It's a Matter of Juggling While You Balance Life

Before camp ended, I made my annual appointment for a complete check up to meet the requirements for working in a State of Florida licensed child care facility. This consisted of an annual physical, annual bloodwork and annual TB test. Upon knowing my family history of diabetes and the results of my bloodwork, my primary physician referred me to an endocrinologist immediately. The endocrinologist further tested me and eventually diagnosed me as a person with Type 2 diabetes and began the fight to put the angry monster in control. At the time of diagnosis my A1c was just above 8.50%. If you are not a diabetic, these number readings hold no value until I share with you a non-diabetic should be less than 6.00% but ideally less than 5.70%. A hemoglobin A1c test tells you your average level of blood glucose over the past 2 to 3 months. It's also called HbA1c, glycated hemoglobin test, and glycohemoglobin. Persons with diabetes test regularly to see if their levels are staying within range and if there is a need to adjust or even change diabetes medicines and treatment plans.

Two decades with T2D

As of July 2018, I mark 20 years being diagnosed as a person with T2D. Have you not heard of this newly recognized vanity, chronic disease? It is Type 2 Diabetes, once called adult on-set diabetes, but basically it means my body has stopped using insulin properly. For most of us, we fight and battle this angry monster through lifestyle changes of diet, exercise and weight loss help keep them within a safe distance from attacking the rest of our bodies. Some may need a little extra defense with medical intervention with oral medication or self-injectables which may or may not include insulin. Yes, I could lose some weight and reduce my stress load but considering I eat overall rather healthy and exercise at least three days a week for a minimum of 45 minutes, I am doing the prescribed right things in trying to keep the monster a safe distance from harming me, but he seems to always sneak back into my life.

What role do genetics play?

My endocrinologist, after reviewing family medical history, a definitive linkage prevailed, all males on my father’s side who had access to routine medical care were being diagnosed with T2D. Let me clarify, in rural Hungary, access to routine medical care is not always as readily available and people don’t make preventative care as a high priority. A small team of medical professionals believe there is the strong possibility of a diabetes diagnosis such as mine, believe taking in account heredity to a greater degree than previous train of thought. Although some of the commonly known indicators and signs of diabetes were present, the monster was not fully awake and screaming loudly to announce their presence. My endocrinologist took in consideration me as the whole person and the entire diabetes spectrum of symptoms and indicators and seeing the similarities and some of the striking unique differences paralleling other family members facing the same demon. The hereditary symptoms can hide behind shadows of the typical symptoms to a lesser degree. One of mine included varying degrees of hunger and thirst. The other is being exhausted, for more times than not, despite thinking I had a good night’s sleep. I attributed both to the long hours I worked outdoors in the Florida heat and humidity running summer camp programs. In this case the medical team plays more of a role of a gumshoe trying to determine if the symptoms are truly diabetes or something else and perform various checks: glucose tolerance tests, continuous blood glucose sensors, food and activity diary, to name a few and some are repeated to compare to the previous readings.

I digressed quite a ways off the intent of this post, but felt it was important to give you a general overview of diabetes and my story.

Navigating the stigma of T2D

The difficulty in battling this monster of diabetes is not necessarily the balancing of food choices, checking blood glucose levels, taking medicines properly and having regular medical checkups but dealing with people and their naivety and their inconsiderate comments and actions. For me, the best conversations and actions that can reduce or even eliminate uncomfortable situations from arising is simply asking what can they do to help me slay the monster within me. Don’t judge my choices based on my actions or decide to discipline me in front of others on my food choices. Trust me. I know what I’m able to handle or not handle as necessary. Those comments “Are you crazy, you can’t eat that!”, “My friend who had diabetes had his leg amputated.”, “You look darn healthy to me.”, “You really shouldn’t be eating that!” and the list continues to grow. Many thinking they’re helping me, when in practicality you are angering me by subliminally telling me rather than guiding me with the challenges I face.

Seeking balance

The need to be discrete when I take my blood glucose to avoiding the inevitable stares and off comments whether it is necessary for me to “do that” in view of others is not easy. The juggling of timing to take medicines, blood sugar checks and watching what you eat. Augmented by balancing stress from work; with deadlines to meet and projects to complete, finding time to meet home life responsibilities and somewhere to find time for yourself; to exercise, to relax and have some downtime before calling it a day. Being a T2D is not always about watching your blood glucose numbers and the foods you eat but how well you succeed in seeking balance in all that you face and do not just every but every part of your day.

Dueling dynamics in social situations

Social situations often put your mind, body and spirit of an occasion can be damper even the best laid out plans. I am ready to go out and enjoy my festivities and my mind tells me to make sure I eat balanced, check my blood glucose on schedule and take my medications as close to schedule time as possible then the body decides to activated all its senses. The smells of fragrant spices filling the venue, the sights of all the food and the one more taste win out then at the end of the event, the curse of indulgence leaves me feeling regretting the choice to participate. Eating outside of my normal situation often creates the dueling dynamics, “can I have a beer with my wings?”, “may just a small slice of cake?” or “if I limit the carbs now can I save them for later?” – easy questions with more difficult answers. A diabetic educator once told me you can eat whatever you want within moderation and knowing what and how much of something you can have, otherwise; you will fail by over indulging when continually denying an occasional treat.

Carrying the emotional burden of T2D

The complications of the monster hibernating deep within the internal realms often lead to those around you thinking this is just a figment of your imagination. The restless nights, the lack of quality sleep, insomnia and the lack of energy to perform to do what was most often taken for granted in pre-diabetes days. Joined with emotions not always in sync with what blood glucose readings may read create times of unexplained melancholy, lazy lethargy and maddening irritability where all you want is to be left alone. Learning to check your body for sores not healing timely, not over scratching itchy and dry skin, understanding headaches and tingling are not always an alarm sounding off and realizing all of this became your new everyday normal. These are the times you fake it to make it, put on your best clown face and dance through the day as if everything is all ok in your world. Only those closest to you know the truth and are able to offer some consolation, if any, once you gain your stability back. Left untreated, the monster takes on systems and organs, little by little, destructing each by taking away your life one piece at a time.

Financial stressors

The latest challenge I am dealing with is health insurance. Most, if not all insurance companies realign their pharmaceutical formularies (a list of prescription drugs, both generic and brand name, used by practitioners to identify drugs that offer the greatest overall value) to be effective January 1 annually. A committee of physicians, nurse practitioners, pharmacists and others decide on what is best economically speaking for the insurance company to meet its financial targets yet still provide drug options for the health seeker. There is a possibility the drug you were taking prior to January 1 will no longer be covered by your current policy or worse at your organization’s open enrollment you find out your insurance carrier has changed and a new formulary will likely be in effect. With the formulary change on January 1, it often brings the strong possibility of taking prescription for the first three months of the year and then on April 1 when insurance policies and/or carriers change. If it’s an insurance carrier change, I end up having to work with my primary physician (with hopes that doesn’t have to change) to go through endless bureaucratic forms, tireless phone calls to continue the medicine I am on or find a new similar classed medication. Then physicians wonder why the body has trouble adjusting to medication as it changed 3 times in a relatively short period of time.

Slaying the monster

I am the face of diabetes. Slaying the monster, one moment at a time with whatever weapon I have at hand and keep moving forward to fight the next one. I’ve shared what makes being a person with diabetes a daily challenge; and how it’s not always about the superficial symptoms, exaggerated expressions and counting carbs but all the unseen challenges that only experience can teach the lesson. There’s an apothegm, don’t be quick to judge people as you never know what kind of battle (or in my case, the monster) they’re fighting. Bingo!, this statement encapsulates the perpetual slaying of the monster every diabetic battles every moment of their life. As another awkward anniversary passes, I am frequently reminded, it’s a matter of juggling while I balance life and the relentless fight in keeping the monster at a distance, even when there is always more to my life than just my numbers.