Wednesday, March 14, 2012

Reflections on the Gift of Insulin/Life


Not long ago my good friend Shi called asking if I had any extra insulin around the house. I keep a bit of a stock pile out of fear that a bottle could break, or that anarchy could breakout in our society and I wouldn’t be able to get it. (I’m the worst case scenario planner, always.) I never forget reading how after the Japan Quake last year lots of survivors ended up dying because they couldn’t get needed medications. As a kid I watched a movie with two diabetics on a bus that crashed, and one of them was out of insulin and the older man gives his last dose to the younger woman saving her and we watch him die a romantic hero. These memories developed my anxiety about carrying enough insulin.  For once my anxiety was useful, my hoarding insulin allowed me to be a super hero that day sharing life giving fluid she and I can't make.


That night I was discussing the insulin ordeal with my husband, and he was appalled to realize how expensive insulin really is. I’ve been very blessed with sufficient health insurance, and a good job to finance my healthcare needs. Many are not so blessed, and my husband brought up the rather controversial issue of wondering how many Diabetics die due to lack of insulin availability and whose fault is that really? In Seattle, there are organizations that pass out free syringes to help drug users, but resources for free syringes and insulin are very limited. Perhaps if I win the lottery, I will start a foundation supplying insulin to those who can’t afford it.


The other night I was on a diabetes chat site, and discussed with a fellow longtime T1 how depressing it is when you have had this disease for over 30 years and your hopes of a cure have died. He and I both acknowledging we carry a lot of sorrow thinking that we won’t ever get to live disease free. My anonymous chat friend has a very strong faith in Jesus, and he wrote that he longs to go home to his Lord but that his faith also provided him the strength to keep dealing with his day to day drudgery of blood tests, injections and carbohydrate counting.


I processed what my friend was sharing, and I found this conflicting desire to be with the Lord and remain here a little confusing. I guess what remains perplexing to me is this concept that the next world is much better, yet those that profess believing in this still seem to be so afraid of going on to it. My friend did confess that he once stopped giving his insulin being ready to return to the Lord, but that he went back on it because he was convinced this was suicide and would cause him to end up in hell.


This statement about suicide got my angst going. Per my friend’s perspective, I am supposed to believe that God created our bodies, and then allowed malfunctions within them to happen. Then years and years later, after lots of people pass naturally, God enables man to invent medicine and remedies to health afflictions. (What some would consider, playing God.) So after the medicine is available, and you don’t take that medicine then it is suicide and you go to hell. Wow, sick people just don’t get any breaks now do they?


I had to ask my friend would he still call it suicide if a diabetic that couldn’t afford insulin passed away. He told me I shouldn’t think so much with my devil’s advocate mind, and that he would get back to me with an opinion on that one.


Being the weird thinker that I am, I can’t prevent pondering if our planet’s over-population issues are a result of many living longer than was intended in God’s bigger picture? Who knows, certainly not me. I’m going to keep taking my insulin, and counting my carbs and fighting the diabetes induced depression. And when I’m old and have used up every last ounce of fight in me, I will be at peace with leaving this body behind knowing I lived this life to its crazy fullest.

Thursday, October 13, 2011

Pump transitions, and insurance things- ANGSTY ISSUES

At the end of Sept. 2011 (about 3.5 months into my pump infusion transition) I went for another doctor consultation and HBa1c test. I was irate to learn I reached an 8.6; a reading higher than I’ve had since 1995. (Picture angry Hemme tantrum here.)



I sat in a medical office chair wondering why I had shelled out so much money for a pump, spent so much time and money for extra medical visits, given so much energy to convince myself that this change would make me better. Fighting back tears, and a sense of helplessness; I counted down backwards from twenty to fight off an in office tantrum.  I wanted to THROW things, to cry hysterically and most of all I wanted to NOT FEEL what I was feeling!  I just want to be OVER F'N DIABETES, to be OVER this constant vigil already.


It is so frustrating to try to improve your glucose control, only to have a test show you...oh, you were better off before you did ALL THIS WORK!

The people I am paying to help me improve keep telling me the pump will make things better, and I hear it and believe it, but have yet to realize it and the tension is mounting inside me.  It is likely that my feelings are adding stress only compounding my glucose control problems, but even that acknowledgment doesn't make it any easier.  At least my new gym has a punching bag, I like the punching bag....punching is GOOD. 

I just want to realize some success, I want to see a return on investment, but my pump investment seems to reflect my stock portfolio right now……..it doesn’t look so good.


I show up at Endo appointments hoping for new information, guidance, some epiphany, and try to ignore my belief that I already know whatever it is they can say……I still believe I know more about type 1 Diabetes than any practitioner I’ve ever encountered; outside of Dr. Richard Mauseth that I worked with as a child.  (He made me the know it all I am now...lol)

I am frustrated with practitioners that keep telling me to dose up more insulin which makes me eat more as well as have more frequent lows, and then I don’t work out as much; I would be 250lbs if I dosed the way a couple practitioners have suggested I try.  The funny thing is, the more insulin I give the higher my HBa1c goes because I am bouncing around even more than I did when I was skimping on my insulin.  I wish that doctors would suggest more exercise rather than more insulin when it comes to hyperglycemic issues with me.  I don't know if I am missing something or the advisers are or...it's all just a gamble as I've tried to explain insulin dosing before.

I wouldn't feel like I was wasting money on doctor consultations if I could get the sense a doctor was trying to understand me, and could relate to how hard my battle is.  I think my greatest frustration is the patronizing talk (or at least perceived patronizing talk) I get during a Doctor consultation....."Do you know how to count carbs?  Do you think your insulin sensitivity ratio is right?"  Of course I KNOW HOW to count carbs, and maybe I could focus harder on my sensitivity ratio, but I want a Doctor to look at me and say, "Okay, you're SCREWING UP real bad, do something or die.." 

Maybe try acknowledging the successes I have in making it this long with Diabetes, and then whip me for not doing what is expected.  My greatest frustration is the awkward encounter I have with a doctor when I explain to them how uber sensitive to insulin and stress my body is, how diabetes impacts mental health and how my anxieties are impacting my control, how a lot of Diabetics don't sleep well (me especially), how TIRED sick people are of being SICK and being patronized by people that are more focused on money than our health.

This dis-ease impacts every aspect of someone’s life, and it needs a holistic treatment approach.  I am frustrated by a medical world that wants to isolate Diabetes care from general care. I am supposed to see one doctor for primary care issues, another doctor for Diabetes issues, been suggested to see a psychiatrist for mental issues and heaven forbid you have a complication and need a nephrologist for kidney issues or an ophthalmologist for Diabetic retinopathy. ARGHHHHHH!!! Just shoot me already. Nobody has the time or energy to live healthy in this country, it is just SILLY!  I should be able to get a pap smear, get meds for a cold AND get Diabetes care from one doctor, or at least in one medical office during the same appointment.


The US med system has made things into silos, for money issues. I am ranting here because IT IS SO FRUSTRATING. I don’t expect to change things, but just want to document what it is that makes me SO DAMN ANGSTY!!

Oh, and as a lovely bonus, I got new insurance this year so I will have to max out a deductible AGAIN!  Yeah, 2011 is gonna be a BIG SPENDA med wise, which is just adding to my pissy tude about all the changes.  ROOOOOAAAARRRRHHHHHHHHHHHHHHHHH!

Now that I got that out, I feel a little better.  Glucose reading is 156, we're (pissy Sarah & happy Sarah) okay.

Tuesday, September 27, 2011

The angst of weight gain and insulin management

The issue of weight is often in the thoughts of those around me.  Especially my female friends spend hours watching it, obsessing over it and diligently managing it; plenty of guys I know do too. My brother in law has commented that, "Americans behave as if having fat is a sin, something so deplorable it shouldn’t be done." He speaks Spanish as his first language so his statements often translate somewhat dramatically in English. Yet, his comment is very on point when I reflect on my friend's beliefs and our media messages.


Type 2 Diabetes is a North American epidemic, Canadians and US citizens especially in colder climates are not only obese, but many are approaching morbidly obese body index rates. “Morbidly obese”, how could being this not be a sin, it sounds TERRIBLE. I’m aware that there are many folks that might be approaching “obese” per medical charts, but their cholesterol, blood pressure and other health measures are otherwise normal or healthy. Yet, our media and much of our culture seems to want to send the message that we all should be jiggle free. Then again, is that just what me and many of my women friends perceive due to our own predispositions?!

Either way, I’m currently pretty embarrassed about my body mass index, weight and reduced muscle tone. I’m more embarrassed about this physical failing than a number of other things I could be ashamed about, i.e. rising HBA1C tests or higher cholesterol.  I may be more aware of these issues with my Diabetes, but I know this obsession is shared by many folks...with or without a chronic challenge.


I’ve known several T1 Diabetic men and women that have quit taking their insulin for brief periods. Some were trying drastic measures to see if they could live without it, and some were taking huge risks to drop weight. Without insulin to convert your food to energy then fat, your body will certainly drop some pounds while pumping acid through your blood. It’s an effective method, but certainly not a smart thing to do for any length of time. Diabetes and eating disorders are inevitably linked, as a kid you’re told carbs make your blood sugar high; your perception is that food is your enemy much of the time. (See, I have very good reason for being so anxiety ridden…this was tough growing up with.) I would guess that most T1 females dealt with a bout of what is called Diabulimia. Some eat and then puke, and some chew on food for a few moments to taste it and never swallow it, or others decide to not give insulin.  I've read about a couple teenager girls that died from diabetic ketoacidosis after skipping their insulin too often to lose weight.  This disorder is more risky than one might think, and the variations on insulin and eating disorders can be pretty extreme in the teen years and well into adulthood.  (Keep a close eye on your teens, and if you think they're lying about what they eat....they likely are.)  There is a book about Diabetes and eating disorders written by Maryjeanne Hunt that is a very good read, and will provide insight on how to turn your Diabetic loved ones on to fitness as a coping method (T1 Diabetes focused, more than T2).

I thought that going on the pump might help me lose weight after I had put on quite a few pounds while taking Lantus and Humalog. Well, perhaps the freedom to eat more easily on the pump resulted in the weight gain, or my sugars are lower all the time and I’m gaining weight due to that. In the 2 months of pump therapy I climbed about 6 pounds, I was horrified! Now in the third month, I’ve decided to give up one of my best friends, beer, and have been jumping on my home elliptical machine a minimum of 2 miles a day. I’m back down 4 pounds, and am seeing more muscle so feeling better. What is a challenge now is that I started seeing some lows when I workout hard, doing 4 or more miles. I start messing with my basal rates, and DOAH, the blood sugars do start bouncing back up. I find it so crazy how some days I need a ton more insulin, and others very little and I can’t really make any sense of it or identify patterns (well, monthly cycles are the one exception, massive insulin needed during those swings)….I feel like taking insulin can be like gambling; it's just luck sometimes.


Whether or not chubbiness is good or bad, I’m not happy with it and I'm about to commit to a 6 week long fitness challenge. Fortunately, it starts right after I get back from vacation so I should be all fat and happy as I start it. No diabulimia for me!! I'm going to do tons of cardio, make healthy choices and I’ll keep working with the pump to dial up the right amount of insulin to keep my sugars level and rebuild lost muscles.  My challenge starts October 10th at Freedom Fitness in Burien, anyone else in?

Wednesday, August 31, 2011

TSA patdowns, and longing for pump breaks

I have had a couple trips to Phoenix, AZ during August as a result of landing a new job.  (Picture me doing goofy endzone celebration dance celebrating that I finally found an awesome firm to join, and am feeling the support of a sound infrastructure to enable me to better serve clients.)  It's been a very exciting end to summer 2011, and if it weren't for the 10lbs I packed on I'd probably be angst free at least until the fall rains come.

As a result of wearing my pump through security, I have had TSA guards coppin feels.  Even though the device doesn't trigger the metal alarm, the pager look-alike triggers much suspicion.  Maybe, just maybe this chubby white girl is carrying a bomb with a tiny tube that goes to her belly, and she is going to blow up her belly and the plane.  Sure, I'd love to blow some fat away, but I'm not your suicide bomber.  I really do wish TSA wouldn't have to be so damned politically correct, and COULD racially and/or demographically profile the folks that are actually a threat.  I don't buy into this bull shit that EVERYONE is a threat to our flights.  No, no, no...there is a very specific subset of the population that is likely to blow themselves up with a plane.  Your frequent business flyer is not part of this subset.  Yes, I'm annoyed that my pump is triggering this slowdown, but even more annoyed that I have to undress and pull out my laptop for this waste of time procedure in the first place.  I don't feel any safer, but I suppose I should be glad that the useless jobs are employing folks.

On a less angsty note, this last weekend the sun showed bright in Seattle and the temperatures rose.  I headed east to Lake Kachess, and went up to Box Canyon Creek for some swimming.  I decided to take some Lantus long acting insulin, and not wear my pump for about 8 hours.  There is some concern that river water could get into the port and cause infections so I had a good reason to choose not to infuse.  When I detached for a few hours, and got to wear my bathing suit without the port I realized how much I was resenting having to wear the thing. 

I am starting to see some improvements in control with the clunky device, but the annoyance of the size of the machine and the itching from the tape and port is causing me to long for breaks.  I suppose the one benefit of having health challenges in life is that they make you REALLY appreciate the most simple moments of feeling okay, and being machine free, even if only for a couple hours.

Yeah, I am doing injections when I go to Maui for sure, the pump is staying home.....no TSA pat down, or open port holes in the ocean, on that trip.

Tuesday, August 2, 2011

That noise is ME, not my pump...I'm an engine reving up more bravery

It’s been said before, the bravest thing you can do when you are not brave, is to profess courage and act accordingly.  In other words, fake it until you make it.
Ever hear those sales pitches when someone says, “I’m going to give 110%!”?!  It’s one of those so fake over promising lines, but it makes us feel GOOD. 
If we’re talking revenue streams, billable hours, or return on investment……..110% is something that only happens after multiple glasses of wine or cocktails.  When I think of examples of when I’ve heard this line, it is reality television involving Donald Trump or the Bachelor series….a whole lot of bull shit.  I've had a doctor tell me once that living with Diabetes requires people to give 110%.
So many folks over-promise, and under-deliver.  Presidential candidates are a perfect example, but that discussion is beyond the scope of this rant.  This rant is about my promising to take better care of myself, to give 110% or even 75% to my health while I give more than 50% to other areas of my life that are more pleasant.
I’ve already professed my aversion to changing from injection insulin therapy to pump infusion.  The battle inside my head, body and soul I could only attempt to put to words, but the angst, excitement and hope I felt really can’t be expressed.  Most of you read my attempt to feign excitement for the change; while I was internally NOT WANTING TO HAVE TO DO ANYTHING, and hoping this malfunction in my body would go away already.
I keep waking up, and each day I’m still a T1 Diabetic.  Every day, all damn day, despite all physical and spiritual endeavors to alleviate being sick……after healing books I’ve read, spiritual healing pursued, Reiki treatments channeling healing energy taken, back adjustments received, as well as attempts to exercise and not eat carbs, or way back expecting Jesus would take away my need for insulin.  Turns out no matter how much "faking" I attempt; I will ALWAYS need a shot or some infusion of insulin.  I take my need for insulin for granted, but try not to take life for granted.
Unfortunately, the line between gratitude for life and frustration toward the work to live gets blurred, and I grow so tired that my positive attitude flips to inconsolable anger.  Blessed are my acquaintances that see only the high energy exterior, cursed are those that get close to me and see the anger I’m giving 100% to hide, or erase and can't.
I’ve had a detachable organ for about a month now.  It is not the panacea I prayed for, but it is a change worth investing in.  Yes, I still must test my blood glucose levels.  Lately, more than I did in the past to deal with the transition to just fast acting insulin.  Internally I feel uneasy, and the anxiety is intensified. 
However, the change in therapy is making testing new and more interesting.  I’m always enthralled by the new and exciting; even if it has the darkest realities.  Turns out my blood sugar is unusually unpredictable, perhaps my blood sugars and indecisive nature somehow correlate.  All this new testing info is informative and scary.  I feel proud to be gathering it, but am also ridden with anxiety that my blood sugars are not PERFECT just like my other life project that I give my all to, my garden.
It is such a catch 22 to focus on Diabetes control only to realize you’re NOT IN CONTROL.  I am at a point where I’m succeeding at my career, paying my bills and then some, growing a great garden (with annoying perfection) as well as being a neighborhood volunteer, and none of it is giving me the satisfaction I seek….I still feel like I’m failing...at being happy, satisfied, or something....not even sure just what it is....but this haunting sense of failure is such a "monkey".  I'd have to give 120% to reach the level of perfection I want, but I'm starting to accept that may not be possible.
I feel overwhelmed and anxiety ridden so much of the time, but that is life dealing with illness…..you’re simply used to the one in a million negative thing happening to YOU or other people in your life that we spend time worrying about.
I have so many days when I test my sugars and see another high, and think I should be dead already.  I swallow thankfully saying I’m going to do better, I’m going to embrace and enjoy my life and live as long as I can.  Then my body sits down, I feel tired, and I feel the machine on my stomach and the awkward tubing….I know my soul is trying, and I wish my body would cooperate more often.
I feel thankful for the technology, but I am still resentful of the price and the hardship that it entails.  Reality is, I am just tired of needing the technology, but I still have some bravery left to keep faking that this SHIT doesn’t cause me so much angst.
As long as we are faking bravery, DAMMIT I will succeed because I am a HEMME; strong like the engine.

A trip to Maui in October will surely help fuel the engine to keep on going..... :)

Monday, May 16, 2011

Bionic Woman or Short Bus Special.....

I finally ordered an insulin pump.   I've been taking insulin since I was 5, sick since I was 3 or so, and I'm coming up on 34 and just now ordering a pump.  I feel excited and defeated. 

My indifference is robbing me of the joy of conviction in a decision once again.

I've been able to function on the cheap injection therapy for years, even hid the ailment from many people.  A pump is expensive, and personally invasive from my perspective.  I'm making this change because there are people that need me here, want me here, and I love life when I feel okay.  Just maybe the pump will make okay happen more of the time.

Change is hard, back to that feeling of defeat.  I have traveled much of the US for work, seen foreign beaches, and had a family (not technically mine, but mine).  Most would think that I am the QUEEN at coping with change, and unsual situations.  However, when it comes to my own health, I can be so unflexible it is just downright SILLY!  I don't know why I see this change as defeat, but it feels that way.  I'm willing to admit that I have never been one to process feelings quite so well.  (hahahha.....feelings.....catch me if you can.)

I watched this video recently that had this chick, Jony or Joni....she became paralyzed after a diving accident.  Instead of being sad and bitter she was talking about how she felt the power of God, and that God gave her the power to help others, do art with the strokes of a brush in her mouth, and wheel herself around in her chair.  She glowed in her chair, was beautiful even as she spoke of how much love she felt from God and how gracious God was.  (If she was on a pain-killer or antidepressant to help her cope, man on man, that ish is GOOD.)

I am an ASS, why am I not feeling this love and being as gracious as Joni?  Why can't I be thanking Jesus that I am healthy, defying previous predictions and have achieved nearly every goal I set for myself?!  I'm a selfish bitch, and am shamed by this chick, she is a SUPERwoman.  I may be a selfish ass, but I am humble with much admiration for the strength in a paralyzed woman that can go out and preach that there (still) is a loving God.

I may never have that kind of gratitude, or that faith, but I can appreciate it.

Pray for me to have the strength to embrace change.