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February 10th, 2012
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ADM logoIt's my time...to remind myself that every caregiver needs a break.

 

I've been my own diabetes caregiver since about the age of 13. I remember the day quite vividly that changed it all. TCH (my pediatric endos at the time) made the switch from "sugar abstinence" to "carb counting." Otherwise known as Intensive Insulin Management.

 

I had to attend a class about carb counting, A1c goals, and overall "intensive management." My mom usually went to every diabetes-related doctor's visit or informational. But this time, the class was on a Saturday. Her job at the time didn't allow Saturdays off, so my dad took me instead.

 

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It's my time...to appreciate the past.

 

Dear Mom,

 

I've probably never thanked you out loud for the years of care that you've put into my life. And I should. Every day of my life. Because you have been the rock, the support, and the lifeline that I've need in the past 16+ years of living with diabetes.

 

I've heard the way you tell my diagnosis story. I hear the fear in your voice, the emotion run through you. I know that those months were some of the hardest in your life. When you talk about watching me have seizures and bad night lows, I hear that same fear and emotion. I know having a diabetic child must be one of the most difficult things to encounter as a parent. I know it wasn't what you expected or wanted or needed in your only girl.

 

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ADM - American Diabetes Month Whether or not we recognize it explicitly, we are all caregivers (aka, T3s). Whether we serve a family member, someone in our neighborhood or church, or just others on the dLife forums and in the dLife community, we are each part of someone else's diabetes support team.

 

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Once upon a time, I wrote about things other than diabetes. I wrote about things like funerals for dead pet fish, my wife’s germophobia and my disdain for minivans.

 

As a kid, I was never a great student. Most of it bored me and I didn’t make much of an effort to store the information in my brain. Math I never understood and still don’t.  This is most obvious when my daughter asks me for help on her math homework. I usually just look at my wrist and tell her, “sorry, I have a thing,” and I run as fast and as far away as I can until I can be absolutely sure that she’s no longer following me.

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There's nothing quite like getting raked over the coals at your endo's office first thing in the morning.

 

It's a necessary evil. It's actually good for everyone with diabetes to check in with their endo -- or whomever is their primary diabetes caregiver -- several times a year. So I'm not saying I don't want to go. All I'm saying is that it's no fun to hear about what a crappy job you're doing being the manager of your pancreas.

 

I think it's been about fourish months since I last saw K, the nurse practitioner at my endo's office. Last week I had an ultrasound on the thyroid nodule that was discovered last year. So tomorrow's appointment will be to go over the results of the ultrasound, to go over results from routine blood work I had several weeks ago, to get my A1C and to check over my general diabetes care.

 

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"So what should we take with us in the RV," I asked No. 3 as I drove her to the sitter one day last week.

 

"Um, cereawl and hot dogs and... um... oh! your blood sugar."

 

"Yes, my blood sugar supplies," I said almost as if I had forgotten.

 

"And skeetles and juice for you," she said.

 

"Yes, in case I go low. You're right." Such a good caregiver.

 

I forgot so many things packing for the RV trip, but insulin, pump supplies, test strips and alcohol swabs were not one of them. I was surprised, actually.

 

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I don't think I'd want to be an endocrinologist or a diabetes educator treating type 1 diabetics.

 

I'd want to be a doctor with answers.

 

I imagine the job has moments of satisfaction. Guiding those newly diagnosed through those very difficult first years must be rewarding. But eventually the insight the endo provides plateaus. What can you possibly suggest to the diabetic who's been in the game for 5, 10, 20 years? What can you tell them to do that they haven't already tried on their own a million times?

 

How many times must I say, "yes, we bolus prior to the meal" and "yes, we rotate the infusion sites every third day."

 

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Several prominent dBloggers have posted this week about issues related to Driving While Low (DWL) and premature death. The subjects of these posts were people with Type 1 diabetes, which is the group with which we normally associate rapid-onset dissociative hypoglycemia. While this sort of hypoglycemia is certainly most common in Type 1 diabetes, it is occasionally seen in insulin-dependent Type 2. Most of the time, these lows would seem to be related to insulin activity peaking early or late -- or at least not in synch with one's food and drink.

 

Unfortunately, insulin is not always the culprit.

 

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The thud my step-mother heard came from the first floor. It was my father hitting the ground when he woke up and tried to stand.

 

The first thing he remembers was a township police officer standing over him. Then his memory cuts to a big breakfast. The EMT stuck around, making sure he ate it all. My dad, a type 2 diabetic, had a blood sugar of 22.

 

Dad blames the brand new flat-screen television that was delivered that day. He was so consumed with playing with its features and admiring its picture that he forgot to have his usual bedtime snack and eventually fell asleep on the couch. Clearly he’s getting too much insulin if he’s eating a regular snack (without insulin) and still waking up on the low side, as he mentioned was the case recently.

 

"It’s so difficult to figure this disease out," he said to me over the phone.

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Can we be better caregivers? I guess. We can always be better. We were thrown into this diabetes life without much warning just like many of you. We were caregivers merely by having children, but care-giving on this level is a beast of another color.

 

On this day, six years ago, Charlie was diagnosed with diabetes. He was still slurping from a bottle. What is it about the fall? So many people are diagnosed this time of year.

 

The changing leaves. Halloween. Sunday football. Apple cider. Sweaters. Murder within the pancreas. All trademarks of autumn.

 

I was giving Maeve a bath when Susanne decided to take him to the hospital despite the pediatrician’s lackluster opinion on the matter.

 

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Michelle Kowalski
Michelle KowalskiMichelle 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)
Kim Doty
Kim DotyKim is a computer systems administrator for a major food manufacturer and lives in Colorado with her husband, Steve, and their children. She currently battles the bulge and tries to develop an exercise habit to better manage her blood sugars. (Read More)
Our Other Bloggers: Brenda Bell, Nicole Purcell, Carey Potash, Lindsey Guerin, Megan, MikeDurbin, Robert Hudson, Julia, George Simmons, Scott Marvel, Kerri Sparling,