The Importance of Being Honest.
I have been writing on this blog about life with diabetes for five and a half years, and I am always proud to share the successes. But it's easy to share the good stuff. It felt good to tell everyone about being pregnant, and having really solid A1Cs throughout my pregnancy. It felt good to keep those numbers steady while I was breastfeeding. I felt like I was in control, at least to a certain extent. And I felt proud to share that control.
But the past three months haven't felt good in any diabetes-related way. I don't feel like I'm in control of my diabetes. Honestly, I don't feel like I'm in control of anything. And I'm not proud to share this. I'm embarrassed and feeling sloppy and burnt out and a little sad.
Last week, I was at Joslin for an appointment with my endocrinologist. She and I reviewed my blood sugars, of which there were few.
"I'm not testing as much as I'd like to be. Sometimes, I'm taking a fasting number and then not checking again until early afternoon. I'm down to like four times a day. And I'm not going to lie - I wrote these numbers down this morning while sitting in the waiting room. I also made that one up," I said, pointing to a number on the sheet that represented a "before bed" test, but was actually a "before bed" from a completely different day.
She looked at my pathetic logbook and made some notes in her computer system while I purged my diabetic guilt.
"I did great while I was pregnant, didn't I? And then while I was breastfeeding? It seems like when it mattered for my daughter, I was able to put her first and make my health a priority. But now, I'm in wicked burn out. I don't CARE about a shred of this crap. I don't want to test. I am going through the motions in changing my Dexcom sensor and my pump sites. I'm just ... pffft about the whole mess. Is that normal for women after they have a baby, after all the hyper-intensive management?"
We talked for a while about how extreme the focus is on diabetes management while pregnant. And how being checked on every week makes for a higher level of accountability, and as a result, a higher level of attention to diabetes. How can things go off the track when you're being monitored so closely?
"It's very common for women to feel burnt out after they have the baby, especially if they were also breastfeeding. That's more than a year of very intense management. But what can we do to help you make changes for the better?"
The labwork technician came in to take my A1C. While we waited for the results, my doctor checked my feet and my weight. "You're two pounds away from your pre-pregnancy weight - nice job!" she said.
"I'll take the small victories," I replied, and the phone rang.
"Yes, okay, thank you," my endo said on the phone, and then set it back on the receiver. "Your A1C came back at 8.6%." She didn't make a face. She didn't show any emotion at all - no judgment. She just waited for my response.
"Whoa, that's much higher than I thought it would be. I figured it would be up there, but not that high. I haven't have that high of an A1C since college." I felt completely deflated. And like a crappy advocate. And a crappy diabetic. And knowing I wasn't in the best health to care for my daughter made me feel like a crappy mom. "That's a pretty shitty number for me, especially where I was at for the last year and a half. But I'm so spent and so burnt out on this diabetes garbage that I can't even muster up a big pity party or a bunch of tears. I'm just like 'whatever.' Yay apathy?"
She and I worked out a very small plan for change, including returning to see my certified diabetes educator in three months. And my goals for the next three months are to test more and to try and iron out my overnight basal rates. (Because I'm still in the "what the hell happened" mode of post-pregnancy, trying to find the right insulin goals for my still-adjusting body.)
Apathy is good at times, because it keeps you from crying over a number you can't change in an instant. Apathy helps you keep the feelings of self-loathing, guilt, and distress at bay. But it also keeps you from feeling like you can make change because you just plain don't care anymore. I can't change my A1C overnight, and I can't remove diabetes from my life equation, but I need to care again. Even though I don't have a baby growing in my belly to keep my head in the game, I still need to take care of her. And taking care of her means taking care of myself.
So I left the appointment feeling something. I'm not sure what, but at least I felt something. I felt like I was ready to try again, and ready to stop ignoring a disease that affects every moment of my day. And I left feeling slightly empowered, because like Chris told me over the phone when I called to tell him my new A1C, "Now you know where we're starting from. And now you can make changes that bring you to better health. We'll do this together."
And it felt good to actually feel something, instead of this emotional health void I've been in for the last 12 weeks or so.
I wish I had successes to share. I'd love to end 2010 with the same feeling of inspiration I felt at the end of 2009, where I knew my world was changing. But now, I have to understand that while everything changed, so much still hasn't. My family has grown, my job has changed, and my home is different, but diabetes hasn't changed. I need to reign it back in and make it more of a part of the background noise instead of assigning it to its own set of surround sound speakers.
It feels good to share the triumphs, sure. But I think this online community is just as important in helping us handle our tougher times. This is an honest life with diabetes, not one that's all rainbows and unicorns.
And that's that. Thanks for letting me vent, you guys.