Yesterday, Chris Snider (@iam_spartacus) blogged about how what looked like a "perfect diabetes day" was marred by thoughts of keeping that perfection the next day, and the next day, and the next...
The spectre of poor control -- that one "bad" reading will screw up your life completely ten years from now -- can keep us on track, or it can cause us to throw up our hands in disgust and declare ourselves "failures". When it motivates us to the positive and we can do well, control our diabetes, and have great readings, we become "role models" and "ideal patients". I'm one of the poster children for that -- as a consequence of "following the rules", I dropped 90 pounds in the year following my diagnosis, got off the diabetes medications, and for a while I was off the blood-pressure meds as well.
This sort of tight management entails some degree of being a slave to one's Diabetes. When can I eat? What can I eat? What if my numbers don't go down low enough to eat, and I end up fasting for a day or two, or not eating the minimum number of calories necessary to avoid other serious metabolic issues? Am I exercising off enough calories to lose weight? The dark side of this road is Diabetes-Disordered Eating. Unchecked, it can cascade into clinically-disordered eating and true eating orders such as anorexia nervosa and exercise bulimia.
Let me introduce you to the Dark Lord of Glycemia -- euphemistically known as "the D Monster".
The D Monster is not soft and furry like the Cookie Monster, and is rarely merely as grouchy as Oscar. The D Monster is more like an emotionally-abusive, perfectionist parent -- or the punitive G-d that many of us learned to associate with the Puritanism of Colonial New England. The D Monster is ever-present, quick to blame us for any glycemic excursion, quick to threaten us with the fear of diabetes-related complications, and constantly eager to punish us body, mind, and soul.
Unlike children, we cannot hope to slay the D Dragon, outgrow the shadow under the bed, or run away from the D Monster's abusive home. We cannot ask a friend to call Child Protective Services for us. But like abuse victims, those years of having been brought down by the D Monster cause us to second-guess our every move, scold ourselves for the least diabetes-related misstep, and blame ourselves for every diabetes-related adversity in our lives.
On Rosh Hashanah, our services include the recitation of Psalm 136, "The Great Hallel". For the longest time, I found this particular psalm... worse than boring. It's long, it's repetitive, it's recited rather than sung, and every second line is identical. It wasn't until I tried (unsuccessfully) to set this Psalm to music that I began to understand it.
Ki l'olam chasdo ("For His Mercy endureth forever") is the basso ostinato -- the continuous, underlying harmonic structure -- that underlies all the other lines of the text. We praise and thank the L-rd of Lords, the G-d of Gods, Who Hast preserved us, redeemed us, brought us forth, caused us to multiply, and caused for us great things to happen, because all that is good comes from the goodness and mercy that is [insert your concept of Deity here]. This Divine Mercy underlies and informs every moment of our lives.
And so it is with diabetes. Is it safe to eat? (Ask diabetes.) Do I need to bolus for that? (Ask diabetes.) Should I exercise? (Ask diabetes.) How about driving home? (Ask diabetes.) Diabetes may be "invisible", but it is as much part of the fabric of our lives as is our Faith.
Faith is what keeps many of us "keeping on". Mother Theresa is said to have observed that "G-d won't give me anything I can't handle." Each of us has learned that, regardless the effort, we can handle Diabetes. And very often, it is through G-d's Mercy that we build the strength to test, insert, calibrate, inject, bolus, correct, and carry on from day to day. It is through His Mercy that insulin was isolated and made available to those who have medical need of it -- that researchers and engineers have developed glucometers, continuous glucose monitors, and insulin pumps -- and that we can live through scary readings, financial and medical hardships, (and yea, even through serious complications) -- and still come out smiling publicly and ready to help the next Pancreatic Pilgrim through the prickly path to "not-Paradise-but-it's-Life, and that beats the alternative".
As for that Dark Lord? We may not be able to -- or even want to -- eradicate it from our lives, but perhaps if we learn to show it G-d's ever-enduring Mercy, its rantings will turn from useless debasing scoldings to helpful instruction.
I'm not holding my breath for that.
To all who observe, L'shanah tovah -- a happy, healthy, sweet, and prosperous New Year. May you and yours be inscribed in the Book of Life for life, blessings, good health, prosperity, and joy in the coming year.
