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September 1, 2014
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Coming Out of the (Insulin?) Closet


When friends in one of my Pagan communities talk about disclosing their religion to others, they borrow a metaphor from our LBGT friends: they "come out of the broom closet". It's kind of appropriate, considering that many are Wiccan and that witches are associated with brooms in both folklore and practice. When we disclose our diabetes to someone, we may talk about "coming out of the insulin closet". I'm not sure the modifier is appropriate for those of us who have type 2 diabetes and who don't (yet) require exogenous insulin. Still, "coming out of the diabetes closet" doesn't have the same sort of "ring" to it...

 

I've been open about my diagnosis (hard not to be when you're blogging on a major diabetes site!) for long enough that my original migration from denial to the "closet", and gradually stepping out to the degree to which I'm open about it now is beginning to get fuzzy.

 

Obviously, those of us in denial wish to tell as few people as possible. We pretty much have to tell the people we're living with, as they're going to see medications hanging around, or drastic changes in diet as we try to "prove" that the diagnosis is wrong, and we manipulate our diets as best we can to change our numbers to dispute it. So my parents, my sister, and The Other Half needed to know. I tended to avoid eating out socially as I tried to figure out my diet when I could eat, what I could eat, how much I could eat, and if there were even a way to eat "low sodium" outside the home. (The 1000 mg/day sodium restriction meant pretty much that anything that had seasonings, and any cooking method other than broiling, steaming, or grilling on a recently-cleaned grill, would put me over.) We had some pretty bad scares eating out such as a simple grilled chicken breast sending my blood pressure skyrocketing and giving me a bad headache. As a result, some of our favorite restaurants learned of my diagnoses long before my friends and co-workers.

 

Still, it's hard to keep things in the closet when the components of that closet are constantly changing. I dropped 80 pounds in the nine months following diagnosis, another fifteen in the following year and a half. I went from a men's/unisex 3X t-shirt to a Youth Medium, from a size 24 pant to a size 10. Slowly, the information leaked out, sheepishly, with words like "yeah, sort of", moving on to comparing blood pressure target numbers and blood glucose numbers, while I struggled to balance the disordered eating necessary for glycemic control without developing a bona fide eating disorder, hydrate in heat, develop an exercise regimen, and all those other things that come with our diagnoses.

 

By the time my numbers were under control by diet and exercise alone, I was open with, but not advertising, my medical status. I found myself in the uncomfortable position of being a "role model", a poster-girl for the ILM (intensive lifestyle management) approach to metabolic control. The problem was, the latter parts of this were done while I was unemployed and on COBRA, The Other Half was unemployed, and we had the leisure for me to put in two hours a day at the gym.

 

The demands of a job which tether one to a phone, short, limited breaks, and/or live customers tend to make one's eating schedule erratic as well as reinforcing the old (bad) habits of getting a meal "done and over with". The functional requirement of eating from the company cafeteria for one of those jobs meant high-calorie lunches that should have easily carried over into three or four meals, gobbled down in fifteen minutes or less. The weight started piling back on, blood pressure started going back up, and even though that company and I parted ways over four years ago, I've not been able to successfully readapt to the type of diet I need to stay healthy. I went back on blood pressure medications while I was still in that position, and the doses have been mounting.

 

Of late, my blood pressure has been higher than I'm happy with, and with no insurance and no money, I can't go through the arduous process of finding a companion medication that won't give me adverse side-effects or permanent damage. I finally used the Bayer A1c Now package I purchased New Year's Eve (before I had to rush out to Queens, the night Mom died). Despite my glucometer numbers reading ridiculously low, it came back with a 6.7. Based on what I've been eating, when, and how, I believe the A1c reading more than I believe the glucometer readings. That means either I'm missing a lot of highs by not checking (very likely), or that the low readings indicate an exacerbation of my peripheral circulation issues (also likely, given that I'm much more prone to "pins and needles" than I was in the past couple of years), or that I need to switch glucometers.

 

Such is the hubris of the hero tale: that after some time at its top, things will settle back down to their previous "normal", drop down a bit, and carry on until the next crisis hits, and one must adapt or die trying. (Or just die, but we won't go there. At least not yet, not now...) There are tools in that there insulin closet, and I need to take some time to weed out the garbage that's accumulated so that I can find them.

 

This post is my March entry in the DSMA Blog Carnival. If youd like to participate too, you can get all of the information athttp://diabetessocmed.com/2012/march-dsma-blog-carnival-2/



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Megan Holmes
Megan Holmes Megan was diagnosed in 2009 with Type I. As an RN, she was familiar with the medical side of her diagnosis; learning to be a good patient on the other hand, was and continues to be the challenge of her day to day life.   (Read More)
Michelle Kowalski
Michelle Kowalski Michelle Kowalski, a writer, editor and photography hobbiest living in Phoenix, was diagnosed with Type 2 diabetes in February 2005. In January 2008, as part of her quest to start on an insulin pump, Michelle learned that she actually has type 1 diabetes.   (Read More)
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