Comparing Bodies

One of the things I do when I'm in a public situation and have the urge to compare is to say my mantra over and over again: "Everyone's DIFFERENT!" Not better, not worse, just different.

Yeah, I see these beautiful women with slender waists (I don't even HAVE a waist!) and slender upper arms (mine swing), but then I remember I also have to notice that some of them have tubby tushies, and thunder thighs, and some of them have no chins, and some of them have multiple chins, and some of them have straight hair and some of them have curly hair, blonde, black, huge boobs, no boobs, and all the other things that people can hate about themselves, and ya know what? Why am I obsessing over my "flaws" when I have so many other parts of my body that are just FINE, and why is it so important, anyway?

I have yet to see the "perfect" woman, but that's because she doesn't exist. So why should I expect perfection for myself?

When you compare, it's not reality; it's your obsession with perfection. Keep reminding yourself of that: it's NOT REAL! You are just as beautiful as the rest of them, if you can only allow yourself to see that. And while I will admit that I'm not always successful at this effort, I think it IS worth it, because I am working on allowing MYSELF to feel better. And that's what matters.

Body Image

I was going to send this private to a certain lovely young lady, but then I decided to post it so everyone could read it. Just like there are stereotypes of all T2's being fat, there are also stereotypes of all T1s being thin (and diagnosed during childhood). None of these is true. While most (but NOT all!) T1s probably WERE skinny at diagnosis, due to the fact that the diabetes had been eating away at their bodies for quite some time before diagnosis, once they went on insulin, their natural body metabolism took over, and they once again were on track to be the size their genetics determined they should be, assuming normal and healthy food intake.

It's bad enough that MOST women buy into this idea that we should ALL be thin and pear-shaped, but for a woman with T1 diabetes, it's even more damaging, because weight loss is so easily achievable (although at a tremendous cost). If truly NORMAL women have a wide variety of body shapes, why shouldn't we? We're no different from them, except for having uncooperative pancreata!

And while I may sound like I'm preaching from on high, this is EXACTLY the issue I myself am struggling with. I was never fat, but I'm built like a barrel, with no waistline. And my family has called me fat ever since I was a child, only because my sister was skin and bones thin. And they threatened me with diabetes (my grandmother had it) if I ate things they didn't approve of. What a load of crap to put onto a child! And if it's crap for a child, it's certainly crap for the rest of us as well. 

I already know that the vast majority of women don't look like air-brushed, anorexic models, but who ever said they should? The women I know and love ARE physically beautiful just as they are, and I want them to take care of their physical and mental health as best as they can (although there are always bumps in the road), and devote their lives to the causes that are important to them. Aren't you a worthwhile person who is contributing to the world, a lovable person, and a beautiful person? So who cares what those artificial, arbitrarily made-up BMI tables say, anyway?

Dealing with an eating disorder

I'm on a list on Facebook called Diabetics with Eating Disorders. You may or may not know that I decided to go into treatment last April because I was literally starving myself, and the day I woke up and couldn't face eating at all, I knew I needed to do something. In fact, I've been bingeing since I was in my teens, but bingeing and not taking insulin is a whole different story. After I binged myself into a coma in Sept. 2010, and was confronted with the reality of the fact that I NEED to control my food intake and take my insulin. So I swung in the opposite direction, and started to limit -- at first under the guise of low-carb, but not true low-carb, because those who are following low-carb diets are not eliminating all plant and most animal foods, nor are they limiting the quantity of what they eat. So I decided to enter treatment.

So one of the women posted about the fact that she had fantasies about gaining enough weight to qualify for weight-reduction surgery, and I have to admit that I've had the same thoughts. But I know people who've had weight-loss surgery, and it's no picnic -- some of them succeed in keeping the weight off by following a draconian diet, and others just stretch out their stomachs by eating too much, and gain the weight back. So I guess we ALL, both people with ED and those without, have to accept, somehow, that we were born predisposed to our own body builds, and we AREN'T going to all look like the models in the magazines. Which is not to say that it's easy -- I just ate a Mounds bar, and felt like crying about it -- but either I work on self-acceptance, or I might as well toss it all in. Because there is no realistic or practical choice, even though your mind tells you lies. I'm going to bet that there are LOTS of other women out there listening to the lies, and trying all the miracle diets and pills, and maybe they can abuse their bodies more easily because they don't have to deal with the diabetes demon as well, but we all have to learn to believe that life doesn't HAVE to be that way. 


So my goal is to accept that I'm NOT obese, and I'm NOT willowy, but I'm shaped just like a 64-year-old should be. And to accept that yes, I have to take insulin, but I'm not even taking all that much -- certainly within "normal" limits, and that it's not a catastrophe to take a little more when I'm having a big meal, which is not very often. My body lets me BE and DO, and the insulin lets my body live and not die. So I need to just let that be, and stop obsessing over it.

Working as a community

I just saw another thread somewhere in which the parent of a T1 was railing about how bad an article about T2 was. Well, it was true that the article really didn't apply to T1, but that wasn't the point. Most of the articles in the press are going to apply to T2 (but sometimes both), because it really is a common and serious disease.

think it's important for all people to have a realistic view of all types of diabetes and genuine compassion for them. SO many T1's are so narrowly focused and invested in their own disease that they remain totally ignorant, and sometimes actively hostile and biased toward T2. It's not RIGHT -- NO ONE with any disease deserves blame and shame, and while it would be nice if the media specified T2 when discussing things that are appropriate to them, a mature attitude for T1's and their parents would be to sit back and remember it doesn't apply to them, and that it DOES apply to the vast majority of diabetics. And appropriate action would be to respond to the media, reminding them that clearly indicating whether they are talking about T1, T2 or both would be welcome and educational. But the comments about how stupid an article that is obviously about T2 is, or getting furious because the diabetes isn't a T1's fault, and remaining ignorant of the very real problems faced by T2s and blaming them for something that is not their fault either is really not helpful to anyone, and only creates bad feelings in a community that should be supporting each other. We need to be open minded and empathetic toward the problems faced by all of us, even if we need to deal with them differently. We need to educate the media and the public, and while that is not easy, we need to persevere. And not take anything personally, but rather use it as an opportunity to educate.

Rethinking Type 2

I just watched a YouTube video of a Barbara Walters show with Paula Deen as co-host, and Dr. Jeff Nathan and young Misty Ayala as guests. You can see it at

http://www.youtube.com/watch?v=Ny5fKOK7DMU&feature=plcp

First off, Dr. Nathan DID distinguish between Type 1 and Type 2 very clearly, and to me, it was obvious that when he was talking about lifestyle changes and about Misty, that he was talking about T2. My only real complaint is the label "the Fat Show", simply because the real problem with merely correlating T2 with obesity is that it doesn't HELP anyone. Telling people they're fat when they know perfectly well they are, and already feel guilty and ashamed about it is not really helpful. Seems to me that the issue is not whether people with T2 are fat, but understanding that metabolism is complicated, poorly understood, and very hard to regulate when it's malfunctioning. And there is increasing evidence that T2 is NOT a merely a disease of pancreatic malfunction, but a panoply of metabolic dysfunctions. The fact that Misty was able to come off Metformin, and get good control of her diabetes while remaining obese points very clearly to the fact that obesity is not the CAUSE of T2, but more likely a result of metabolic dysfunction, whose mechanism is not yet fully explored. I think this is what T2s are trying to say when they object to the linking of T2 and obesity. And it seems like many people are plugging their ears and singing lalala when T2s try to make this point.

One of the things I am working hard on is NOT to take it personally when the media is clearly talking about obese T2s. I know that T1s get upset when they are ragged about why don't they clean up their diet, etc. by people who really don't know anything about diabetes, but it's JUST ignorance, and we really need to learn to let it roll off our backs. In my mind, it's just about the same as when people tout miracle cures for ANY disease. I do have my own personal crap detector (AKA Snopes) in my brain, and I'm really working on learning to use it more automatically. The real issue is to call out the bullshit when appropriate and to be able to distinguish when it IS appropriate. When your best friend tells you that your diabetes could be cured if you'd eat less, call them out on it, and when the media fails to clearly distinguish between the types, send out answers and press releases, but when the media IS appropriate, even if not perfect, as I thought this show was, I think they should be applauded for it, not criticized.

The 4 D's

It started when I was in the 5th grade. I made a naive remark that grossed someone out, and they started avoiding me, or else tagged me and ran after the others screaming "I've got the cooties and I'm going to give them to you! Ha ha!" and it turned into a game of tag. For everyone else, not me. No one to eat lunch with, no one to walk home with, no friends to play with after school. I must have been acting badly at home, too, because my mother was always yelling at me as well. And I remember thinking to myself that the only time I was at peace (not happy, just not being tormented) was while I was walking between home and school.

Eventually, the other kids forgot about it, and we moved on, and I began to have friends again and became more content, but the experience seems to have scarred me for life, because I have had recurrent major depressions ever since then. Events that other people find stressful can throw me into a tailspin, and I have had as many as 5 suicide plans in my head at any one time.

And then diabetes came into the picture. I was 45 when I was formally diagnosed, and I was distraught. Blame and guilt and confusion, and poor medical guidance threw me for a loop. I spent many hours crying, alternately pretending it wasn't true, and frantically trying to get information and guidance. In the beginning, I didn't even know whether I had diabetes or not (my doc called it hyperglycemia), and even though it is beyond question by now that I have diabetes, my emotional self still wants to deny it, and I don't always take care of myself. And when I'm depressed, I really DON'T take care of it, and we all know where that leads!

So I call my illness the 4 D's: Diabetes and Depression, the Deadly Duo. Either one would be bad enough, but together they almost killed me.

I think mental health care needs to be a component of EVERYONE'S diabetes management plan. For me, the one makes the other worse. If my blood sugar is high, I'm more likely to get depressed, and if I'm depressed, I don't take care of myself, resulting in high blood sugar. Vicious cycle if I ever heard of one. So I would like to see more mental health professionals who are familiar with diabetes and what it does to a person's head, and better access to mental health care for people with diabetes.

And I am happy to report that I AM now getting very good care, both with antidepressants and talk therapy. I've been pretty stable for the last couple of years, and I now have a plan and a way to get help if I do get depressed. I wish everyone had that.

Not a teenage issue

When people think eating disorders, they think of girls in their teens and twenties, and they think of the stereotypically emaciated models and actresses. And the media feeds on this image, showing young women in bikinis whose bellies have sagged (oh no, she's gotten fat!) or women whose backbones look like mountain ridges.

But it's blatantly untrue and damaging to ALL women, no matter what their age. I've been talking to other women about whether they compare themselves to other women they see and judge whether they are fatter or thinner than the other woman, with corresponding despondent or joyful feelings. And most of them have admitted that they do. How depressing!

And we all know that T1 diabetic women are more susceptible to eating disorders, because they have the diabetes to deal with on top of the discomfort that most women feel.

But I'm going to posit that eating disordered thoughts occur in older women as well as younger women, and that they exist in T2s and well as T1s, because all of us are dealing with food issues, regardless.

With that as an introduction, I'm going to freely admit that I have an eating disorder. I have had it since I was in my early teens. At the time, having been restricted from eating anything with sugar by overly health-conscious parents, my brother and sister and I used to spend our $1 of allowance money buying 20 candy bars each (and they were bigger in those days), and consuming ALL of them in one sitting. Looking back, I recognize that that was the beginning of binge eating, although I was not aware of it at the time.

Later on, when I got out on my own, I went into full scale rebellion, deciding that I would eat anything I wanted, however much I wanted, any time I wanted it. This developed into a habit of eating only one food at a meal, sometimes a giant portion of ice cream, and subsequent weight gain, although I was never actually obese.

Then came the diagnosis of diabetes, which caused even more feelings of rebellion. I couldn't stick to the meal plan I was given, and I was so starved that I would eat until my stomach was distended and painful, and still feel hungry. Once I went on insulin, the hunger abated, and I actually LOST weight on insulin, even though the literature says insulin causes weight gain.

But I was still bingeing, and in the summer of 2010, I started bingeing hardcore. And binged myself into a life-threatening coma. As a result, I became hypersensitive about food and began to limit my carbs. Well, at first it was only a few foods that I eliminated, but my food vocabulary got more and more limited, until I was only eating a cup of milk in the morning, a cup and a half of Greek yogurt midday, and a small hamburger patty at night.

And I lost more weight, and people kept telling me how good I looked, and I kept on trying to assuage my guilt for being fat (most recently, not even overweight) by eating less and trying to feel virtuous when I was hungry. And still occasionally bingeing. The only concession I made to the bingeing was to monitor my BGs and take insulin when I thought they had gone high enough. Needless to say, this was NOT a good way to live.

So about a month ago, I started to take steps to deal with it, which first of all, took awareness of the condition I was in, and then the willingness to do something about it. But it's HARD for someone as old as I am to admit to having a "teenage" condition, and second to actually seek help.

So I've been in treatment for about 2 weeks, and yes, it has been EXCEEDINGLY stressful and difficult. They're making me eat more than I feel comfortable eating, and making me eat foods that I had eliminated a year and a half ago. Some people can do well on a low carb diet, especially if they like a lot of different vegetables, and are creative with and like carb substitutes. But I've been a picky eater since I was tiny, and never liked to cook, so the obsession with eliminating carbs became an illness for me.

The reason I'm telling you all this is because May is Mental Health Awareness Month (or something like that), and eating disorders are a mental health issue. And they're probably a lot more common than we realize. And they're NOT just a teenage issue!

Diabetes as a Spectrum Disorder

I've really been thinking about the T1/T2 wars (and please don't deny that they exist!), and was contemplating how to reframe the question so as to help everyone understand each other. And I think the concept of diabetes as a spectrum disorder is a really helpful one.

In academic studies, they concentrate on insulin resistance and autoimmunity as an either/or in order to make the population they are studying as homogeneous as possible. But in real life, it's just not that simple. Think about it:

First of all, insulin resistance. The fact is that EVERYONE, not just diabetics, falls somewhere on the scale of insulin resistance, all the way from people who are extremely insulin sensitive to those who are extremely insulin resistant. The curve is actually skewed to the right, which means that most people are at least somewhat insulin resistant. Of course, if their pancreas is healthy and they don't have the genes for diabetes, their pancreas merrily churns out the exact amount of insulin they need. While it's true that obesity correlates to some extent with T2 diabetes, it's NOT the cause, because while 33.8% of the general population is obese, only about 8% have diabetes of ALL kinds, so there are far more obese people who DON'T have diabetes and never will, than those who do.

Then there is insulin production, which again falls on a scale from zero production to massive production. Autoimmunity is not the only cause of pancreatic failure: it could be surgery, it could be amyloidosis, or it could be another cause which has not yet been determined. But again, this is not an either/or criterion; it's a spectrum, and some people can be producing some of their own insulin, yet not enough to stay alive.

So if you visualize an axis, with insulin resistance on the x axis, and insulin production on the y axis, you would see that a person could fall anywhere in the quadrant, regardless of the cause of their diabetes. So you could have extremely insulin-resistant "T1's" and you could have insulin-sensitive, slender "T2's" and everything in between. And because of that, clinically and experientially, the either/or, T1/T2 distinction breaks down -- the whole point of diabetes treatment is to do what the individual needs. So there is really NO basis for anyone with diabetes to feel hostility toward anyone else, because we're all unique individuals, and not one group fighting against perceived blame or victimhood, or any other response from the other group.

The fact is, we're in it together, and we need to support each other, no matter where we fall on that graph!

Diabetes and the Media

It's sort of a damned if you do, damned if you don't position, you know. People with diabetes don't want to be discriminated against because of their diabetes, and some of them go to extraordinary lengths to seem just like other people. But when everybody was so excited that Nat Strand won that race, no one mentioned that she had several episodes where she would have died without the help of her partner. No one mentions what could happen to that race car driver if he had a sudden unexpected low on the track, either. You see the smiling faces of all these super-healthy, attractive young people with diabetes on all kinds of advertisements, or you see equally handsome, not quite as slender, but still healthy looking older people, so who can blame the world for thinking that managing diabetes is not particularly difficult?

While it's true that diabetics should NOT be discriminated against, and should be able to do anything they're capable of, the media, in both articles and advertisements, gives a VERY distorted view, and the public has no way of knowing any different. And you're right, it's irritating as hell!

Learned the Hard Way

OK, a day late on this prompt, but it's one I can't skip. Because I learned something very important the hard way. And that is, I have diabetes.

I have always joked and called my diabetes Type Weird, mostly because I never fit into any of the boxes very well. My diabetes developed relatively slowly -- in 1990 I had a normal fasting glucose, in 1991, I had numbers that would be diagnosable today, but weren't then, in 1992, I was just at the number for diagnosis, but since I had had a coronary artery spasm, they chalked it up to being sick, and in 1993, I went over the line and got a diagnosis.

Needless to say, during these years, I was emotionally in bad shape, because my family was terrified of diabetes since my grandmother had had it, and I was raised with "Natalie, don't eat that, you're going to get fat, and you're going to get diabetes!" And my reaction was always a quiet, mental "shut up!" So as my numbers started to go up, I was scared and rebellious. On the one hand, I wanted a diagnosis, because I wanted to take care of it so as not to get any complications, but on the other hand, I DIDN'T want to be bothered with thinking about diet and exercise. And on the third hand (there is always a third hand!), I desperately didn't want to be considered fat, and be told that I had caused my diabetes by getting fat. (Thank you, family and media!)

Well, the fact was that I wasn't fat, although I was overweight, and diet and exercise didn't work for very long, and then Glucotrol, a sulfonylurea didn't work at all, and I was on insulin 5 months after my formal diagnosis. Insulin worked like a charm, and control was pretty easy, because I DID still have some endogenous insulin production. And because control was so easy, I would often omit insulin, and watch my BGs climb for a few days until I had to admit that no, the diabetes did not go away while I wasn't looking. But all I had to do was take a little insulin, and my BGs would go right back down again. And meanwhile, I lost 20 lb. and if I had been a true T2, that should have improved my situation, but it didn't do a thing -- my insulin production continued to deteriorate slowly.

OK, fast forward to 2010. During all those years, I had been playing at not having diabetes, and always caught myself before I got into real trouble. But 2010 proved different. I was feeling really rebellious and REALLY didn't want to deal with the food restrictions, and I started bingeing badly. I had always binge eaten, but this was a crisis situation. I didn't omit insulin entirely, because I did wear my pump, and always had that basal going in. And I did take boluses, but not always, and often not enough. So my BGs started going up and I just sat there and watched them, but didn't do anything about it.

Until I started going and staying above 400 all the time. With excursions into the 500's and sometimes HI. Then I started trying to fix it, but was having no luck. One day I took 150 units of insulin and nothing happened. I have since learned that when the BGs are that high, all the cells in the body become extremely insulin resistant, and the metabolism gets totally screwed up, and it's time for the ER.

But I didn't know that at the time, and I tried calling the local Diabetes Wellness Center for help, and all I got from them was a pamphlet on counting carbs. Then I went to my doc, with a fasting BG of 302 and an A1c of 10.1, and liver enzymes in the 100's (normal is below 40), and he had no suggestions and just sent me home. 6 days later, I didn't show up at a picnic, so my friends came looking for me, and found me near-comatose. They got me to the hospital and the doc there told them that if they hadn't found me, I would have been dead by morning. Obviously, I didn't die.

So the lesson learned, but not gratefully, is that yes, I have diabetes, and no, it's not going to go away while I'm not looking. In addition, I learned that yes, I'm dependent on insulin, and my CDE told me that for my own safety, I need to make sure that all medical professionals treat me as a Type 1, because while I was in the hospital, first they tried Type 2 protocols, and they didn't work. But the rest of you can call me Type Weird, just because I don't fit into the boxes. Except the big box that says "Diabetes". :-)

Writing style

Gonna do yesterday's prompt today, because I really don't have anything to pin up. I ain't a pin-up girl -- never was, and by now, never will be, LOL!!

So I'm going to talk about my writing style. I'm a reactive writer, which is why I'm doing so well with this prompt system. Ask me a question, and I'll write away. And while I do edit and consider my words, I'm a pretty much stream-of-thought, but fairly well-organized writer.

And I do think I have my own unique viewpoint, and things worth saying about health and diabetes. Other things, too, although I don't write about them as often.

But one of the things I'm discovering using this month of prompts is that I have a lot to say about myself, and one goal is to write about my journey of self-discovery after the month is over. That means it will be a little wider than diabetes itself -- I have things to say about mental health and emotional honesty, too. This may well turn off some people, but I think I need to be honest about myself and I don't find journaling helpful. But knowing that someone might actually read what I write is very motivating to me, and getting responses is even MORE motivating.

And I think that the moment that you stop learning about yourself and discovering new things is the moment you start to die, and I'm not ready for that yet.

My Dream Day

Another toughie. Again, for all of us with diabetes, it would have to be a day without it. What would we do differently if we didn't have diabetes?

It would be nice not to even think about it, as if I had never had it. Not to have to plan for what I'm going to eat, not care about food groups, just eat and enjoy the food, whatever it happens to be. Don't care how many carbs, don't care how much insulin, because it just doesn't matter.

Another part of my dream day would be not caring whether the food I eat is going to make me gain weight. Just eat what I like, in the amount I like and absolutely not care.

Exercise if I feel like it, doesn't matter what time, nor what the intensity is, nor for how long. None of that. And don't need to test before or after. And don't need to carry glucose tabs (which I HATE) because there is no danger of going low.

Nothing plugged into my belly. No buttons to press, because the pump is not there. 

Not pricking my fingers AT ALL. Diabetics DON'T love pricks.

Nothing else even matters. I don't care whether it's rainy or sunny or snowy (although I'd prefer not to have hurricanes, earthquakes or tornadoes), I don't care whether I'm up early, or sleeping in, reading a book or watching a movie, or even washing the dishes or doing the laundry.

But it would be nice to spend the day in the company of good friends, and to laugh and talk and enjoy ourselves, and my mind would be fully free to participate in the fun without that little diabetes demon clinging to the back of my brain muttering "my preciousssss" while trying to grab the part of my brain that really wants to be free!

10 things I couldn't live without

This ones' a kind of double-cross prompt, because as diabetics, we ALL could just list out diabetes supplies, and that would come out to more than ten things! If we were dropped on a desert island with nothing but our diabetes supplies, they would run out and we'd be dead soon thereafter, anyway.

So here are ten OTHER things I couldn't live without:
1. Shelter. I'm lucky, and have a house, but I KNOW that there are millions of people all over the world suffering because of lack of shelter.
2. Food. We in America are among the luckiest in history because we have a wide array of food available to us -- far more than we could grow locally, and we are not subject to local crop failures.
3. Clean water. In most places in the US, clean water is available at the turn of a tap. We don't remember how people died from cholera and other water-borne scourges because they couldn't get clean water.
4. Indoor plumbing. We here in the US live without having to endure the stench and inconvenience of outhouses, nor do we have to do the disagreeable job of emptying and cleaning chamber pots! We also have warm water on demand, so we can enjoy those soothing showers!
5. Refrigeration. Our food lasts longer and is less subject to contamination because we can keep it cool or even freeze it. We can have a glass of iced tea in the summer without even thinking about where that ice came from.
6. Electricity. While we could certainly conserve electricity, we would be very unhappy without our lights during the dark evenings of winter, not to speak of our music, computers, e-readers, microwaves and other electric appliances.
7. Education. What a pleasure to be able to read! By reading, we can communicate with the centuries, and it even makes our daily lives easier, like when we pin a note to our kindergartner's coat! And the vast majority of our jobs depend on the ability to read, write and do arithmetic.
8. The infrastructure. Almost everything we use is transported over roads, or by train, or even by airplane -- we would be in a mess in our large cities if the infrastructure didn't exist. That includes transportation to our jobs and to do our errands.
9. Medicine. For all that we Americans complain about our health care system, it's the system and not medicine itself that is the problem. As diabetics, we really NEED our insulin, but there are others just as dependent on other medications for other illnesses. And then there are the accidents and other sufferings that are not chronic, but still need care.
10. Each other. I saved that for last on purpose. I couldn't live without the people who have helped me, comforted me, loved me, and done things to make my life easier. And that includes my cats! LOL!

Stream of consciousness day

Well, this is a kind of follow-up to the blog I wrote about me.

I have finally come to the point of having enough strength to admit that I have problems with food, and the desire to do something about it. The picky eating, the diabetes, and the problems with both bingeing and starving myself make for a complex situation.

Right now, I am struggling with the fact that if I eat only a minimum, it's much easier to control my blood sugars. But when the minimum means one cup of milk in the morning, and a cup and a half of Greek yogurt in the afternoon, and frequently nothing else, that is really not a nutritionally complete diet.

I am considering going into an eating-disorders program which has a diabetes component. This means that the staff has dealt with diabetics before, which is comforting. On the other hand, they have never dealt with ME, unique zebra-creature that I am. And that is scary.

So I am looking at this huge step with a mixture of hope and trepidation. I am not a diabulimic teenager, and my health is stable, so I'm not in crisis, but still, I may have a couple of decades left in me, and my thinking mind says I should attempt to live them as healthily as possible.

One of my fears is the wide diversity of opinion as to what constitutes a healthy diet. I have considered all the sides that I have been able to discover, but in the end, I guess my picky eating and my diabetes have the final say. It might be healthy to eat walnuts, but I can't tolerate them, and it might be healthy to eat whole-grain bread and oatmeal, but my diabetes says no. And, like many, I fear weight gain -- I HAVE lost weight on my restricted eating, and while my weight is in the "normal" category, I'm certainly not thin.

So I plan to enter the program next week, but meanwhile, I'm living with a lot of anxiety, and my little devil eating-disorder friend is desperately trying to talk me out of it. And I'm just trying to hang on.

Dear 16-year-old me

It was a good year, but there are storm clouds brewing. You finally figured out how to get around your parents' strict food restrictions, and you're spending your lunch money on glazed doughnuts in the morning at school, and bingeing on $1.00 worth of candy bars (20 bars!) whenever you get your allowance money. Oh, my, that stuff tastes SO good!

But you're not eating very well -- your picky eating is preventing you from getting the nutrition available in many fruits and vegetables, and you have no idea how to circumvent that, because the only way your mother knows how to make vegetables is overcooked and mushy, which you can't stand. But you do love your mashed potatoes with lots of butter, and bread and butter!

So you don't know it, but you're setting yourself up for carb addiction, and when the diabetes hits, you will NOT be in a good place either nutritionally or emotionally. The very first thing the CDEs will do is send you to a dietitian, who will place you on a meal plan that you will absolutely abhor, and not be able to follow. So you will throw it to the wind, and you will NOT be doing your diabetes any good.

So I'd like to suggest that you try food, a little at a time, and when you're on your own, do more investigating about nutrition and work on body image and sense of self. This is hard to do without any support, and I don't know if you can find the support, but at least try. Don't be so hard into denial of your food issues, even before diabetes. It's a hard road, and you may have to travel it alone, but try.

OK, I have no idea if I did this right -- it wasn't very intuitive, but I did the best I could. In case it doesn't show up right, the prompt was to create a poster at the Keep Calm site, so I did. Not really very creative, but I'm actually just trying to keep my spirits up today.

I had a good/bad weekend -- enjoyed a lovely Passover seder on Saturday night, then a ladies' luncheon on Sunday, but with the clearly foreseen results that always happen when I actually eat "people" meals -- stubbornly high BGs that won't come down for hours and hours. And then, today, inexplicably feeling down and not ready to deal with the world. Wanna crawl in a hole and pull the cover over me. So you'll understand if I have nothing wise or wonderful to say today.

About me

Today's WEGO prompt was free writing. And I decided to write about something about myself.

The first thing that not many people know about me is that my grandmother had diabetes. When she was diagnosed in 1927 or 1928, insulin was commercially available, and so she was never at risk of dying, as she would have been just a few years earlier. And she was an adult at the time, just like I was at diagnosis.

She had young children in the house at the time, and my mother remembered coming home from school to find her lying on the couch with a wet rag on her forehead nearly every day. And that she would always eat puffed rice cereal in the afternoon. I wonder whether she was having hypos every day. The insulin available at the time was pretty crude, and pretty unpredictable, so it's not an unlikely scenario.

I also remember living with her for a short while when I was about three. I have a clear memory of the black bakelite case she kept her syringe in, and her boiling it on the stove, and her pulling up her dress to give herself a shot in the thigh. So my child mind made the association between shots and old people, and when I started to study diabetes seriously after my own diagnosis, it initially seemed weird to me that it was the children who needed the shots and that the older folks (T2s) could often use pills!

Because of my grandmother's struggles with diabetes, my family was terrified of the disease, and I was raised not being allowed to eat sugar or candy or chocolate or cake or cookies, because at the time (1950's) they believed that eating sugar caused diabetes (as well as tooth decay -- my father was a dentist). And I still have the admonition ringing in my head: "Natalie, don't eat that -- you'll get diabetes!" Not a nice thought to grow up with.

So when I was diagnosed, I was distraught, because in my head, all that I could think of was the voices saying "I told you so, I told you so!"

So having diabetes has always been a rocky road for me. I continually struggle with accepting the reality that I DO have it, and that it's NOT going to go away while I'm not looking. And that in truth, I CAN'T tolerate much in the way of sweets and carbs, which, because of my restrictive childhood diet, still seem like attractive forbidden fruits to me.

Every so often, I go into rebellion mode, and omit insulin, just to prove to myself that I really DO have diabetes. I know that this is not the healthiest behavior in the world, but it remains part of my emotional struggle. And for me, the emotional part is by far the most difficult part of living with diabetes.

Health Haikus

Today's prompt is health haikus. Well, at least American haikus, which are a totally different art form from the traditional Japanese haiku. I've shared American haikus with Japanese, and they just shake their heads and tell me that just because it's 5-7-5 doesn't mean it's a haiku. Well WE think it does! That amuses me! :-)

Anyway, here goes:

Pump infusion set.
Pop! goes the weasel into
My tender belly.

Blood sugar goes up
Blood sugar goes down, alas!
Not where I want it.

How many carbs does
That delicious looking plate
Of spaghetti have?

Insulin and carbs
Are not best friends and do not
Play well together.

Pup got a seagull
Kerri got a tall giraffe
Oh, what will I get?

(CGM users will understand this one!)

What's it like to eat
Thinking not at all about
Carbs and insulin?

Enough? :-)

Ekphrasis

First off, we have to define the word, because it's not a common one. The dictionary says that ekphrasis is a description or commentary on a visual image, and the WEGO prompt was to choose an image and then talk about how it relates to our health concern.

The title of this picture is "The Light Harvest", by Brad Wagner. And it made me think of a day with diabetes. Each little hanging flower is a point of time, and if we let them all pile up on us, we can so easily get overwhelmed. There is so much to do and so much to think about and process and figure out in the course of managing our disease.

But the young man in the picture is not focusing on all the flowers. He's focusing on just one, and appreciating it. I imagine that he could focus on the others, each in their own time, with the same degree of attention and love, but for now, it's just this one.

That's how it is with diabetes. Of course we will have to confront what the day brings us as it progresses, but for now, we need to deal with the present. If my blood sugar is high or low, then I need to deal with it NOW. It doesn't matter what else I want to be doing, the diabetes takes full priority.

This can be very annoying, and even dangerous, for example, when you have a low while driving. All the more reason to focus on just this moment, and do what needs to be done. And remember that, nuisance that it is, you do it because you DO want to focus on yourself and take care of yourself, and love yourself. It really boils down to love.

I don't love my diabetes, but I DO need to focus on it in order to love myself, just like the man in the picture.

Why I write about my health

Today's WEGO prompt is: I write about my health because...

Of a couple of reasons.

The first part is because, like many people with chronic health conditions, I have a lot of emotional issues surrounding my health. Journaling is not really helpful to me, but writing in the hope that at least someone will read it, and maybe even respond is what motivates me to keep on writing. And I haven't even begun to get into all the issues that bother me, even though I have had diabetes for 20 years. Everyone needs an emotional outlet, and I'm struggling to find mine, because I don't have much opportunity in my daily life.

The second part is that I'm naturally interested in science and medicine, and I read various blogs, newsletters, and journals and I want to share what I've learned. That means that I'm not writing about myself for the most part, because I don't fit into any of the diabetes boxes perfectly, but I want to share things that may be of value to others. I'm not a certified diabetes educator, and not eligible to become one, but that doesn't mean I can't contribute to the education of others.

I have come to have an interest in Type 2 diabetes and obesity, although I suffer from neither, because I feel like they are a very underserved population, and subject to a lot of scorn and shame and blame, and the more I read the scientific studies, the more I realize that it is not their fault, although there are things they can do to ameliorate the natural tendency toward Type 2 and obesity that they were born with. But in order to help people with Type 2, it is important to approach them with compassion and understanding, not to lecture them about what bad people they've been. So I guess I've cycled back to the beginning of my post, which is emotional support and caring. Yeah.