True Story

I work at Target.  It’s not the greatest job ever.  Most of the time I return the stuff that people decide they don’t want.  And sometimes I cashier.  I can’t wait to graduate from nursing school.  But hey, it pays the rent.

Anyway, I work with a fellow type 1 diabetic.  We’ll call him Justin.  Obviously we’ve had a connection since we first found out that we’re both type 1.  Sometimes we freak people out by checking our blood sugars at the same time in the break room.  Some people can’t take all the blood.  Wimps.  Haha.  We compare pumps.  We talk about lows.  We talk about how thirsty we get when we’re high.  He brought me juice one time when I got low while cashiering and couldn’t leave my lane.  We’ve had an entire conversation about how awesome Diet Coke is.  It’s great having another type 1 diabetic around.

This weekend I won a piece of pie.  (Sidenote:  We’ve had drawings for books, DVDs, pop, and just about anything you could possibly imagine.  I’ve entered every single one.  So far I’ve won gummy worms, pumpkin cheesecake and chocolate cream pie.  Irony?  Yup.)  After I checked my blood sugar (136 mg/dL, by the way) I walked over to the bakery to collect my delicious prize.  I was walking back, salivating and getting ready to devour the entire massive piece of pie it when I walked past Justin.

“Justin, help me guess the carbs.”

“Ok.  Let me check my pump.”

“I’ll check mine, too.”

We both pull out our pumps and go to our food libraries.

“Oooh, found it.  Chocolate cream pie.  Mine says ten carbs for each ounce.”

Justin picks it up and ‘weighs’ it.

“I’d say about sixish ounces.”

“OK, I’ll go with 60 carbs.  Thanks!”

True story.

Dear Ellen

Dear Ellen,

 

I’ve written to you before but I felt a strong urge to pen this note after watching an episode of Oprah this week.

 

Oprah did an episode about diabetes. I think she had great intentions, but she completely missed the boat. She had many doctors trying to help the millions of people with diabetes or pre-diabetes.  They talked about how bad sugar is.  They visited a woman dealing with multiple complications.  They stressed the importance of exercise.

 

But there’s so much more that they didn’t do.  They didn’t clearly define the differences between type 1 and type 2.  They didn’t address the emotional aspects of this disease.  They didn’t talk about the diabetes online community and the crucial role it’s played in so many lives.  They didn’t talk with a healthy type 1 diabetic who is doing everything she can to live a normal life and avoid future complications.  They didn’t show healthy children living with type 1 diabetes.  They didn’t talk about the advancements being made in diabetes technology such as insulin pumps, continuous glucose monitoring systems and even an artificial pancreas.  They didn’t even have an endocrinologist on the show.

 

Here’s where you come in.  This is the perfect opportunity for you to highlight everything they missed.  You can help the diabetes community heal after this crushing blow.  Please just consider a show focused on diabetes.

 

Plus, I know where you could get a really great guest (ahem, me). 

 

Thank you,

 

Kay Ritzdorf

Break Down

Last night diabetes just became too much to deal with and I broke down.  And I cried a lot.  And my mom hugged me a lot.

My mom was in town last night because she had to catch an early flight this morning and I was going to take her to the airport.  We went out to eat at Red Robin and then went to see Up in the Air.  (Fantastic movie, by the way.)

The last couple days my blood sugars have been very up and down for no good reason.  Basals that had me constantly muching glucose tabs last week now can’t even keep me below 200 mg/dL.  I’ve just constantly had a +75% basal for a few days.  When I work out my blood sugar just goes up.  And my usual lunch of mixed vegetables and a hunk of roast beef sends me soaring.  I’ve just had enough of this.  I changed my pod and opened a new vial of insulin and nothing’s changed.  My mornings are constantly littered with vibrations and beeps from my DexCom letting me know that I’m high.  Things just aren’t working, no matter what I do right.

I was thrilled to start out dinner with an 84 mg/dL reading.  I had three onion rings (that onion ring tower is freaking cool!), a burger without the bun and some fries.  I ended up bolusing about 10 units (which is more than I bolus total on most days).  I watched the DexCom and saw it start to slowly creep up and by the time we were heading over to the movie I had double arrows straight up and was at 186 mg/dL and alarming.  My mom looked at it and said to not worry about it, it’ll come down, and let’s enjoy the movie.  So I put DexCom in my pocket and got ready for the movie.

But every thirty minutes I kept feeling that vibration in my pocket that I was still high.  I’d just press the button through my jeans pocket because I didn’t want to deal with diabetes during the movie.  But after the third vibration I pulled it out to see 234 mg/dL and arrow angling up.  I cursed under my breath and pulled out my PDM, checked my blood sugar, rage bolused 5 units and made sure my basal was still +75%.

We finished the movie and got into my car.  I checked my DexCom like I do every time I drive.  I check it, then put my seat belt on.  I was at 246 mg/dL.  I’d taken 5 effing units over an hour ago and now I was higher?  I was not happy.  We were driving back to my apartment when my mom said that maybe it was all the fat and protein in the burger that was making me high and keeping me up there.  I said maybe.  Then this conversation happened (with lots of tears):

Kay:  “Sometimes I just really have a hard time understanding why my body is doing its best to kill me.  I mean, I basically had an organ shut down on me.  How unfair is that?  Why?”

Mom:  “I know it’s hard for you.  But you’re doing a great job.  I could never do what you do.  You’re doing an excellent job.  The day you were diagnosed was the worst day of my life.  I never want to feel anything like that again.  If I could I would take it from you in a second.”

Kay:  “What really gets me is that no matter what I do, or how much I take care of myself and do everything right I’ll still have it.  It’s not like a project at school.  You don’t work really hard on it every single day for a month or two and then you’re rewarded with having it over and done with.  It’ll never be over and done with.  I’ll never get that reward.”

Mom:  “I disagree.  When you do all of this every single day and take care of yourself you’re rewarded with good health.  In 20 years you’re going to have both legs.  Your kidneys will work.  You’ll be able to see.  Those are rewards.  I know they don’t seem like it, but they are.  You know, there’s a reason you have this.  I’ve always known it but I’m finally starting to really see it.  I think you’re going to be an excellent nurse.  And if you want to work in the endocrinology field you’re going to be the best they’ve ever seen.  Not only will you be able to take care of a diabetic patient but you’ll know exactly what they’re going through.  This is maybe the reason you have it.  To help others.”

By this time we were home and I was still crying.  I think it just felt good to cry and vent about it for a little while.  We sat on the couch and talked about a lot of stuff.  When I was first diagnosed my dad left the hospital to go buy my first meter because hospitals didn’t just give those away.  It was a $100 brick that took 45 seconds to count down and required a lake of blood.  We talked about what I’d do if I was cured for a day.  It came down to this:  I would eat a huge high carb breakfast, carry a tiny, miniscule purse, and get insanely drunk.

After I was done crying I felt better and my DexCom was showing a 139 mg/dL.  Much better.

My mom made some very good points last night.  There is a reason why I have this.  I know that I want to work in the endocrinology field.  In fact, I’d love it.  And even though having both of my legs, functioning kidneys and eye sight may not seem like an awesome reward for taking care of a fickle disease day in and day out but it is.  I want to live a long and healthy life.  And it’ll just take more work from me to get that reward.  I’m not afraid of hard work.

This is long.  And rambly.  And cry-y (that’s not a word).  But I don’t really care.  Diabetes sucks.  Plain and simple.  It just sucks.  And to deal with it sometimes you just have to break down a little bit.  In my opinion, no one can be 100% positive about this all the time without going crazy.  Yes, I can deal with whatever diabetes throws at me like 98% of the time but there’s that 2% of the time that I just need to sit back and break down a little bit.

I’m feeling much better this morning.  I’m ready to take on whatever diabetes challenges me with today.  Bring it on, diabetes.  BRING IT ON.  I’m ready.

Beeps

I love my insulin pump.  And I love my CGM.  They’ve completely changed how I manage my diabetes and are helping me live a longer and healthier life.

But they never shut up.

I’m constantly beeping.

It could be that I’m low or high and missed the first vibrations from my CGM.

Or it could be that I’m bolusing.

Or my pod’s 72 hour warning.

Or it’s been 80 hours and I NEED TO CHANGE MY POD!

Or it’s my pod failing while priming.

It could be that I didn’t feel the vibrations from underneath my pillow and now DexCom is blaring in my ear waking me up.

Or sometimes it’s just my language that should probably be beeped out when one of these other beeps is DRIVING ME ABSOLUTELY CRAZY.

Progress

After work this morning I came home, flipped my computer on, checked my blood sugar (90 mg/dL, by the way), bolused, started eating lunch and checked Twitter.  Then I almost choked on my mixed vegetables.

Artificial pancreas.

Those words mean a lot.  Not as much as ‘cure’.  But they mean a lot.  They mean progress.

After 18 years with this disease I still hope for a cure.  Really, I do.  But after so many years I understand that a cure in my lifetime isn’t a sure thing.

An artificial pancreas is a huge step forward.  And you know, the next huge step MIGHT be that elusive cure.

Memories

I’ve had diabetes for over 18 years.  I really don’t remember life without it.  I have one distinct memory of life before it.  Ironically it occurred in a hospital.  It was meeting my little brother, John, for the first time.  I’ve had it longer than my other brother, Joe, has been alive.

I remember always being thirsty and for some reason really wanting to eat banana bread.  I don’t think the banana bread was diabetes related.  I remember wetting the bed at a hotel several times in one night during a family gathering.  I remember throwing a huge fit (which was very unlike my three year old self) because I wanted to brush my teeth again in the middle of the night.  But I don’t remember my mom having to “slap” me to stop my hysterical crying and screaming after nothing else had worked to calm me down.  It worked.  And I got to brush my teeth anyway.

I don’t remember my grandma wondering aloud to my mom if it was diabetes.

I don’t remember my appointment at the York Medical Clinic with Dr. Demuth when he confirmed my parents’ fear of diabetes.  And I don’t remember Dr. D telling my parents that he’d never had a patient so young with diabetes and that we needed an expert.  Someone with more knowledge about juvenile diabetes than he had.  And I don’t remember the trip to Lincoln.

But I do remember the hospital stay.  I remember sharing a room with a girl who painted my fingernails for the first time.  I remember being mad at the girl down the hall who was using the TV with the VCR when I wanted to watch a movie.  And I remember looking out my window and seeing upside down Santa legs kicking out of a nearby chimney and being tremendously worried that Santa wouldn’t be able to give everybody presents that year.

I remember the lab tech who came in to check my blood sugar with a fingerpoke and whispered “Shit!” when he saw my reading.  When I was high they had to take more blood and I didn’t give up my blood without a fight.  Very professional and appropriate reaction with a three year old in the room.

I remember sitting on my hands so that the nurses and lab techs couldn’t check my blood sugar.  And I remember that they always gave me cheese and crackers for a snack and expected me to eat the entire snack.  But I hated cheese.  Still do.

I remember relatives and friends coming to visit me in the hospital.  I remember getting a big stuffed dog.  I remember walking down the hallway holding my mom’s hand to go take a bath.  And I remember waking up in the middle of the night to see either my mom, 7 months pregnant with Joe, or my dad sleeping on a cot at the foot of my bed.

I remember going home right before Christmas and thinking that since I was out of the hospital I wouldn’t have to worry about being poked anymore.  I remember I was shocked when Mom and Dad kept poking my fingers and giving me shots.

I remember when my life changed forever.

Peanuts

Christmas as a little kid with diabetes wasn’t always fun for me.  Well-meaning relatives would give me sugar-free candy.  I’d maybe get a cookie if I was low.  I’d have to come inside from playing in the snow to treat a low.  It just wasn’t always that much fun.  But my Mom and Dad always did their best to make it special for me too.

After I thanked my relatives for the sugar-free candy they’d take it and throw it in one of the cupboards we never opened and eventually, when it was hard as a rock, throw it away.  They’d make cookies without frosting.  They’d keep some sugar in the garage so I wouldn’t have to venture inside and take off all my snow clothes when I got low making a snow fort.

But, my favorite diabetes-related Christmas memory involved Santa.  All my pre-school and then kindergarten classmates would help their moms bake cookies for Santa and his reindeer.  They’d make chocolate chip, peanut butter, sugar, etc…

But my Mom would take me down to the grocery store.

“You know, Kay, Santa doens’t even like cookies.  Everyone just thinks he does.  He can’t have a whole lot of cookies either.  Just like you.”

“Really?  Does Santa get the ones without frosting too?”

“I’m sure he does.  But what he really likes are peanuts!”

“Peanuts?!  I can eat peanuts too!”

“Let’s pick out the best peanuts in the grocery store and set them out for Santa.  He’ll really like that.”

“OK!”

I was three the first time we did this.  We did it for a couple more years after that.  I’m at home right now and Mom and I went to the grocery store to get some groceries and we walked by the same peanut bins.  I asked her about it and she doesn’t even remember picking out peanuts for Santa instead of making cookies.  But I remember it and it will always be a special Christmas memory for me.

Anyway, that Santa guy would probably benefit from a few less cookies. 

Home Sweet Home

I’m at home right now.  I’m enjoying it.  Really, I am.  It’s nice to be at home with my parents and my brothers.  The Christmas tree is up in the living room.  The lights are blinking outside the windows.  There’s plenty of snow on the ground and we’re forecasted to get more in the next couple of days.  It’s really nice.

But, at the same time it’s not so nice.

I absolutely love my parents to death.  But it’s really hard to be around them sometimes.  And those times always have to do with my weight.

I worked late last night so I didn’t leave Omaha until about 1:30 AM and didn’t get to York until about 3:00 AM.  My mom had texted me to sleep in Joe’s room because John was in mine and Joe was in John’s.  (I really don’t understand why we’re not sleeping in our own rooms.)  And she said that she was going to go walking at the city auditorium at 8:30 AM if I wanted to join her.  I told her I’d think about it because I didn’t know if I’d be up yet.  Hello, less than five hours of sleep.

Well, I was up at 8:00 AM and couldn’t fall back asleep so I decided I’d go walking with Mom.  I stumbled out into the kitchen to check my blood sugar and get some breakfast.  Mom was sitting at the table reading the paper and looked at me.  Then she looked me up and down.  Then she went back to reading the paper.  I grabbed my PDM and 16g of vanilla wafers and sat down to bolus and enjoy my breakfast.

“Kay, how are the holidays going?  Are you eating right?”

“Yeah…”

“Because it looks like you’ve gained weight since I last saw you.”

“Mom, my jeans fit the same.  My belts are all on the same loop.  All of my work pants fit just fine.  My goals for the holidays are to just stay close to my current weight and not worry about gaining or losing right now.  And I haven’t had a lot of time to work out regularly because of the end of semester.”

“Ok, well, I’m your mom and I just want to make sure you don’t slip up again.  Your pants just look tighter to me.  Maybe it’s just that one pair of sweat pants.”

“Are you ready to go?  I need to move my car.”

End of conversation.

Really, Mom?  I know that you’re only trying to do the best for me.  I really do know that.  And I fully understand it.  But with my history of diabulimia and all of my other eating problems I don’t need your comments about my weight.  I didn’t need them in middle school.  I didn’t need them in high school.  And I sure don’t need them now.

I’m doing my best to lose weight the healthy way and every time I hear a comment about how I haven’t lost enough weight I just want to stuff my face full of carbs, “forget” to bolus and watch those pounds slip off again as if by magic.  I’m not happy with how I look either, OK?  I still hate looking in the mirror.  I still see you size me up and down in the kitchen when I’m reaching for something.  But do you see the tears on my pillow when I go to bed because I know how disappointed you are?  No.

So, please, just stop it already.

18 Years

Today is my diabetes’ 18th birthday.  It can buy cigarettes.  Which it will probably do because it’s stupid like that and usually does the exact opposite of what I want.

I don’t remember not having this disease.  It’s been there for nearly every part of my life.  It’s older than my brother, Joe.  I’m used to bleeding a little bit before I eat.  After a year, I’m used to wearing a pump.  And, after a month, I’m used to my DexCom.

Diabetes has come a long way in the past 18 years.  Back in the day I was using pig insulin.  I was putting a HUGE drop of blood on a meter the size of a brick that took 45 seconds to count down.  I was only checking my blood sugar four times a day.  I was using food exchanges to eat.  (When I say, “I” I really mean my parents.  Because, come on, I was three years old.)  It was ridiculous.  But, luckily, I came along after the days of urine testing.  Dang it, I’m so sad I missed out on that!  (Insert eye roll here)

I’m so thankful for how far diabetes technology has come in the past 18 years.  And I truly hope that there’s a cure soon.  Because, really, who else was told there’d be a cure within 10 years of their diagnosis?

Until there’s a cure I’ll continue to say…

“…Eff you, Diabetes.”

Bonus Question

The last bonus question on our NS220 final:

 

Write a question that you think should’ve been asked on this final.  Include four answers and circle the correct one.

 

My question:

 

A newly diagnosed type one diabetic is at lunch with her friends.  A friend says, “Oh, my Grandpa had that.  He went blind, lost his left foot and then died from it.  I know that you can’t have any sugar at all or that’ll happen to you too.”  Which of the following answers demonstrates that the patient received the correct teaching from the nurse regarding her new type 1 diabetes diagnosis?

 

A.  You’re right  I can’t ever have sugar again.

B.  You’re wrong.  I can have sugar.  Actually, I count carbohydrates.  As long as I check my blood sugar regularly and give the correct amount of insulin for the food I’m going to eat and take care of myself I can eat sugar or any other food that I choose to eat.  And no, I don’t appreciate hearing horror stories about your Grandpa, who probably had type 2 diabetes.  I’m sorry that this happened to your grandfather and your family.  I’m sure it was very hard for you.  But I don’t like hearing stories about terrible compications that I am trying my hardest to prevent.  So, please pass me that last piece of carrot cake.  I’m going to check my blood sugar, inject insulin and enjoy this wonderful piece of cake because I can.  I am hungry and I want cake.

C.  You’re wrong.  I have to watch my fat intake.

D.  I don’t know.

 

Obviously, I circled B.