevented that spike, but without the data from my CGM, I’ll never know exactly what happened.

I confirmed my falling blood sugar with my meter, which reported that I was 69. I ate a 10 carb snack, and began preparing my lunch. My CGM, however, showed the word “LOW” where a number should have been. PANIC TIME! The “LOW” indicated that my blood sugar was below 40. Even though I knew that was probably incorrect, I loaded up on more gingersnaps while cutting way back on my insulin for lunch. It’s hard to ignore the urgent beeps and vibrations when you’re 20 minutes away from driving to work. By the time I was ready to leave, my blood sugar was up to 126. Score!

My Saturday afternoon shift turned out to be pretty busy- the store was packed and I was feeling stressed, which was only compounded by my blood sugars. Try making change, or just trying to make the correct words come out of your mouth, when your blood sugar is 50! During my six hour shift, I corrected a “low”- my CGM lied to me and I was actually about 100- then corrected with insulin for the resulting high.

After I came home, I dealt with several more deceptive spikes and rises on my CGM receiver display, causing me to improperly treat my blood sugars, and just generally stress me out. I spent most of the night over 200, waking up every few hours and woke up feeling really sick- something I haven’t experienced since I started on my Dexcom in March. I was also feeling really discouraged: I had lost several hours of sleep, and was upset about the lack of control I’d had over my blood sugars the day before.

As cliche as it sounds, I knew that today was a new day: I could definitely smooth out those mountains from the day before, and make my 24 hour trend line look more like a straight line than an EKG. I headed back to work (where I tried to keep my blood sugars stable, but that didn’t happen. At least I tried!), kept my stress level down, and gave everyone the correct change.

We all know that living with diabetes can be immensely frustrating, upsetting, and scary sometimes. And life without diabetes is the same way. Everyone has days that just don’t go our way, but keeping things in perspective is important. One day doesn’t define your talent, your abilities, or your progress. For all the T1s reading this- you are some of the strongest people I know, and you all work so hard every day to simply live your lives. If you have a day like the one I just had, just remember that it will get better. The ride will stop (or at least slow down), and the mountain ranges on your CGM will flatten out.

Now I’m off to catch up on some sleep, where I hopefully won’t be interrupted by my CGM.