Monday, May 04, 2009

Tonight, on a very special "Adventures of the Big Digital"...

This post has been several weeks in the making. While I'm sitting here today waiting for some queries to run (the data tubes appear to be pretty jammed up today), I figured I'd start writing it up.

This has certainly been a big year of changes for me already. I started my first "real" job in January, finally finished up everything for my PhD this semester (which reminds me I need to update the header on this blog, given that I'm no longer a student), moved to a new place after 2 years at my last one, and bought my first new car.

Along with all those great and exciting changes, I also had a big change that was kind of a bummer. I've been having some mysterious discomfort in my left side, about where the rib cage ends, and had a CT scan in January that didn't find anything noteworthy. Given that I was starting a new job and would be changing insurances with that change, I decided to wait to seek further answers until my new insurance kicked in. When that finally did in March, following some rough weeks, I was finally able to see a new doctor about the pain. He didn't have any real answers and ended up referring me to a GI specialist (a story for perhaps another day). However, what he did discover was that the sugar level in my urine sample was abnormally high, which made him ask if I was diabetic or if anyone in my family was. I answered that, no, no one in my family was diabetic. He said he wanted to draw some blood to have it tested for blood sugar levels. And I started to get really nervous. He asked if I was urinating frequently, and I said, not that I'm aware of. (But how often is frequently? I still don't know the answer to that one).

I got my test results back and my blood sugar levels were indeed high, which led to another blood draw, this time while fasting (basically just before eating breakfast) which was also high, which in turn led to another blood draw, this time to test my Hemoglobin A1c levels, which is basically a measure that gives an idea of what a person's average blood sugar levels have been over the last 2-3 months. Normal ranges are between 4 and 6. Mine was at 7.5. So, I guess at that point, I was officially diagnosed as diabetic.

So, there I was, an overweight 30-year old with Type II diabetes. Not something I ever expected to be. I started reading online about what in the world that meant, and what I was supposed to do about it. Lots of stuff about watching your diet (but with no real numbers of what I was supposed to eat or not eat), descriptions of things I'd need to watch, like my feet and my eyes. Larry H Miller, owner of the Jazz and famous Utahn had just recently passed away from diabetic complications that first resulted in the amputation of both his legs. Those first couple weeks were definitely a tough time. Not knowing what to do, and mostly feeling depressed, guilty, and maybe above all, for the first time, dealing with my own mortality. I definitely felt like at the time, and maybe rightfully so, that I'd been handed a death sentence. Not that I was going to die anytime soon. Just that I now had a pretty good guess of what might kill me. Definitely a weird thing to think about. Of course, I could still die in plenty of other ways, but if I live long enough, diabetic complications seem like a pretty likely "underlying cause" on my death certificate. (I'm currently working on a death certificate-related project at work, so that's probably another factor in the whole thing).

During this time, a good friend of mine asked me how I was feeling about things. (I still haven't told a lot of people about my diagnosis, in part, because I'm still not real sure how I feel about it, and how it affects me). Here's an excerpt from my email response:

And yes, of course the possibility of having diabetes bums me out. It
makes me feel guilty about not be more conscientious about my health
up til now. It makes me imagine which complication of diabetes will
end up killing me. It makes me wonder if I'll be eating crappy foods
the rest of my life to postpone those complications. It makes me
wonder if I'll have to be giving myself shots all the time, and poking
my fingers to check my blood sugar levels. So yeah, kind of a bummer
when I think about it. I guess I'm wondering if it will be such a big
deal that it'll be one of my defining characteristics. I hope that its
not something that takes over my life, but I suspect that once I get
used to managing it, that it won't be such a big deal. I just don't
know enough at this point to say how it will affect things. That's
part of why I'd like to get some follow-up. Now, any time I'm not
feeling 100% well, I start wondering if it's something diabetes
related, and if so, what I ought to do about it.

I'm glad that I wrote that out at the time, because it's interesting for me to look back on that. That was 6 weeks ago, and I still hadn't officially been diagnosed. Clearly, I was coping with a lot of uncertainty and emotions.

Since then, things have improved quite a bit. After being diagnosed, I was able to have a series of appointments with diabetes educators, who helped me to know what I ought to be eating (My carbohydrate intake is the main thing I have to watch, and I now have some solid numbers to stay within), how to check my blood sugar (Yes, I do poke myself in the finger twice a day to check my blood sugar levels, and yes, at first I would get really nervous about doing it, which I found only made me have to make multiple attempts. I feel like a pro now by comparison), I don't have to give myself insulin injections thankfully, although in my training courses they made it clear that some day I probably will (on average its 7-10 years after diagnosis), but that is part of the normal progression of the disease and not something that indicates that I screwed up or anything. Generally before people go on insulin they start taking medications that also help with the bodily processes related to diabetes. For now, I'm lucky enough to be managing my diabetes with diet changes, and with starting to exercise regularly. My doctor said that some people make those changes and are able to go 30 years without needing medication for their diabetes. My classes since then made me a little skeptical about those numbers, but definitely for now that seems to be working pretty well. He also said that some people aren't willing to make the changes and have to go on medication and eventually insulin. I feel lucky to have had the will power to make the changes for now.

The diet changes haven't been too bad. 45-60 carbs per meal is actually not that bad, I just have to avoid pigging out, or having too many starchy items, and being pretty careful with dessert. Hamburger = just fine. French fries = not so much. Hostess Chocolate Pudding Pie = yeah...maybe I'll never have another of those. (tear) Anyway, most of the effort on that front comes when I'm grocery shopping and reading food labels on everything, and I suspect that as I have more experience with this, I'll develop a good stable of choices that I enjoy and that are within my bounds. The website was very helpful in tracking what I was eating and for checking nutrition information.

On the exercise front, there's an exercise room right across the hall from my office at LDS Hospital, and for only $10 a month I can use it all I want. It has lockers and a shower and lots of towels and a fair amount of equipment and it's usually not too busy. I've been trying to get in 30 minutes of cardio after work most days and then follow that up with a little bit of weight lifting.

Between the exercise and diet changes, I've already lost at least 10 pounds, maybe more in the last 6 weeks, and lately people have been asking if I've lost weight and saying that I look good, so that's been a nice outcome.

Even with these changes, I really don't feel like much of a different person. I certainly don't feel like food defined me, and in days of yore, I was no stranger to physical activity, so none of those things make me feel like I've lost my identity. I just feel like I'm finally making some healthier choices that I've been wanting to make for a long time. Hopefully I can take advantage of the inherent motivation of this new condition to develop some long lasting good habits.

Kind of the last frontier for me has been knowing how to let people know about my diabetes. Definitely a part of me still feels guilty about it, and as a result I'm embarrassed to admit it to other people. Like it's at least partly my fault that by not taking care of my health for so long that I've developed diabetes. I've had two of my nurse educators specifically say that it's not my fault. Part of me still think that they're just saying that to be nice. On the other hand, there are plenty of people my age who are as overweight as I was who don't have diabetes, so it might not be ALL my fault. :) The health professionals I've met with seem to be genuinely surprised that to my knowledge, no one in my family is diabetic. At the education classes I just finished pretty much everyone else there was 50+. Not the best support group.

Not being comfortable telling people I'm diabetic occasionally leads to some awkward moments. Usually when someone is offering me treats and I don't want to have one, and don't want to explain why not. Or when I have to excuse myself to go check my blood sugar, or can't eat something until 2 hours after dinner because I'm waiting to check my blood sugar. Anyway, between being embarrassed about my diabetes, and still not being 100% sure how I feel about it and how it affects my definition of who I am, it still hasn't been the most comfortable thing for me to discuss with most people. For those of you who read my blog and didn't know already, don't take it personally. I do feel lucky to have good friends and family members to talk to about things who've been very supportive.


Rachie said...

You shouldn't be embarrassed about having diabetes. A lot of people do, and there is a genetic component to it, so there's no point feeling bad or beating yourself up over it. It is a total bummer about the diet and finger poking, though. :(

Three of my grandparents are/were diabetic, so I'm basically just counting down the days until I get the diagnosis myself. Bleh.

Shiloh said...

So sorry to hear about this-- that has got to be hard. But I agree-- no need to feel embarrased! I'd be proud of the way you're dealing with it head on and making the changes that need to be made!
And there really will be changes in diabetic health within your lifetime--so you might have to think of a new way to die! ;)

Kimberli said...

That really stinks! Since Geo is not the world's greatest at relaying info from his phone converstaions :), a lot of this is new news to me. I am so sorry. I had no idea you had to finger stick yourself. What a pain!

Shayla said...

I don't know anything about diabetes, therefore I have no advice for you as far as that goes...but I DO think you should do your weight lifting and THEN your cardio.

Natalie Marie said...

you do know Grandma Harden is diabetic right? I mean yes, it's not immediate family, but there's got to be some genetic factor in there. Can't wait for your par-tay! See you Saturday

Anna said...

Dr Tripp-
So, I didn't know that YOU had a blog!?!!
I found it though. Hope you don't mind.
This entry of course peaked my interest.
Bummer with diagnosis- but really don't be hard on your self. There are so many resources now that make life livable and enjoyable.
Good luck with the life changes,they will be sure to bring good things. :)

ps- I shed a tear for you for the hostess pudding pie too. ;)
pps- So are you against me linking your blog from mine? We are official blog friends now. Relationship to the next level-;)