The Brain: Rescue Squad for Diabetics

The brain is an amazing device.  With it's mind-boggling complexity, it controls every aspect of our being.  It regulates our emotions, tells our heart and lungs to work, and allows us to basically do whatever we want (make bad choices, fall in love with losers, lick our lips when they are chapped… ) you get the drift.

I have recently been thinking (with my cranium, of course) that thanks to my brain, I have not died.   My brain allows me to make decisions-- I look both ways before crossing the road, I don’t throw my body in a fire pit, or decide to go pet wild ferocious lions...  but I’m talking about when my brain automatically saves me from death when I am not in control.   How about when I am asleep?

*Just to be clear, 1 in 20 type one diabetics will die from hypoglycemia.* 

Low blood sugars kill.  So how does mine save me?  Well, what if I told you that your brain is also a super hero?

During the night, most type 1 diabetics like myself experience low blood sugars.  However, on rare occasions, I catch them before I go to sleep.

For instance, after a long night of dancing, drinking champagne, and munching on finger foods at my sister’s wedding, my blood sugar got up to 519.  Because of the dress, my pump was hidden in the leg strap and I did not have the remote to my pump on me.   Between making toasts and mingling with friends and family, I did not think about diabetes.   Whoa, big shock there.  So of course, at midnight when I checked and saw it was 519, I realized I ate a few too many cupcakes and chicken salad sandwiches.  I bolused for the correction, and survived the next hour and a half of cleaning the reception up by drinking a gallon of water. 

When I finally got home, around 1:30am I checked my blood sugar again through my droopy eyelids.  It said it was 147.  Wait…what?  Shouldn’t it be 250?  No.  147.  I looked at how much insulin I had on board, and I still had five and a half units!  I knew that if I fell into the deep slumber I was craving that I would surely die of hypoglycemia.  So I got up and ate the kitchen.

I ate pasta salad, crackers, drank some lemonade, ate a handful of cereal, and topped off my mini feast with 3 glucose tablets.  I had full intentions of setting an alarm to wake me up so I could check around 3am, but I was just too darn tired.  I fell asleep as soon as my head hit the pillow.

Thankfully, the next morning I awoke (alive!) and my blood sugar was 115.  I have my kitchen grazing to thank for saving my life on that one.  However, what happens when you can’t catch it before you sleep? 

Your brain puts on a cape and saves the day.

While I am sleeping, my brain is working at 100mph.  I dream almost every night.  Sometimes I can tell when my dream is reflecting what is on my mind, or even when my dream incorporates things that happened during the day prior.  I have the absolute craziest dreams (Joe can vouch for me).  I wake up and can remember vivid details, whether they be that a character had a tattoo of the letters “JB” on their index finger, or that I was drinking a grape Nehi  (not just any Nehi, but a grape one).  Like I said…crazy.

Diabetes also causes me to have strange and often annoying dreams (because you know Diabetes rules every aspect of a person’s life).   However, it’s not always a bad thing.  I have found that an annoying dream that won’t end is actually my brain’s way of screaming for me to WAKE UP. 

There are two types of brain rescues that work together to save the day (night).  Sweat and dreams. 

Let’s say I am having a normal dream where I am exploring a house with Joe.  We are walking through various rooms and pointing out some of its features.  If my blood sugar is low, my brain will start incorporating annoying details.  For instance, a dog will start barking outside.  It becomes a constant, continuous sound that begins to wear on my nerves a bit.  Then, maybe Joe’s phone will start ringing and he won’t turn it off or answer it.   The noise becomes so frustrating, and I am ready to scream, when I finally wake up just to end the noise in my head! 

I wake up.  Roll over.  Fall asleep again.   Why not?

This time, I start to dream, but it’s the same dream I just had!  The dream starts about 3 minutes prior (where we are just walking around the house).  Slowly, the noise starts back up and I’m having deja vu.  The dog is barking, the phone is beeping, Joe is asking me the same question over and over because he can’t hear me speaking to him.  I’m yelling at Joe, and waving my arms around, and tears are falling down my cheeks because I want it all to end! 

So what do I do? I wake up again.

Now, either this happens for another four or five cycles (honest truth!), or I finally realize I need to do something.  This is often when my brain sends in the 2^nd rescue squad:  sweat.

A few months ago, I woke up in a pool of sweat.  I actually thought someone had tossed a bucket of water on me.  My pajamas, sheets, blanket, mattress pad, and even the mattress were soaked with sweat.  All thanks to diabetes.  Talk about being grumpy and gross.  At 4:00am.  I ended up pulling the bed clothes off, and sleeping in a sleeping bag while I waited for the mattress to dry.

Back to annoying dream sequence:  once I get so fed up with my dream stuck on repeat, I generally start noticing that I’m hot (which only adds to my anger and frustration).   Why can’t I just get comfortable? Then, like a lightbulb moment, it hits me. 

My blood sugar is low. 31.

Thank you, brain, for saving my life.

I get up, check, eat, drink, wait, check, and go back to sleep.

How Diabetes Ruined My College Graduation

How did Diabetes ruin the most important day of my college career, you might ask?  The answer is simple.  Diabetes affects every aspect of my life.  Why did I think graduation would be any different?  I clearly am not invincible, so why the cockiness all of a sudden?

Joe and I (and the gorgeous dress!)

May 9, 2014—the weather was beautiful, my family had arrived… it was going to be a great day.  Finally, the day I had dreamed about was here!  This is the day that I will walk across the stage as the first person in my family to earn a bachelor’s degree.  Talk about being proud!  I had everything prepared.  My dress (which I did not get until the night before) fit perfectly and I absolutely loved it! I had all of my cords, my sash, my cap, tassel, gown, shoes… check, check, and double check!  I was ready to go.

Oh wait! Diabetes interruption--Where am I going to put my pump?!  I have the perfect dress, and it won’t go anywhere.  I couldn’t wear my leg strap because it would show, and the dress was low cut so the bra was not an option.  I cursed the day I decided to get a pump, but I eventually clipped it to my bra. *Tall people looking down could see it, but then again no one saw it under my huge gown*

Now, I had a debate with myself for a few days prior to graduation.  Should I carry a small purse with me to carry during commencement?  Unfortunately, anything you carried (a purse/ phone, etc.) would be stuck with you for the entire ceremony (~2 hours).  I really didn’t want to carry a bulky meter, but I also didn’t want to carry a purse (or wear a crossbody under my gown).  At the last minute I decided that I would carry absolutely nothing with me.  This is where I went wrong.

The ceremony may last about two hours, but I had to get there an hour earlier.  Therefore, that is THREE hours without a meter and glucose tablets.   When I parked my car, I checked my blood sugar—109.  I handed my meter, glucose tablets, and phone to my mother and said my goodbyes before I whisked off to the gym where the graduates were meeting.  While I sat there anxiously waiting with my fellow graduates, I started to feel a bit shaky.  At first I thought it was just nerves—no wonder!  However as I sat there it got worse and worse.  Thoughts raced through my mind:

“If I get up now, maybe I can find my family and eat some tablets and make it back in time…”

“What if I can’t find my family…?  It’s almost 5pm, there’s probably a thousand people in the stands by now…”

“Maybe I can borrow someone’s phone and call Joe, and he can bring me some tablets…”

“Now it’s 5:08, I can’t get up now, the ceremony starts at 5:30. I’m sure they are about to start lining us up…”

“Maybe the ceremony won’t last long, and this is just nerves.  If it is my blood sugar, maybe if I stop thinking/stressing about it, it won’t drop as fast…”

Before I knew it we were lining up and walking in.  I had committed now, there was nothing I could do.  As I walked in the coliseum I started to feel a little better (Whew, maybe it was just nerves!).  However, as I stood there waiting for all of the graduates to come in, I felt extremely shaky. 

Once we were seated, I could relax.  I tried to focus on the ceremony, NOT my blood sugar.  I had found my family, and so I kept turning to smile at them, as a reassurance so they wouldn’t worry (I was looking pretty solemn as the graduates were entering).  Other than shaking like a leaf, I was okay.  The less I thought about it, the better I was.  During the keynote speaker‘s address, I zoned out a few times thanks to my dropping blood sugar.  I cannot explain how upset I am now looking back.  I should have been in the moment, soaking it all in.  Instead I was silently suffering in my chair.

When it was time to stand up and move our tassels, I was in big trouble.  As soon as the chancellor said for us to move our tassels from the right to the left I had this moment of confusion.

For starters, I could not figure out my right and left.  For some reason I thought that my tassel had been on the wrong side to begin with (already on the left side), and everyone was moving their tassel the wrong way.  I stood there holding my tassel in my right hand and looked around.  I felt panicky.  “Why are they moving their tassel to the wrong side?”  I finally turned to the girl beside me and asked her, but it was so noisy I don’t think she heard me.  She just pointed for me to move it, so I did. 

Then it hit me.  I am ruining my own graduation.  Because of my complete lack of judgment, I will forever regret this moment in my life.  Will I even make it to shake the chancellor’s hand, or will I pass out on the way?  Will I remember walking across the stage?  As I stood there shaking, the thoughts in my mind were deafening. 

All of a sudden we’re moving.  I heard my name being called from a distance and I looked to my right to see a huge gap in the line.  One of my classmates was trying to get my attention, we were about to go across the stage!  I shook my head as if to erase the negative thoughts as I hurried down the row to catch up.  My cheeks were flushed from embarrassment, as I waited for my name to be called. 

Okay, it’s my turn.  I handed the reader my card.  Yes, that’s how you pronounce my name.  Then it happened.  The moment I had waited for.  My name was called and I walked up to the chancellor with a huge grin on my face as I shook his hand.  All of my negative thoughts disappeared and time seemed to freeze.  I couldn’t hear my family cheering--I was too busy focusing on the moment.  After I received my diploma I turned to walk down the aisle back to my seat.  I stopped to shake the Dean of the education school’s hand, and instead of walking to the left of him like I should have, I awkwardly walked around the right of him and back to the left to go to my seat.  That in itself was embarrassing, but I didn’t care.  I survived.  I graduated and didn’t pass out at the ceremony!

Watery eyes with my siblings

After the ceremony was over, the graduates exited out the front of the coliseum.  Because I did not have my phone, it took forever to find my family.  Unfortunately, because of my severely low blood sugar, all I could think about was finding my glucose tablets, not hugging and celebrating with my family (again, another way that Diabetes ruined everything).  When I found all 10 of them, I gave brief hugs and asked for the tablets.  I stood there crying, chewing the tablets vigorously as I gave hugs.  Everyone had made a sort of semi-circle around me and I felt embarrassed.  I was ruining the moment of celebration for my family.  I just kept repeating, “I ruined my own graduation.” “I’m so sorry, I ruined my own graduation.”  Once I started feeling better, everyone wanted to take pictures.   In all of the pictures, my eyes are puffy and watery.  Diabetes strikes again. 

Dreaded DMV

Ah, the DMV.  The Division of Motor Vehicles.   Without them, driving from point A to point B would be absolutely chaotic, so obviously we need them.    Driving a vehicle is a rite of passage, as well as visiting the lovely DMV to do so.   Now most people dread going to the DMV, and for good reason!  Not only are you corralled together with other frustrated and cranky people, but you have to sit there for at least an hour before you’re called back.  Once your name is called, you sit across from yet another grouchy person that obviously would rather be outside in 100 degrees digging a ditch than to be sitting across from you giving the eye test.   The whole trip to the DMV can be summed up in one word:  dreadful.  I too, had a dreadful experience at the DMV thanks to my forever sidekick, Diabetes.

Anyone who has type 1 knows that the DMV will bombard you with letters.  “Are you healthy enough to safely operate a motor vehicle?” “How are your eyes?” What is your A1C?”  Oh and my personal favorite, “Have 10,000 forms filled out (by a doctor) in less than 30 days or your license will be taken away!”  At first I received these letters when I was getting my learners permit.  I had to make a special trip to see my pediatrician to have them filled out so I could drive.  After that, I had to get the forms filled out again for my license.  Each time I visited my doctor he would give me “the talk” about whether or not he should sign them.  I must say his method worked—after the appointment I tried really hard to get my blood sugars under control once he signed them.  As I got older, things got a little more difficult.

As many of you know from previous blog posts, I have struggled to take care of myself since I was in middle school.  Part of it was laziness, and the other part was just being tired; tired of having Diabetes on my mind 24/7.   So when I received the threatening DMV letter, my heart sank.  I had just gotten my license renewed in December on my 21^st birthday (because it expired then), and it was summer when I received the letter.   Like usual, they gave me 30 days, which was NOT long enough.  Unfortunately I had to make an appointment with my endocrinologist so she could fill them out, but the whole process was going to take too long.  After many phone calls to the division, I got an extension (of 2 weeks). 

I arrived at my doctor’s appointment on May 20^th with my thick stack of paperwork in my hands.  After explaining the papers to my doctor, she gave me The Look.   I could feel the knot in my throat grow till I could hardly breathe as she spoke.  She told me that she would be honest in filling it out, and that she did not feel comfortable with the fact that I could be driving with a bad blood sugar and kill an innocent person.   **Insert waterworks here**  I had never been more upset with myself than I was in that moment.  I knew she was right, but I couldn’t help but feel like she was being too harsh on me.  All of my regret and disappointment I felt toward myself slowly turned into anger towards my doctor.  How dare she prevent me from driving!  I have to go to school, in Wilmington!  That’s a four hour drive from here!  I have never been in an accident, and I don’t have a single ticket.  My record is clean—I am a safe driver.  I left the appointment crying, and the tears kept flowing for the next few days.

After my doctor sent in the paperwork there was an awful waiting period.  I called the medical review board twice and they told me they were processing the paperwork and it would take up to 3 months to hear back.  So I waited.

August came, and I moved back to Wilmington to start school again.  Things were going great until one day I received a phone call from my mother.  She told me that I had a letter from the DMV and asked if she should open it and read it.  I was scared for her to read it aloud in case it was bad news, but she would find out soon enough.  She then proceeded to read the letter aloud and my heart clenched in my chest as the words ripped me apart.

Great.  Now I have a restriction.  Oh wait, what’s that?  I have less than 15 days to go to the DMV and get a new license.  Awesome.

I arrived at the DMV on September 10^th and waited in the sardine box for what seemed like hours.  When I was finally called back I showed the letter to the DMV employee.   As if this whole process could not get any worse, he informed me that I would have to do the driving test because I was getting a restriction.   THE DRIVING TEST.  So I had to go back to the lobby and wait with the other young teeny boppers till it was time.  I burst into tears.  I walked outside and called my mother, who tried to reassure me.  I was a nervous wreck.  Not only did I forget how to do a 3 point road turn, but I still couldn’t back up to save my life, and it’s in Wilmington!  I don’t know these roads!  I waited outside for the longest time until my snubs subsided.  I slowly walked back into the DMV with my head drooping where I awaited countless stares from people wondering why my eyelids had suddenly turned into puffy pink pillows.  When it was time for me to drive, I took a deep breath and just went with it.

I must say it went okay.  I messed up the 3 point road turn, but he seemed fine with my sloppy job.  He commented by saying, “at least you didn’t hit anything.”  So, at least the man was friendly enough-- he thought it was crazy that he had to ride with me in the first place.  He had never seen that restriction, and he even checked with his coworkers and they had never seen it either.   Long story short, I passed the driving test and had a new license made.  Complete with my puffy pink eyelids and bloodshot eyes. 

So Diabetes has once again ruined my life--at least my driving life for now.  I was informed that this will never go away.  Now that I am in the system with a restriction, they will require me to take the driving test every year.  IF I can get my A1C down, and have a decent medical evaluation sent to the DMV, then it might be moved to every 3 years.  If I have a perfect A1C after that, then it may get moved to every 5 years, but that’s it.  Therefore, I have no tolerance for anyone complaining about having to go every 8-10 years to get their license renewed.   For the rest of my driving life, I will be seeing a lot of the DMV thanks to Diabetes. 

Get The Facts

“That was so sweet it gave me diabetes…”  That was so unfunny it gave me the urge to smack you...

Ever heard that? You see, diabetes is one of those diseases that everyone thinks they understand completely.  That type I and type II are the same, except for age;  that we aren’t allowed to eat sugar (we can’t partake in the church’s ice cream social, we can’t eat the pizza everyone is having, and heaven forbid we have a slice of cake at a birthday party).  Not to mention the popular stigma that we can eat all of the “sugar free” candies our heart desires (because of course they don’t have carbohydrates in them)…good grief.

Type I and type II are different.  Type I diabetes is an autoimmune disease – which means that basically my immune system made a mistake and attacked my body tissues.  Specifically, the beta cells of the pancreas (which produce insulin).   Now, type II is generally onset by obesity, but not always.  Type II is not due to the body attacking itself.  Instead, their pancreas still produces insulin, but not enough for their body’s needs.  Did you know- In many cases, type II’s produce more insulin than they need, but the problem is their cell’s lack of sensitivity to the insulin (mostly fat and muscle cells). 

Some interesting facts about diabetes:

Early Treatment (starvation verses insulin)

• If you haven’t researched the history of diabetes, then I highly recommend you do so.  In ancient times, diabetes was detected by either a) sipping the patient’s urine, or b) pouring the urine on the ground and waiting for ants to show up.  If the urine was sweet, ants would be attracted to it.  Physicians during this time did not know how to treat diabetes except to starve the patient (which slightly prolonged their life).
• The earliest known written record that likely referred to diabetes was in 1500 B.C in the Egyptian Ebers papyrus. It referred to the symptoms of frequent urination.
• The Greek physician Aretaeus was credited with coming up with the name "diabetes" in the first century A.D. and thought a snake bite caused diabetes. 
• In the late 1850's a French physician advised his patients with diabetes to eat large quantities of sugar!!  Obviously this didn’t last long...
• Insulin in the 1920s was initially extracted from the pancreas of a cow or pig.  Nowadays insulin is created in the lab, cultured from bacteria and yeast through recombinant DNA.
• Type 1 and type 2 diabetes were officially differentiated in 1936. However, the difference had been noted in the 1700's when a physician noted that

  

  1st Insulin Pump

  some people suffered from a more chronic condition than others who died in less than five weeks after onset of symptoms.
• Portable blood glucose meters for patients were not sold in the U.S. until the 1980's!!
• The first insulin pump was developed in 1963- It delivered glucagon and insulin via an apparatus the size of an adult backpack!
• Famous type 1 diabetics: 
• Halle Berry, Mary Tyler Moore, Nick Jonas, Jay Cutler, Bret Michaels, and Gary Hall Jr. 

Getting Dressed With a Pump

After exploring the stores for weeks in pursuit of the perfect dress, you have finally found The dress to wear to the rehearsal dinner.  You’re so excited, and you can’t wait to show your friends!  You bring it home and try it on once more.   While twirling around in front of the mirror, you stop and listen.  “Buzzz… Buzzz... Buzzz...”   You direct your attention to your pump lying on your dresser.  A wave of panic rushes through your body.   And as your heart drops to your toenails you realize, “Oh my God.  Where am I going to put my pump?”

Most everyone has been in this situation before: Whether it’s your prom dress, your wedding dress, or even just a cute outfit for Saturday night’s date.  It’s that sinking feeling when you realize your caboose (aka insulin pump) is not going to fit anywhere, and ultimately is going to ruin a good outfit.  As this has happened to me a lot, I decided to post some pictures of my handmade pump cases that have helped me out of some very sticky situations.

Ol' Faithful

 
First of all, when I wear a dress I usually stick with Ol’ Faithful.  The leg strap my mother made out of an elastic band, a bra clasp, and some fabric.  With just a few easy sewing steps, you have a leg strap to use for nearly 10 years (and longer!).  This works great for loose/flowy dresses like my blue and white polka dot dress in the picture.  However, if your dress is tight around your legs, you can often clip it to your bra and it be hidden (It's just extremely uncomfortable!). Try to avoid a bulge if at all possible, the idea is to hide the pump, not draw attention to it.

With my prom dress, I had a little more trouble.  After searching for the midnight blue dress I so desperately desired for my senior prom, I had no idea I’d have so much trouble with my pump.  Because I chose a mermaid fit, it was too tight around my legs to wear my handy dandy leg strap.  Also, because it was a one-shoulder, I was not planning on wearing a bra (so I had nothing to clip my pump to).  This is when my mother decided it would be easiest to just sew a pocket into my dress!  It turned out great, and no one could see it when I had my dress on. The inside liner allowed my mother to sew the pocket to it, without ruining the dress.

                 

If you’re more active, a band like this may work better for you than the traditional clip that comes with your pump.  When I played basketball and tennis in my youth, I used this band a lot.  It’s made like the leg strap, but the elastic band is thinner and longer.  As you can see, it is made from a bra clasp as well (which can be found at most craft stores).  However, it also has a small patch of Velcro sewn inside, to prevent the pump from coming out of the pocket.

Remember, you should not be embarrassed by your pump!  I for one understand that it’s annoying when it’s bulging out from an outfit.  It makes me feel like everyone is looking at it.  According to Joe, that’s not the case.  However, with pumps like the Animas Ping, you can hide your pump anywhere you’d like because you can control it with the remote/meter.  Therefore, if you hide it by clipping it to your bra, you don’t have to go around digging in your top when you’re about to eat dinner and have to deal with the mortifying look on your date’s face.   Just remember, if you are going to clip it to your bra, make sure you double check in the mirror to see that it is 100% hidden!  Haha, because absolutely no one wants to deal with this embarrassment: