Reflecting on World Diabetes Day

Today is International Diabetes Day (AKA World Diabetes Day). 

This year is actually my first year celebrating it.

I couldn't wait to put on my blues today!

Earlier last week, I had sent out an office memo to my co-workers of medical assistants, physicians, and nurse practitioners. 

Facts and mission statements were noted in my memo. I provided a brief history on insulin, as well as the scientists who led to the discovery of this life-saving therapy. 

I then asked everyone to wear something blue to show their support for me, and help raise awareness of type 1 diabetes. 

The response was overwhelming. 

Our director of CarePoint East, the building I work in, copy and pasted my memo, and forwarded it to each and every employee in our building (almost 600 people). 

I walked into work today, and EVERYONE was wearing blue! Blue scarves, blue ties, blue dress shirts, blue scrubs, even blue shoes! I was so overwhelmed and humbled by the support. 

The certified diabetes educators in our Diabetes Research Center walked around the building all day, taking photos, and quizzing everyone on the difference between the types of diabetes.

I feel so lucky to work with healthcare professionals who treat me like one of their own; It feels amazing to have support from the people I work with and see everyday. 

This first photo is only 1/4 of my office. Left to right, is Dr. Kim Fisher, Shaneata (my best friend and fellow medical assistant), me, Donnita Tate, our nurse practitioner, and Dr. Andrew Schreiner. 

This photo is Dr. Michael Langan, our residency program director. He has the best sense of humor you'll ever see in a person; his patients are crazy about him, and he knows a lot about diabetes! 

This photo is Dr. Kimberly Fisher, one of our second-year residents, with Dr. Andrew Schreiner, one of our attendings who precepts our residency clinic two days a week.

I'm glad I participated this year; it is so very important to advocate diabetes. So many people don't understand the "whole picture." I'm thankful to have lived 22 years with type 1 diabetes; It has helped shape me into the well-rounded young woman that I am. 

I can't wait for next year!

Could You Be The Most Beautiful Girl in The World?

October 22, 2013.

I woke up around 5:30 AM to shower, and get ready for work. 

After my shower, I put a towel over my head and walked into my kitchen to take my Synthroid and my supplements. My phone had a text message, at 5:57 AM. It was my mom. "r u up" it asked. I texted back that I was, and is everything alright? "Katie is in labor, water broke."

THIS IS THE DAY I HAVE BEEN WAITING FOR! 

My sister and my amazing brother in law, Drew, were finally going to become parents, and make me an aunt to this amazing baby girl.

I went into work, to open the clinic, turn on the TV in our lobby, print the doctors out their schedules, etcetera. 

I called my clinic manager at 7:08 to tell her about the good news. We agrees that I could stay until the 8:30 medical assistants clocked in. 

My patients arrived for their appointments, and I couldn't conceal my excitement. I told them what was happening, and everyone wished me well when I left around 8:36. 

I drove from Columbus to Delaware, which is about a 45 minute commute, but with the morning traffic, it set me back about an hour and a half.

Once I reached my exit, I filled my gas tank and stopped for coffee. It took another 20 minutes to get to the hospital.

Parking was so easy; I was relieved.

I walked in the automatic doors of the main entrance, and was greeted by a brunette sitting at the Information Desk.

"May I help you?" she offered. "Yes, if my sister is currently in labor, where do I need to go?" I asked. She directed me around the corner to the elevators, and instructed me to take it to the 4th floor: Labor & Delivery. 

I remember passing the hospital gift shop and coffee shop; oh man! They have Starbucks coffee here? I could have saved some misery going through the drive thru! No matter!

I got to the 4th floor and turned to the right, as previously instructed. The maternity waiting room was very small, with 2 flat screen Plasma TV's. There was a call light that had to be pressed to enter. The card read, “Please state your name and reason for visit.” 

Someone responded, "May I help you?" I advised them that I was Katie's sister. Open Sesame. The double doors opened wide, and I cautiously walked through them to the nurses's station. 

Once I was escorted to my sister's room, I walked in to find her tied up to IV's. She had a nasal oxygen mask on. Panic set in. Drew was sitting beside her, and he greeted me with a big hug. 

Katie said the contractions were, "no joke." She prides herself on being able to tolerate certain degrees of pain, but she said these were unbearable. Every 3 minutes. 

I laughed when she told me about her water breaking. She admitted she felt loopy from the epidural she had received, just minutes before I got there. 

Her nurses's name was Megan; she was very personable, and I was happy with how she was treating my sister. 

The nurse decided to start another IV to kick start Katie's contractions. I decided to go back to their house to hang out with my mom; I wanted them to have this moment together, without their kid sister getting in the way. 

I left around 10:08, and got back to Katie and Drew's new home. You can still smell the fresh paint when you walk in; I love that.

I found my mom vacuuming their living room, while our dog, Maggie, was patiently wagging her tail at me.

I made some coffee, and sat down to hang out with Mom and Maggie.

At about 12:30, we got a text message from Katie; she was fully dilated! We grabbed some miscellaneous items, and a baby gift, and headed out the door.

When we got there, Katie looked sleepy, and was watching a horror movie on Sci-Fi. Drew was pacing. Drew's parents arrived, and we hung out in her delivery room for about 30 minutes, before the show was ready to get on the road.

Drew's parents and I waited in the maternity lobby for over an hour. We were told at 2:30 that she had just started pushing. 

At 4:15, I was growing impatient. I kept ringing the call light for the maternity ward. "Hello?" someone asked. "Yes, this is Katie's sister. Is she OK?" I asked, breathlessly. "She just started pushing," someone responded. I was in disbelief. Someone has these important events turned around. I needed to know; I'm the aunt of that baby! 

The double doors to the ward opened up, and a nurse who must have just finished her shift, saw all 4 of us standing there, waiting for some kind of update. 

"You guys can't go back there yet." 

Duh. 

Another half hour passed. We asked a nurse in the hallway about Katie and Drew. She went to ask another nurse at the station; when she came back, she was smiling! Elliana was here! She had been born! She advised us that Drew would be out shortly, to deliver the good news.

Drew came out of the ward, in all smiles, with a paper mask hanging around his neck. Elliana Joy was born at 4:51. She was 8 pounds, 7 ounces, and measured 21" long. He showed us pictures; she had a full head of dark hair, and gorgeous, chubby cheeks! 

We wanted to go back, but Katie was doing skin-to-skin contact with Elliana. Drew told us to go have dinner somewhere, and come back.

We went to the Bag of Nails Pub that was up the street. All of us ordered our food and ate it in record time. Drew's dad ordered meals to go for the new parents. 

We met back at the ward, and Katie's best friend since childhood, Lesley, greeted me. 

We all walked into the ward to Katie's room. Katie looked beautiful; she was sitting upright in the bed, with Elliana in her arms. 

Elliana is perfect! She has the longest lashes you've ever seen. Her nails were so long! She didn't make a sound, she was so content. 

We all took our turns holding her, and watched the nurses give her a bath, as well as her immunizations. My baby girl niece is perfect! I am in shock! I still can't believe she's here! I just spent the last 7 months rubbing my sister's belly, and talking to her, and now, here she is!

Lots of tears were shed; ones of pure joy. 

My dad and my brother came up the very next day to visit with Elliana. 

Since she has been born, I have changed her and held her countless times. She is a very good baby. I'm known as Aunt Meggie, or Auntie M! 

It's the best feeling. My sister and Drew are such great parents; I'm so lucky to have the family I've got. 

Until next time...

A Cinderella Story

Last night was interesting.

It started out as an ordinary Wednesday evening after work. 

I popped in Jim Henson's "Labyrinth" (circa 1986), and measured out some cereal to munch on. 

My living room was dark, except for the candle lights flickering. 

My vision started to get fuzzy, and spotty. I brushed it off as just needing to take my contacts out. I checked my Dexcom; it was 82, and I had just confirmed it with a finger stick glucose, not even ten minutes before (my meter had said 76). 

Then my brain started feeling fuzzy. I was getting tunnel vision, and I started getting the head tics that happen, right before a seizure happens. 

I started panicking and ran over to my meter bag. I struggled to get a single test strip out of its bottle, and it took me two or three tries to get the test strip inserted into the meter the correct way.

I pricked my finger, and because I was snuggled under a blanket, and my fingertips were still warm, the blood came flowing out, and ran down my finger and pooled into my palm. Five seconds later, the number on my meter that greeted me sent me into sheer panic.

Thirty-one.

31, 31, 31.

My heart immediately started racing; I couldn't tell if it was out of rhythm, because it was pounding so fast.

I paced back and forth in my tiny apartment; ran into the bedroom, nothing there. Ran into the living room, nothing there. Raced to the kitchen, and looked into the refrigerator. Two Juicy Juice boxes. I grabbed them, and ripped off the straw, unwrapping it and trying to insert the straw into the top of it. I broke my straw. I grabbed the other juice box, and couldn't get the straw in, so I gave up and threw it. 

I found my stash of Gala apples from the apple orchard, and bit into it. The juice was cold, and so sweet. It tasted so good. I rummaged through my cabinet and found my half-eaten jar of Jif peanut butter, and started scooping it out with my fingers. I coated my entire mouth with peanut butter, praying the sugar from the apple, and the "protein" in the peanut butter would bring me back up. 

I checked Dex again; double arrows pointing down, and not even a reading, just the word, "LOW." 

I started hyperventilating, and crying. 

I am alone in my apartment with a severely low blood sugar, and there is no one to help me save my life, but myself.

I'm still having the head tics at this point, and I can't support my weight by standing up in my kitchen, so I sink to the kitchen floor and lean up against the cabinets for support.

I can hear the Labyrinth blaring in the background; my favorite part! The "Dance Magic Dance" scene! I'm trying to sing along, and picture the movie playing out in my head, but I can't focus. I can't keep my thoughts together. The only thing that is permanent, is this:

"Keep eating, Meghann. Keep eating. Keep eating. Keep eating."

After I finish the apple and peanut butter (I didn't even wipe my hands off, let alone wash them of sticky apple and peanut butter), I went back out into my living room. The movie is still playing. Dex keeps vibrating and beeping at me. Still double down arrows and LOW. 

I feel awful, I'm scared. I can't breathe. I'm shaking. I'm terrified I'm going to have a full-blown seizure and pass out. Who will find my body, if the worst happened? I remember thanking myself for wearing my medical bracelet with my mom and dad's telephone number on it. 

I'm laying on the floor of my living room, curled up in a ball. Terrified. 

I look up to the clock to see what time it is. 9:08. This started at 8:56. 

Then my eyes fell on it—the glass pumpkin jar, filled with my fall favorite—candy corn. I remember yelping out in happiness; pure sugar. Something I know for sure will raise my blood sugar. 

I remember buying the bag, over 2 weeks ago, at Wal-Mart with my mom. She scolded me, and told me I shouldn't eat them. But the $2.25 bag of Brach's candy corn ended up saving my life. 

I shoved 42 pieces of candy corn into my mouth and chewed them as fast as I could. I wanted that sugar to coat the inside of my body and raise my blood sugar as high as possible. I didn't care how high, I just didn't want to die. 

While still chewing, I made it into my bedroom, and fell face first into my pillows.

I texted my mom. 

"Blood sugar went super low to 31 but I am ok. Ate a lot of food, just wanted you to know."

I can feel my vision coming back. My thoughts stop racing. My heart isn't pounding anymore, and I'm no longer having head tics. 

Mom tells me to test my blood sugar again; 136. Fifteen minutes later, 167. 

I feel so much better. Everything happened so quickly. One of the most terrifying moments of my life. The sheer desperation of eating to live, and the fear of being alone combined, wore me out. I cried from relief, and a little embarrassment. 

Mom and I made plans via text messaging to recheck my blood sugar at midnight. 

It's amazing how something so insignificant, like candy corn, can be such a beacon of hope in a moment of desperation. 

That small, pumpkin-shaped glass jar filled of candy corns saved my life. And maybe the Gala apple and Jif peanut butter! 

This Cinderella made it home before midnight, and lived to tell the story.

My Story

I have had type 1 diabetes, or "juvenile" onset diabetes, since 1990.

 

I was four and a half years old when I was diagnosed.

 

Living with type 1 diabetes is no easy feat; the decisions I make are primarily based around my disease. I am consistently testing my limits, wondering if the choices I make will affect me and my disease in a positive or negative way.

 

People try to understand – people say that they can “totally relate,” when the reality is: You Think You Know, But You Have No Idea.

 

A day in the life? I am a walking pin cushion. In the days before my Medtronic insulin pump and my Dexcom CGM, I had to test my blood sugar up to eight times per day. Can you imagine drawing blood from yourself before and after each meal, or any time you didn’t feel good? How about injecting a chemically engineered liquid that saves you from winding up six feet under, more than 5 times per day? The thought makes many nauseous, but it’s unfortunately become routine for me.

When my parents and my endocrinologist gave me the reins to take care of my disease on my own, I abused it. More on my story with diabulimia can be found in earlier posts.

 

I was denied the privilege of having my driver’s license at 16 – my parents wouldn’t even let me get my permit until I started taking better care of myself to bring my hemoglobin A1c down.

 

I finally obtained my driver’s license at 17 and a half years old – well into my junior year of high school, when most of my friends had already been driving since they turned 16.

 

I was also unable to attend college after graduating high school, which at the time, was hard to understand from my parents point of view. I wasn’t healthy, I was having too many high blood sugars, and having intermittent seizures from low blood sugars – they couldn’t trust me to take care of myself, and they were scared. I understand this now, but at the time, I was angry. It was no one’s fault but my own. So, while my friends were getting ready to pack up for college and have the experience of their lives, I was working two jobs and applying at technical/trade schools for medical assisting and phlebotomy.

 

Being 27 years old now, and looking back at the 18 year old me, is such an out-of-body experience. Who was I back then?

I was a hypocrite—I wanted to be a nurse, to care for others, the way I have been cared for my entire life, but how could I even try to take care of my patients, when I didn’t even take care of myself?

 

In 2007, I started using an insulin pump, but the process to get one wasn’t easy.  I had to keep a log for 60-80 days. I had to write out my blood sugars (up to eight times per day), the food that I ate, the amount of insulin I used, and the correction that was needed. My doctor even had me wear a CGM, or “continuous glucose monitor” for seven days. The needle/sensor that they injected into my belly was a good 1” long, and I won’t lie, it hurt! The CGM (circa 2006-2007) looked like a cardiac Holter monitor, and it was concealed in a black bag with a strap that I had to wear on my shoulder, like a purse. I had to put a Ziplock bag over it when I showered. It was exhausting, but for the first time, I wanted the change. I worked my butt off, and my hemoglobin A1c that was consistently between 10% and 12%, dropped to 7%, one month before I received my insulin pump. I achieved that on my own, and I was so proud of myself.

 

At that point, I was 21 years old, and had a great job with great insurance, but I was still worried about the cost of an insulin pump.

 

After my physician submitted a letter of medical necessity to my insurance company, all I had to do was wait.

 

I finally received a phone call from a “Juan” at Medtronic. The call came while I was getting ready to sit down to dinner. Once Juan delivered the news that, yes, I was approved to receive an insulin pump, and yes, it was covered 100% by my insurance company, I sank to my kitchen floor and started crying. This was going to change my life. This would possibly extend my life. No more injections? Like, ever? I couldn’t believe it.

 

Pump training was miserable. All great changes are preceded by chaos, am I right? My dad was laid off from work at the time (winter of 2007), so he drove us to Toledo and attended the 3 hour long class with me. It’s funny, to me, because those are some great memories of just my dad and I.

 

We learned how to draw up insulin into the reservoir, how to inject the infusion set, how to remove the infusion set, and how to disconnect from your pump. Confusing, right? Are you still with me?

 

For a week, I had to infuse saline with my pump, instead of insulin, just until I got the hang of it. I was still using injections, but I would have to remember to enter my blood sugar and the amount of carbohydrates (measured in grams) I was eating into the insulin pump, so it could calculate the amount of insulin (or saline) I would need to cover my meal and my blood sugar, if a correction bolus was warranted.

 

The most hilarious part of training and learning to use my insulin pump on my own, were the mini “freak outs” I had. I was frustrated with learning. I couldn’t get it perfect each time I tried, and that made me crazy (because I’m a perfectionist)! I remember running downstairs before I got in the shower, telling my dad that I couldn’t disconnect my infusion set from my body—it’s going to be stuck there forever! I’m going to die! Oh my God! Help! It always makes me smile when I think about it, how overwhelming change can be. I am the world's biggest drama queen, because I made my dad attempt to disconnect my pump with a pair of PLIERS! So hilarious!

 

I moved to Columbus in 2009, which was nerve-racking. How would I be able to care for my diabetes so far away from home and the familiar? At the time, the insurance I had through the first hospital I worked at had ridiculously expensive co-pays for my insulin and my pump supplies; Three hundred dollars plus! I went back to using injections temporarily, because it was what I could afford.

 

The first endocrinologist I established care with through Mount Carmel was awful. He never kept eye contact with me. He didn’t explain his plan of care for me. He billed my insurance company as Type 2 Diabetes. I was angry. He never listened to me. I felt like he didn’t want to help. I was dealing with my own personal hell, and this guy wasn’t making my life any easier.

 

I would intermittently just skip doses of my insulin to save money, and because I was still struggling with diabulimia.

 

At the time, I was working full-time at a cardiology office, where 14 physicians dictated my whole shift. I was given dirty looks when I would take a break to test my blood sugar, or run to the break room to drink juice for a low blood sugar. To the doctors I worked for—who only knew the cardiovascular side of medicine—stopping to check my blood sugar, or treating a low blood sugar meant that I was "brittle," or "uncontrolled." It meant weakness.

 

There was one exceptional cardiologist that I worked for, who advised me to stop seeing the endocrinologist I had just established care with, and to make an appointment with one he recommended. “You’ll love her!” he exclaimed. His excitement for this endocrinologist gave me newfound hope.

 

Since establishing care with my new endocrinologist, I feel confident working 50+ hours a week and living alone.

 

I applied for a CGM (continuous glucose monitor) by a company called Dexcom in February of 2012. A sensor is inserted under my skin (subcutaneously), and stays there for approximately seven to fourteen days. The receiver, which looks like an iPod, transmits the data and allows me to track my blood sugars via graphing. 

I met with my area Dexcom representative at Panera one evening after work, and she showed me how to use it, and how to insert the sensor under my skin, which was another frustrating learning experience. I didn't want to say goodbye to her—I needed her! She took me in the women's restroom and inserted my first sensor for me. The whole time, I'm just standing there, completely overwhelmed, but smiling and verbalizing that I understood what she had just shown me and taught me. Oops.

I wish someone could have seen my mini “freak out” (the sequel) when I had to change the sensor for the first time by myself. I was dancing around, fake crying, and being so over dramatic (as usual) about it! I had Kerri, my Dexcom representative on speaker phone, coaching me through it. It took me about a half hour to insert a new sensor by myself, and now, months later, it takes me less than 10 seconds to insert one!

 

The Dexcom has been extremely crucial and beneficial to my disease. I love being able to know what my blood sugar is, at any given moment. I can confirm the blood sugar reading on my Dexcom by doing a finger stick glucose, and 90% of the time, they match.

 

Now that you know a little bit about my background, let me tell you about the “Diabetes Police” or the people who constantly criticize the way I care for myself and my diabetes.

 

The “Diabetes Police” are those individuals (even a group of people) who constantly feel the need to judge everything I eat. These people are sorely uneducated. They shake their finger at me when I have ice cream or pasta. They tell me I will eventually die from eating these things. Are you kidding me right now? You know what I want to say to them? “If you keep eating the way YOU eat, you’ll end up with Type 2 diabetes, and then we’ll actually have something in common!”

 

Just because I have diabetes, doesn’t mean I can’t eat something. I can eat anything I desire, anything I am craving, anything that a “normal” person eats, I just have to make sure that I take the correct dose of insulin to break down the nuclear content of the food, in order to convert it into energy, like someone with a working pancreas does.

 

If I don’t take enough insulin for something I eat, I’ll have a high blood sugar (hyperglycemia). When my blood sugar is high, I need take insulin to bring it back down. This is known as a correction bolus. I don’t feel good when my blood sugar is high. I feel grouchy, impatient and so thirsty. I feel feverish, like I have the flu. I need to drink lots of water to prevent the blood sugar from rising even higher, and from developing ketones in my urine. Ketones in my urine could be the beginning stages of DKA (diabetic ketoacidosis), which is potentially fatal to type 1 diabetics.

 

If I take too much insulin, or get too much exercise, I’ll have a low blood sugar (hypoglycemia). When my blood sugar is low, I need to eat 15 or more grams of carbohydrate (with a small dose of protein to stabilize the blood sugar), like peanut butter crackers, or Goldfish crackers. I also need to drink juice, or a regular soda—something with fast-acting sugars. I can eat candy, such as Smarties, or Nerds (my favorite!) to bring my blood sugar back up to an acceptable level. I can usually feel when I am low; you feel shaky, sweaty, and hungry. I also get very irritable and near-impossible to deal with. I usually explain to others that my low blood sugars feel like borderline intoxication. I have trouble thinking and processing information. After I eat a snack, I usually wait 15-20 minutes to recheck my blood sugar. If it’s still low, I have to eat more to bring it back up. The lower my blood sugar gets, I can become combative. My mom used to tell me I had "super human strength" when my blood sugar dropped to a level where I required assistance. Falls put me at risk with extreme lows. Low blood sugars can be just as dangerous as a high blood sugar; in the past, I have had seizures from going so low. This is considered a true diabetic emergency—I would need the assistance of an EMT to administer what is called a Glucagon (a manmade hormone injection) to raise my blood sugar quickly. I have not had a true emergency since 2001, and for that, I am grateful. The side effects of the Glucagon shot are not pleasant! Vomiting and feverish for hours!

 

Having type 1 diabetes has also subjected me to teasing and ridicule from people. Co-workers, friends, family members, and strangers offer me their two cents on a daily basis. I don’t mind answering questions and providing education where I can, but the teasing, especially since I am a 27 year old woman, is uncalled for.

 

I currently work in a medical office, and each day at lunch, there is a gang of women who are ready to pounce on me at a moment’s notice when I walk into the break room to make my lunch.

 

My lunch usually consists of a large salad—not because I have to eat it, but because I want to eat it; I enjoy salad. These women always roll their eyes at me and announce, “Oh, here she comes with her huge salad! How do you eat that? Ew! I’m so glad I don’t have diabetes so that I don’t have to eat that crap.” One day, I had finally had enough, so I provided detailed information and education on type 1 diabetes. I don’t think they listened to a damn word I said, because they were still asking stupid questions like, “Did you get diabetes because you had too much sugar as a kid?” and providing commentary, such as  “My cousin has diabetes and he is so overweight. Did you lose weight to become a type one?”

The only thing you can do in a situation like this is to find a different place to eat your lunch every day.

​I once had a physician, whom I worked for, tell me that I would lose my feet from eating too much sugar. First of all, you’re a doctor—you should know the laws of diabetes have changed, and type ones can eat whatever they would like, to their heart’s desire, as long as a sufficient amount of insulin is provided. His nurse would also constantly badger me about every single thing I put in my mouth—even gum!

​Strangers are a whole different playing field. I have people accuse me of wearing a pain pump, saying things such as, “Wow, you don’t look like you are in as much pain as I am in. My doctor won’t even prescribe Percocet.” I explain that it is an insulin pump to help infuse insulin for my type 1 diabetes. The woman then goes on to say that, “You must have it bad, then.” I tell her that I wasn’t aware a ‘bad’ kind existed.

My mom tells me stories all the time about when I was younger, and the terrible things people said to her about me. “Say goodbye to your old daughter,” one woman had said. “She’s gone. This is the new Meghann.” What sort of heartless person says that to a terrified young mother?

 

The only thing I can do is to just ignore the ignorance, continue to provide education at each opportunity, and smile through the tears.

 

As I have said, many times before—diabetes is hard.

 

I assume I was chosen by God to live with this disease, so that I can be a symbol. What kind of symbol, you ask? A symbol of strength, courage, and bravery. I want to use this opportunity to be a light in someone else’s darkness—a sign of hope.

 

To me—That’s worth fighting for.

 

 

 

 

​

Who is passing out cures? Are they free?

Here we go again...

My past two entries that I have posted, along with their overwhelming response, has triggered a very strong desire to stop my insulin. 

With those posts, I wanted to raise awareness, and let other type 1 diabetics, who are struggling with the same issue, know that they are not alone.

I sort of feel as though I'm in the spotlight, and I have that unsettling, "all eyes on me" sense of being. 

I enjoy the center of attention, don't get me wrong. I love laughing at myself and making others laugh at my expense (it's sort of my thing), but I have recently just felt so unworthy of it all—the praise, the attention. Am I being judged? Not my character, but my body? Do I deserve to be referred to as brave, and courageous?

The weather here has been slightly cooling off; a season of the year that all of us Ohioans call, "football weather." I couldn't wait to put on my jeans when the high temperature hit 64 degrees on September 2. 

I dug through my neatly-folded and stacked pile of jeans on the top shelf of my closet. I chose my favorite pair; a flare-style, dark wash pair from Express. I had purchased them on sale, the day after Christmas in 2011. They were so cheap. Anyone who knows Express, knows that their clothing isn't exactly the most affordable. This $100 pair of jeans was mine for a mere $40. They fit so wonderfully on my short stature—they even made me look like I had more of a backside! I cut out the tag that stated the size—I have this thing where I don't like having a number define the size of my ass—so, I couldn't be honest about the true size of them. All I know, is that when I went to put them on, they were uncomfortably snug. To the point where I was trying to stretch them—you know, the embarrassing act you engage in, mostly in dressing rooms. You duck-walk, jump, and hold each side of the flaps apart, in order to somehow make the jeans magically bigger. 

No such luck. 

These babies were TIGHT. I was panicking. How much weight had I really gained, since I quit smoking? I thought it was only eight pounds, but it felt more like sixteen. 

The next morning, after a relaxing Labor Day, I arrived at work to use the scale. Fortunately, it was before the rest of the department got to work, so I made sure to remove EVERYTHING. It's 6:08 AM, and I am standing in my bra and underwear in the middle of my clinic area, on the same scale I use to weigh my patients. 

This scale is a son of a bitch.

It's September 3rd, at 6:08 AM, I'm half naked at work weighing myself, and the number that greats me on the scale was so unkind. I am up ten pounds. Ten.

So, after I dressed myself for the second time that morning, I went back to my office to sit down. I needed to try and slow down the thoughts that were frantically running through my brain. 

JUST STOP TAKING YOUR INSULIN.

JUST STOP TAKING YOUR INSULIN.

CANCEL YOUR APPOINTMENT NEXT WEEK WITH DR. CHRISTOFIDES.

RESCHEDULE IT IN ANOTHER TWO MONTHS OR SO.

SAY YOUR WORKLOAD IS TOO MUCH TO BEAR, AND YOU CAN'T SKIP WORK FOR AN APPOINTMENT.

At this point, my heart starts racing, and I become sweaty. I look down at my Dexcom, which had just begun to greet me with loud beeping noises, indicating that my blood sugar was dropping. 54 mg/dL. I panicked myself into a hypo. All over the number I had seen on the digital scale.

The work day carried on as usual, nothing too crazy. Flu season had begun the week before, so I was busy giving each of my patients an immunization. 

All I could think about all day was stopping my insulin to lose weight. My blood sugars were perfect; glistening 80s, 90s, and 100 mg/dL readings on my Dexcom. Why would I want to ruin that? 

In an effort to keep my mind off of harming myself, I went for a walk on my lunch break. Do you remember me telling you about the rheumatologist I had worked with, back in 2010-2011? Well, I ran into her on my walk. 

"Meghann, hi! How have you been?" I responded appropriately, despite the lump in my throat (that happens when you really struggle to keep yourself from bursting into tears). I could feel her eyes look me over. Twice look me over. 

"Any special guy for you, yet? Are you continuing to watch your diet and exercise? How is your weight doing?"

There it was. The unspoken. She was inadvertently trying to tell me that I had picked up weight. 

I get it; the woman loves me, she cares about me, but COME. ON.

I sweetly responded to her that yes, diet and exercise are in check, and my blood sugars are immaculate. She wished me a good day, and headed in the opposite direction.

I immediately walked to my car in the parking lot and stewed. Was I overreacting? 

When I got home that evening, I had forgotten that I had brought home my entire diagnosis summary and hospital discharge notes from 1990. It was a 3" binder that was entitled, "Diabetes Notes," from the Medical College of Ohio. I had found it at my parents house over the weekend, cleaning out my old room of junk (I'm a closet pack rat—Don't tell anyone).

I sat on my couch and began to flip through it. My actual discharge papers! On a fading, yellow sheet of paper.

Day of admittance: 12/06/90

Day of discharge: 12/11/90

Lots of sheets with "safe" foods. "Free" foods. How to treat a low blood sugar. How to treat a high blood sugar. Personal notes written to my parents by my pediatric endocrinologist; he even provided them with his home telephone number!

In one side pocket, I found letters from other parents of type 1 diabetic children that my parents had befriended in their diabetic education classes. 

A woman named Mary Ann had shared a diabetic recipe for carrot cake. A gentleman named John provided helpful insight on how to educate my teachers about my diabetes. And of course, my infamous "Dear Mom" letter on a piece of faded, orange construction paper.

Behind those letters, were letters from Dr. Horner, my pediatric endocrinologist from 1990-2007. They were all test result letters dated 2001-2005. 

I read through them, paying special attention to the personal instructions he would pen to me, always in the right lower corner of the letter.

February 10, 2003, Dr. Horner wrote, “We need to work on improving your blood glucose readings and HgbA1c, Meghann. Call if you need help. Doc H”

At this time, my Hemoglobin a1c was 12.2%. Looking at that number on this deteriorating sheet of paper made my stomach turn. I read through some more.

“Meghann, you really need to get serious, get those BG readings under control, and lower that A1c.” My Hemoglobin a1c on May 13, 2003 was 11.9%.

“Meghann, you really need to work on improving your diabetes control. Doc H”

My Hemoglobin a1c on September 8, 2003 was 10.0%.

They were so disappointing. Why did I do this to myself? When I read his dedication to me from October 28, 2005, I completely lost it; even the lump in my throat couldn't prevent the tears that started and didn't stop. 

“Meghann—you really need to work at improving your diabetes to avoid the chronic complications of the disease. You need to take control and protect your kidneys. Doc H”

At this point, I'm sitting on my couch, and having second thoughts about renewing my lease with diabulimia. No way; I can't go through this again. I need my kidneys. I want to be around for my family, and my unborn niece. 

I had my six week follow up with Dr. Christofides today; the appointment I had wanted to cancel last week, during my personal crises. 

We chatted about my blood sugar readings, that Josie (her amazing front office assistant) had downloaded from my Dexcom. We chatted about my basal rates, my correction factor, that one time I bolused 40 grams of carbohydrate for half a head of cauliflower (I know, right?), along with my dose of medications. 

I don't even know how the conversation started, but I was crying. I was telling her about my thoughts. How I wanted to lose the weight I had gained. How I wanted to fit in my jeans, and that the thought of buying a bigger pair disgusted me most of all.

Dr. Christofides, in true form, looked at me with her big brown eyes, and said: "Meghann, fuck all those people. I don't care about your weight. You are beautiful inside and out. We will fix your thyroid levels. Once those are straightened out, then I will worry about your weight. You have my permission to tell those people to fuck off." 

People, hear me: I smiled through the tears. I love this doctor. I mentally send Dr. Archer a thousand kisses everyday for recommending her to me. 

We made some changes to my pump, I made my follow up for ~7 weeks, and then I made my drive back to Reynoldsburg. 

I am happy, once again. I am in a good state of mind. I sang along to the radio. I waved cars in front of me (which is hard to believe, but I rarely allow that). 

I came home, cried a little more, and decided upon typing up this blog post. Honestly, I was kind of disappointed that my title wasn't very catchy, or witty, but I have plenty of upcoming opportunities to make you all giggle.

I have juvenile diabetes. 

I am the face of a chronic illness.

I have an invisible illness.

But—

I am healthy. 

I am alive.

I am free of complications.

I don't expect to see those negative thoughts anytime soon, and I didn't appreciate their brief appearance cramping my style, but... I'm back.

Here are some photos of the letters from Dr. Horner:

And here is the letter I wrote to my mom, in a Crayola magic marker:

To celebrate my strength, and deciding to not give into temptation, I'm eating a chocolate chip cookie—gluten free, of course. And maybe sharing it with Phoebe.

Facing Old Demons, Part 2

“The strongest people are not those who show strength in front of us, but those who win battles we know nothing about.”

Diabetes is hard. It's a constant struggle. You have to think about it twenty-four hours per day, seven days straight. Diabetes doesn't take a vacation.

Many people assume insulin is a cure. That, with insulin, you are cured, and you don't have to worry about a thing. I worry constantly. Will I meet someone who cares enough about my well-being to handle me at my very worst? Will he check my blood sugar in the middle of the night, just because? Will I be able to have his children? Will I die in my sleep from a low blood sugar, or have a heart attack, or stroke, caused by a high blood sugar? Will I die young? Will my death certificate state that my cause of death was type 1 diabetes? 

Diabulimia came without warning; it started off as an innocent fling, and ended up turning into a tumultuous relationship that I can't seem to break free of. 

You see, the demons can never be silenced for good; they can be refused by your own strength and dignity, but it is a hard fight. Being brave and courageous will not always save you from giving into the temptation.

In my last entry, I left you with the cliffhanger of myself as a 24 year old academic secretary for Ohio State.

The comments made directly to me about my weight from my colleagues was more than likely meant to be constructive criticism, but when someone hates their body, and punishes themself because of a chronic illness, it's sometimes best to keep your comments to yourself. Period.

I wrote off my rapid weight loss to my co-workers as a "low carb diet" with "plenty" of exercise. Ha. I knew damn well what I was doing, and I didn't care. 

The holidays were upon us at that time, and in order to maintain a "safe weight" prior to the festitivites, I completely disregarded my diabetes. The denial had set in deep, once again. I was determined to prove that I was NORMAL, and that my size 12 butt would fit into the size 8 and 10 pants hanging in my closet. 

I would wake up every morning and weigh myself naked. In November of 2010, I was back down to 154 pounds. I was 4 pounds away from being my weight at 15 years old! When I had stopped taking my full daily dosage of insulin back in September, I had weighed 170 pounds. It felt so good to see a smaller number on the scale. It felt amazing to fit into pants that were not my true size. I felt giddy about my dirty secret. 

I had dark circles under my eyes, because I wasn't getting any sleep at night. I would get up constantly to use the restroom, and I would chug two 16 oz. bottles of water before going back to bed. 

The mornings spent at my apartment, getting ready for work, were unbearable. My muscles were so stiff, it literally pained me to walk 20 feet. I could hardly raise my arms to get a shirt on. I would have to take tiny breaks, inbetween mascara and lipstick, to lay down.

I had a headache that wouldn't go away. I felt dizzy. I was sweating profusely; I had to take extra make up to work to make touch ups. 

En route to work, I would pull my car over to the side of 670 West (every single morning) and vomit. It was yellow bile. Sometimes, it would be nothing at all; just dry heaving. I would drive to work in 20 degree weather with my air conditioning on. I didn't wear a coat into work; I was so hot all the time. But my belly was shrinking, so I insisted on keeping it up.

I never ate lunch, or took snack breaks at work. I lived off of water, Diet Coke, and coffee from Starbucks. I probably had one meal per day, that was barely 300 calories.

My pharmacist would call and inform me that my insulin was at the pharmacy, waiting to be picked up (I had signed up for auto renewal, months before). I would lie, and say I had just been busy, but don't worry! I'm coming to get it!

Living two and a half hours south of my home town meant it was easy to lie to my parents about my diabetes; they only saw me maybe twice a month. "Yes, mom. Doing just fine. Yes, I have enough insulin." When I was 15, 16, 17, 18 years old, lying to my mother wasn't a big deal. Being a young 24 year old woman, it hurt me to lie to her, but it was just something I had to do, until I reached my goal weight. 

Dr. Christofides is no fool. She knew exactly what I was doing. She called me out on it at every single visit. I would laugh it off, and tell her she was wrong. 

Dr. Christofides insisted on taking me to see her patients in the hospital. Women on dialysis. Women who were going blind. Women who kept having miscarriages. All because they neglected themselves. 

To me, I was invincible. It didn't matter what the hell I did to my body; That would never be me. It would never happen to me. I wouldn't need to be on a wait list for a donor kidney. I wouldn't have to worry about not being able to have a baby of my own. 

At Christmas, we all gathered back home at my mom's sister's house. Everyone complimented me on how great I looked. It felt so good. I could button and zip myself into a size 8, 9, and 10 pant. I would have to be crazy to go back to religiously taking my insulin. 

Another year passed. It was 2011. My weight was holding steady at 155 pounds. 

I ended up transferring my academic secretary position to another department, only, I would now work as a medical assistant. I instantly fell in love with my new work family. I wore my insulin pump, but I never bolused; I was only receiving my basal, or "background" insulin.

About two months into my job, I received an email from my clinic manager, stating that she and I needed to talk about my attendance. 

I was in jeopardy of being fired for my many call off's. 

I told my clinic manager that I had FMLA. 

She told me that she didn't care—if I am a full time employee, then I am expected to report to work full time. I accepted the write up, and walked out of her office rolling my eyes. 

Working in general internal medicine, we see a lot of chronic health problems, especially diabetes. I felt like a hypocrite. I was standing beside my physician, preaching about a healthy lifestyle to his diabetic patients, and meanwhile, I wasn't even taking care of myself. 

Now, put yourself in my shoes. I am supposed to be the "shining star," the "good example," of what a diabetic should "look like" to my patients—and I don't even take my medication. I was disgusted with myself. So, I stopped being a diabulimic for awhile.

I ended up bringing down a hemoglobin a1c of 9-something percent, to about 7%. I can also tell you, that my weight shot back up to 170 pounds in eight short months. I hated myself. 

After discussing my issues at my appointment with Dr. Christofides, she recommended seeing a psychologist, or entering a rehab program.

I looked into different outpatient clinics throughout the Columbus area, and found one close to my apartment. 

When I called to schedule an appointment, the woman I spoke to seemed alarmed and rather concerned. She suggested an inpatient rehabilitation program. The thought of being hospitalized for 4 to 7 days (or more) terrified me. How much money would that cost me? I ended up hanging up on her. She never called back, and I never bothered with it again.

I went in and out of my phases with diabulimia; half of my daily dose here, all of my daily dose there, none of my daily dose the next day. 

I was desperate to be with people who had diabetes; I needed someone to relate to. It wasn't a very personal or enlightening conversation with my friends who didn't have diabetes. Their response was always the same: "That sucks." 

In an effort to branch out and meet new friends with diabetes, I applied to be a camp counselor for Camp Korelitz, through The American Diabetes Association. The camp catered to both type 1 and type 2 children, ages 8 to 17. 

Camp Korelitz was located in Clarksville, Ohio, just right outside of Cincinnati. The camp ran for 7 days. 

I was in charge of six 13 year old girls. Another counselor, named Grace, assisted me in caring for our campers. All of our girls had type 1 diabetes, many already on an insulin pump.

Every night, we would sit around and have what was called a "Cabin Chat" before bedtime. We would talk about how ignorance and assumption can hurt our feelings, and discuss how the teasing from "outsiders" affected our mental health.

These girls were so brave. Many of them encouraged one another to accept ignorance as an opportunity to educate about type 1 diabetes. They didn't harm themselves to cope. They would ask me how I dealt with the teasing, and the burdens of diabetes, when I was their age. I had made a promise to myself, even before attending camp, that I would not poison their minds with diabulimia. I never mentioned it. I didn't want them knowing it existed, or that it was even possible to harm yourself this way. 

We would have to wake the girls up at midnight and 3:00 AM to check their blood sugars. It killed me to do that to them; I can totally relate to the parents (as well as my own) of type 1 diabetic children! It's awful! Ripping their hands out from underneath their pillow, just to stab it and make it bleed to check a glucose level. Sometimes, they would be so combative in their sleep, we had to go for toes. The lows were terrible. Having to fully wake them up to ingest a juice box and some Goldfish crackers (some of these kids were veterans; they could drink and eat, all while still sleeping). The high blood sugars were a little more difficult; you had to check with the cabin doctor or nurse to see if it was appropriate to correct with insulin.

I stopped to think about all of the times I had woken up with high blood sugars, due to my hyperglycemia—I had never corrected a single one. It was agony. Why had I done this to myself?

Being with type 1 diabetic children made me angry at myself; I felt like I was cheating them. I wasn't being a good role model. They had such positive attitudes, and I would lay in my bunk at night, selfishly thinking that it never gets better.

But it does. 

Support is a wonderful thing. Sometimes, you don't even realize how bad you need it. 

After camp, I had made another promise to myself—I wasn't going to shatter my neverending hope of a normal life. I wasn't going to hurt myself anymore, because my kidneys were important to me. I didn't want to end up on dialysis. I was not invincible, like I had once thought. 

I returned to work feeling miserable. The lack of sleep I got at camp—playing camp counselor, nurse, sister, and parent—made my blood sugars high, and I had ketones in my urine. I ended up leaving work before the lunch hour to take care of myself, which was totally fine with my clinic manager. 

I remember driving home and thinking, "Maybe I should just ride these high blood sugars out, and see if I can drop a couple pounds." By the time I got home, I was dry heaving. Nope. Time to correct with a manual insulin injection, and place my insulin pump on an increased temporary basal rate. 

By 4 o'clock that evening, my blood sugars were on the mend, and my ketones had pretty much resolved.

I saw my endocrinologist the very next week for a 6 week follow up. I told Dr. Christofides about my revelation. I expressed gratitude to her for never giving up on me, in lieu of the lying that was associated with my diabulimia. 

My best friend got married in September, and I was a bridesmaid in her wedding. Myself, Kristin, (and all of our friends) laughed at my disadvantage with my insulin pump and my Dexcom CGM—I looked so lumpy from my lifesavers' outlines in my dress! 

The holidays came, and still, I was tempted with stopping my insulin in order to lose weight.

But I didn't do it.

I enjoyed the holidays as a healthy, 26 year old. I wasn't hiding a secret anymore. I wasn't missing work. I was happy, for once. Of course I would have my moments, where I wanted to stop insulin for a few days, just to feel better in my jeans, but it's not worth it. I can't even really tolerate a blood sugar in the 200 mg/dL range anymore! I end up feeling weak and flu-like, just as I did when I wasn't giving myself insulin. 

It took some growing up, self love and acceptance, to realize that diabulimia isn't worth it. I don't want to die, cut my life short, all because of a number on a scale. 

I had to accept that I was given this diagnosis as a blessing—to help others, especially children, with type 1 diabetes. 

I had to accept that with this disease, comes the realization that I will never be perfect—and the best part is, I don't have to be. Blood sugars will go high and blood sugars will go low, and sometimes, I don't want to try and put them back together again, but I have to. There is no choice. Life is too important to me. 

There is a great quote I have come to find, spoken by a Mary Anne Radmacher. She said, “Courage doesn't always roar. Sometimes, courage is the quiet voice at the end of the day, saying, "I will try again tomorrow."” I have found this to be very comforting throughout my journey of self discovery. 

I don't believe I will ever be "cured" of diabulimia, just like I have not yet been cured of type 1 diabetes. I still think about stopping my insulin every single day. The thought is always there; it always comes to the surface, once, twice, sometimes three times per day. But, I have a great support system in my family, my friends, my co-workers, and my endocrinologist. 

I'll always have a little extra chub on my belly (insulin is a hormone that just happens to aid in the storage of fat, which is why a lot of type 1 diabetics have a difficult time losing weight), but I don't care. I'm alive, and I don't have any complications from my juvenile diabetes.

I have recently been eating a healthier diet, and trying to get more exercise. I have replaced a lot of my favorite carbohydrates with vegetables and nuts. I live off of Quest Nutrition Protein Bars—they are virtually bolus-free! I'm finding myself using less insulin, only, now in a healthy way! Less high blood sugars, less correction insulin used. Less carbohydrates ingested, less insulin needed to cover the food in order to prevent high blood sugars. I think I have it figured out, for once in my life! 

I wanted to provide my readers with photos for comparison, but a lot of them were just too difficult to share. I was unrecognizable, and I didn't want to trigger anyone's recovery with diabulimia. 

This is a photo from 1990, when I was 4 and a half years old; This photo was actually taken at the hospital, during my stay for my type 1 diabetes diagnosis.

This photo is from after my discharge; I went to the local Southwyck Mall in Toledo, Ohio, to get my ears pierced after my follow up appointment.

Happily accepting a dinner time basal injection at Christmas, circa 1994.

This photograph breaks my heart. This was during the middle of my freshman year of high school, in 2001. I looked so sick. Hiding all of that pain behind a smile.

This is from my 17th birthday, the middle of my sophomore year. It amazes me how small my upper body was.

Some full body-comparison shots. The photo on the left was my junior year homecoming; the photo on the right was at some point during my sophomore year.

And here is a collage photo; just recognize how much the weight in my face changes. It's so crazy to me!

This photo was taken on Christmas, 2008. I am pictured (middle) with my siblings. I must have been "sober" here. My weight looks heavy.

This photo was taken during the summer of 2011. I'm saddened by how unhealthy I look; I am on the far left. 

This photo was taken in August of 2012, the day after I returned from Camp Korelitz. This is Kristin; we were at her bridal shower. I'm healthy here!

This picture was taken in September of 2012,  for Kristin's bachelorette party. I'm the 3rd from the left. I am healthy here!

Kristin's wedding day, 9/26/12. I am on the right hand side, in the middle. Healthy again! 

In closing, I hope that each of you can take something from me sharing my story of struggle. A personal world of self acceptance and love is a wonderful place to be, and it took me a very long time to get here. 

I am a warrior, and I refuse to let someone else's words bring me down and take me back to that awful place. 

I'm not going back. 

Ever. 

**If you or someone you know is struggling with an eating disorder, please call the National Center For Eating Disorders, at 1-877-829-2142. Get the help you need, and help save a life.