Living.

"Let me drive you home, please?"

"I'm fine," I replied, "not low anymore. Not shaky, not dizzy, not feeling weird, and my blood sugar is 7.2mmol. And I've eaten a granola bar. I'm fine."

"Yeah, but..."

"Yeah but what?!" I interrupted. "This is my normal. Lows are something I'm used to, highs are something I'm used to. If I stopped every time...sought help every time...I'd never do anything alone. You've said I need to trust you, you need to trust me too. I live with diabetes every single day, and have done for the last five and a bit years. I know what I'm doing."

"Fine. Text me when you get home, just so I know you haven't flaked on the train and ended up and the end of the train line!"

"I'm not gonna flake out. And if I do, that's what my medic alert's for - hedge my bets!" I was hoping to lighten the mood, but instead my manager just glared at me. "Okay, seriously, I've done some stupid shit, like frozen my insulin, but I'm not stupid enough to try to make it home if my blood sugar's crummy."

"You've frozen your insulin?!"

"Story for another time, boss. See you tomorrow. I'll text you when I'm home."

I know there are times when I'm fiercely independent and far too stubborn, but this was one I wasn't going to back down on.

For the record, I made it home. Which you've probably gathered seeing as I'm blogging about it.

"Conceal, Don't Feel, Don't Let Them Know."

Maybe it's just me, but I feel the need to hide my bad diabetes days from those around me. Maybe it's pride? Not wanting to admit weakness? Not wanting to be seen as weak? Or just different from those around me? All of the aforementioned? More than likely.

Here on this blog, I will write about my bad days. And my good days, for that matter. I feel comfortable doing that here. You're more than likely reading this because you "get" diabetes. Whether you live with it, you're the carer for someone who lives with it, or someone you love has it, you have a level of understanding. 

Those I work with know I have type one diabetes. They know I wear an insulin pump. And they know where to find my medical notes and emergency contact details (a document I drew up myself, and keep in a sealed envelope in my desk drawer). They know about low blood sugars and high blood sugars. 

For the last few months, as you may have gathered from previous blog posts, "high" would be a very good description of where my blood sugar's been at. For me, highs aren't as noticeable as lows. It was easy to plod along and pretend I had my shit together. Telling my manager that I needed to go back to see my consultant four weeks after my last appointment was hard ("You're really good at pretending you've got your shit together!" he said. "Thank you," I replied with smile. "Wasn't meant to be a compliment." Of course, I knew that). I felt like I was admitting defeat, that I couldn't deal with my diabetes on my own. And I know that if it were someone else in my situation, I would tell them to stop being stupid, it's not weakness, etc, etc. But walking my talk has never been something I'm good at. 

Over the past three weeks, I've put a lot of effort into basal testing, checking my insulin to carb ratios, correction factors, the lot. My blood sugars are starting to come down, which has been an interesting adjustment - running high for as long as I have done means I feel hypo at 6mmol. This has also meant that when I have actually been hypo, I've been hit with every hypo symptom: shaking, sweating, no coordination, lack of speech, double vision (manager with two heads, anyone?!) and, my least favourite of all, crying. 

(Painted you a lovely picture there, haven't I?!)

It's these "low moments" when I do everything in my power to hide what's going on.

Source.

Get through the meeting, then treat the hypo. 

Finish responding to my emails, then treat the hypo.

Finish my conversation, then treat the hypo.

Finish [enter other random tasks here], then treat the hypo.

It was after a conference call that my manager (getting ever so more observant) approached me.

"Are you okay?"

"Yes," I nodded, not trusting myself to string a full sentence together.

"Do you want to try that again?"

"I'm fine," I replied, proud of my two word sentence and use of a contraction in my hypo state.

"You ought to trademark that response. It's you're go-to," and he handed me a bottle of lucozade.

With shakey hands, I picked the bottle up. The lid had already been unscrewed, and I counted six gulps and waited for my blood sugar to come back up, my manager now sat the opposite side of my desk. 

As my blood sugar came up and my mind began focussing on other things, and not my low, I looked at my manager. 

"Thank you," I whispered.

"You need to start trusting us, Vicki. We're not going to look at you any differently if you need to leave to sort your diabetes. I'm not going to sit here are pretend I know what you go through on a day-to-day basis, because I don't. What I do know, however, is that you're not putting yourself first some of the time. Start doing that, okay? And know my door's always open if you need or want to talk. Is your blood sugar back up now?"

"I think so. I'll just check. You no longer have two heads, so progress!"

"You're forming full sentences too. Progress again."

I laughed. "I'm sorry. Put me first. Got it."

As much as I enjoy my job (most of the time, anyway), and want to prove myself and further my career, not putting my health first isn't going to help me achieve anything. No negelecting of me, by me. It's one of many balancing acts I'm working on.  

Back-Up.

"So, I also need to make you aware of something...I have type one diabetes. I wear an insulin pump, which is a small device that constantly gives me insulin..."

I said to my boss, rather awkwardly, yet carefully gauging his reaction.

Work Christmas party.

"Give it a couple of weeks, and I'll sit down with you and others I'm working with to go over all things diabetes that you'll need to know. Chances are you'll never need it, but there have been times in the past where I've needed help. I'd rather you know and never need the info I give as opposed to not telling you anything and then one day I do need help."

It wasn't until I went to the office Christmas party that I remembered that those conversations hadn't happened. 

So last week, I sat down with a group of colleagues I've got to know over the last few months and I went full diabetes disclosure on them. 

I showed them my insulin pump. I showed them how to check my blood sugar levels, and I told them what was "normal" medically-speaking, and then what I was comfortable with (because my personal targets are different). We spoke about highs and lows and how I treat both. 

"I know this is a lot of information to take in, and I don't want this to feel like a burden [diabetes insecurities coming in to play here]. The chance of you ever needing to react is slim, but it makes me feel safe knowing that I've had this conversation with you." I rambled on. 

I kind of felt like a child: despite being 22 years old, there I was standing in front of a group of colleagues, asking them to learn a little bit about my medical condition. Because diabetes is one of those things that's fine...until it's not.

That's what I hate about diabetes: it's never solely mine. I'm the one that wears the pump, pricks my finger to check my blood sugar level, I feel the effects of a high, the effects of a low. But if my blood sugar gets so low I can't treat it myself or so high my body just shuts down...it's not only having an effect on me, but on those around me too. That part really, really sucks. Yet it makes me feel safer when there are others in the know. It's a lose-lose situation.

Disclosure is a personal thing, and there's no right or wrong way to go about it. I just know that I feel safer, and happier, knowing that those I come into contact with on a regular basis are aware of the insulin pump on my person. Despite my best efforts, there are a lot of aspects of this condition that I can't control. But I can control who I disclose to, making them aware of what could happen, protecting myself at the same time too.  

Reworking The Routine.

I love that I now have a job. But trying to establish any sense of routine is hard going at the moment. 

For me, routine is the best thing for my diabetes management. Whilst at uni, I used to get up, go to the gym, go to class/work on assignments, go home. It was great. When I wasn't working, I made sure that I woke up at a similar time every day, and I'd go for a run most mornings.

Now that I work, things are trickier. I start work at 7am. So I wake up at 5.30am to leave at 6am-ish to get the train. The walk to the station somewhat wakes me up, as does the coffee in my thermos. I eat a piece of fruit on the train, as I'm not usually that hungry, but I want to keep starvation ketones at bay after they reared their ugly heads on my second day. I go on lunch around midday, and finish at 3pm. By the time I get home, I am shattered. I haven't been working out, but I want to be. I just don't feel like I have the energy. I now drink far too much caffeine to get through the day. I don't feel like I have the time to do anything online (checking emails is a rarity at the moment, much like blogging and spending some time on Facebook and Twitter). I even struggle to just keep in touch with friends in the same town as me. 

It's time to re-balance things, instead of continuing to float on through, as it's not doing me any favours. So, in list form (a favourite of mine if you haven't noticed), I give you my game-plan:

1. Go to bed earlier! To be quite honest, it's no wonder I feel so tired when I'm getting up at 5.30am yet still going to bed around 11.30pm!
2. Cut back on the caffeine! Ideally, I'd like to go back to decaf. I've done it before, so I can do it again. 
3. Turn email alerts off on my phone. As soon as this blog post is published, I'm going to do this one. Not exactly health-related, I know, but one that will help me stay on top of emails at least! By actually having to log on to my computer to access emails, I will read and respond straight away, and delete whatever crap that comes through as well. I look forward to having an organised inbox!
4. Basal test on a work day. I find my blood sugar in the 4s around 9am, so I set a temp basal that then alarms when it's finished, usually when I'm talking to someone important! I think it's time to look at setting up a new basal profile, so I can switch for weekdays and weekends.
5. Once all of the above are done (i.e once I don't feel like a zombie, have a better idea of what my blood sugars are doing whilst I'm at work, and not as heavily powered by caffeine as I am) look at bringing back the workouts. Not necessarily daily like before, but at least twice a week initially, and increase accordingly. 

As always, keeping myself accountable by writing my plan here. Also means I can look back and think something along the lines of "What a load of crap! I've got this!" Kind of like I do with a lot of my blog posts!

Diabetes Disclosure.

I've never considered my diabetes to be a hindrance in my life. A pain in the butt, yes. A hindrance, no.

Yesterday, I went to an information evening about applying to do the PGCE course at my current university. Everything was going well until I had a chat with the admissions team regarding my diabetes. I've always been honest about my diabetes. It's not something I shout from the roof tops, but I also won't hide away in the toilets to do injections; it's not something I would mention on a job application, but if I get invited to an interview, it is something I then bring up (at the end of the interview, mind you!)

However, yesterday, I was made to feel that my diabetes may be an issue. 

"You have diabetes? What does that mean exactly?"

"I have type one diabetes. Basically, I have to check my blood sugar levels and I inject insulin when I eat. Sometimes I suffer from low blood sugar, sometimes I suffer from high blood sugar, but I just deal with it and get on with my day. Nothing stops as a result of it. It's just something that will need to be disclosed."

"Oh...you might want to talk with the Dean of Students to see if you'll be okay to do this course..."

Whatttt?! 

Yes, there are some jobs I can't do as a result of my diabetes. Teaching isn't one of them. Upset doesn't even begin to cover it, and I definitely regret my decision to even mention my diabetes.

I left the information evening just a bit peeved off, but so determined to prove to them people at admissions that I'd be perfectly capable of being a teacher with type one diabetes. I do it now, albeit only volunteering once a week. Diabetes has it's moments, don't get me wrong, but I know my body, and I know how to handle the highs and the lows quickly, and under the radar.

This whole situation has, however, made me reconsider how I'll approach diabetes disclosure in the future. What would you do?