Tuesday, September 10, 2013

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.














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