Do you ever use your diabetes as an excuse to get out of doing something?   

It sounds dorky and pious, but I used it as an easy excuse to get out of drinking alcohol in high school and college.  (It meant I didn’t have to tell my friends I wasn’t interested in being as stupid as they were when they got drunk.  And I didn’t have to deal with my parents learning I ever drank.)

I know several people who have used their diabetes to skip lines at amusement parks.  I myself love that I always have an excuse to have food with me at places where no food is allowed… even if I’m not low and don’t need the food. 

I’m not talking about necessary reasons to avoid going to work or school if you are in DKA or need to do something for your health; I’m talking about knowing you actually can do something you’re supposed to do, and using diabetes as an excuse to avoid doing it because you simply don’t want to do whatever it is.

Those are the excuses I’m talking about.

I think we’re lucky that life with either type of diabetes doesn’t mean life in a hospital or a life with restrictions.  Yes, we need to pay super attention to things few others need to pay any attention to whatsoever.  Sure, it’s a difficult and draining thing to live day in and day out and watch every morsel of food and calculate and guess and be wrong much more often than we feel right…

… but it isn’t like our daily lives require us to avoid stairs or that we need help breathing.

I think other people living with other diseases and other physical limitations have it tough, too.  Like I always say, my diabetes is a thing… and we all have things. Some have a tortuous childhood, some have a missing limb, some have an incurable infection.  We all have things.

I will never forget the man in front of me at my first marathon who ran that dang thing on one leg.  I mean, who am I to complain I had to stop to check my blood sugar when this guy has one leg running twice the distance either of mine ran.  Sheesh.

People do some amazing things.  I use their words about excuses and limits to put some perspective on my life with diabetes:

“I never want to hear that I have limits; I want to push the envelope every day.”  – Brian Boyle, a 2004 car accident victim who was in a coma for 2 months with a narrow chance of surviving.  He had to relearn how to talk and walk… and who now succeeds at Ironman competitions.

“Setting goals… helps when your life has been turned around twice.  It’s kept me out of the pity pit.” –Nick Roumonada, a man who lost his leg to bacterial meningitis at age 13 and who at age 31 developed focal dystonia which impairs motor skills.  He manages his symptoms with running and marathon training.

 “…I worried about falling [as I ran the 2008 New York City marathon with 2 guides].  But I’m glad I did it.  I need to keep moving forward.” –Yuki Goto, a man who was in a 2006 car crash that left him with traumatic brain injury.  He still suffers from seizures, poor balance and double vision.

These are some amazing folks.  I think one of the most amazing things about each of them is that they probably don’t think they are very amazing at all!

Have a great day out there.  Don’t let anything hold you back!

Yesterday I went to see my diabetes doctor.  (I somehow like that term better than “endocrinologist.” I like the alliteration!)  I’ve been a mess for the past few days because I knew I was going to see her.  I was a mess driving over to her office.  I was a mess sitting in the room waiting for her.

As I sat in the room I could hear a man in a nearby room speaking to another doctor.  (He was speaking dramatically louder than “classroom voice” so it isn’t like the walls are thin.)  He had a woman with him, perhaps his wife, and I could hear her nervous laughter as he spoke to the healthcare provider.  He spoke of boluses and blood pressure and over-corrections and all sorts of pump- and diabetes-related topics.

My anxiety levels skyrocketed as I listened to him speak. 

He didn’t seem normal.

He seemed incredibly anxious.

I recognized it from my own doctor visits and my own emotions just this week.

I don’t know what it is, but the visits I have had with my diabetes doctors have always felt emotionally supercharged.  I’ve observed it in many other people living with diabetes, too.

I can’t figure it out: the good medical providers are there solely to help.  They want us to be as healthy as possible, and they want to support us in our efforts to achieve the same. 

So what’s the deal?

The only reason I’ve been able to come up with this afternoon is that perhaps we feel like we don’t need to explain anything about the disease to these medical experts: we expect they know all of the intricacies and daily difficulties of living with the disease.  We expect they will be able to understand our difficulties better than a layperson.  Maybe they are the only ones we feel comfortable will listen.

Or maybe we do our best every day and it still doesn’t feel like we’re doing enough.  Maybe we assume our medical professionals think we should be doing more, or better, or smarter work with our disease.  Maybe we doubt ourselves because we know, if we just said “no” to that cookie or took our medication at a different time that day or if we had just managed our holiday stress a little better we would be healthier and we wouldn’t need to be sitting with a medical professional.

It sounds so illogical when it’s written, doesn’t it?

Yet it’s that dang double-edged sword again: telling someone they have the power to keep their diabetes under control often results in that person feeling like a failure when it doesn’t stay there.

I know my doctor kindly teased me I’m trying to be a perfectionist, and that is certainly true (although I told her I’m just MOTIVATED).   I’m sure I’m being less than logical when my anxiety creeps in and I think “I should be able to do my diabetes better.”  I do my best all the time!  And my body does amazing things in response, and I don’t have much to complain about when it comes to my diabetes.

But because living with diabetes is so constant there isn’t a good way to separate all emotion from management.  Minimizing the emotions by recognizing all blood glucose readings are simply “data” from which to make educated decisions and do not carry any judgment with them at all is a major step in the right direction—a direction we would all benefit from taking. 

We all need to remind ourselves that our best is enough, and the right medical professionals aren’t judging our efforts.  The good ones are in fact trying to provide additional tools we can use to make our lives easier and healthier.  Maybe they’ve got some tricks up their sleeves they want to share.

I fortunately think my doctor is doing exactly that, if I’d just stop with my own stuff and listen.

I bet that guy in the other room could say the same.  I hope, for his sake, that he can.

Reading the introduction to Mindless Eating: Why We Eat More Than We Think by Brian Wansink, Ph.D.  I am amazed at all of us living with diabetes.  Seriously.  Wansink says the average person makes an about 200 food or food-related decisions every day.

Those of us living with diabetes are WAAAAY above average.  I am a bit frightened to think how many decisions about food those of us with any type of diabetes make in our average day. 

I for one think about what will taste good, what it might do to my blood sugar in the near and far term, what kind of caloric hit it will take, what I ate an hour ago, what I think I’ll eat later, what I ate yesterday, what exercise I plan on performing in the next few hours, whether  I know what all of the ingredients are in the food or whether there are hidden sugars, whether there is a lot of fat or fiber that may slow down my digestion… and that’s just what I’m thinking as I type right now! 

I do a lot of it so often I am not sure I am actually consciously aware of most of my (more than average) food decisions.

Beyond that, Wansink’s position is that manipulating these (average) decisions is done far before any decision is actually put in front of us: advertisers, packagers, marketers, even architects and interior designers all play a role in our food choices.

And he isn’t even factoring in a disease like type one or type two diabetes.

 Wansink discusses how whether we eat in bright sunlight or a dark movie theater, or whether we eat off a small green plate or a big red one, or whether the food is 90 degrees or 92 degrees when we put our plate down on the table all have subtle psychological influences on our food choices: how much we eat, how much we enjoy it, whether we regret eating it later and so forth.

Those of us counting every carbohydrate need to be aware of at least some of this because, simply, we are counting the grams of carbohydrate in the food we put in our mouths, not what we put on our plates.  (Or our bag or box or carton or what have you.)

Yes, those of us living with diabetes have to be pretty darn smart.  We have to be so smart that we can sometimes outsmart ourselves!  Managing our food choices requires being aware, as much as possible, of many of the psychological effects external factors have on what we do and what we eat.

Sounds difficult.

But we can do this.  We’re smart, you know. 

Pretty darn smart.

I tried to make this week all about motivation but I changed my mind a bit this morning.  I was paging through a book I have about raising kids’ self esteem and thought about how motivational tips and tricks end up meaning nothing if you don’t celebrate your hard work and resulting accomplishments along the way.

I’m serious.  If it means dressing up and going to a fancy dinner, or getting a pedicure, or opening that bottle of wine you’ve been saving, even if it means raising your glass of ice water at lunch, recognize and celebrate as many accomplishments as possible.

What do you have to lose?

I can’t go so far as to say every kindergartener needs a 2-hour graduation ceremony at school, but I will say they most assuredly need one in their family room.  (Cap and gown optional, but seriously fun!)

Nowhere is this more important than when you live with someone with diabetes, or if you have diabetes yourself.  Diabetes, type one or type two, requires such constant and unflagging vigilance with so few measurable “rewards” we must create them for ourselves and our loved ones.

First time your child has given himself a shot?  First time your child checked her own blood glucose?  Three in-range numbers in a row?  Five whole days of workouts this week? CELEBRATE.

Clearly, the celebration here is not the motivation.  But let me assure you, when you watch a young one race around the dining hall at camp collecting high fives for that first shot in his abdomen or first time drawing up her own insulin, you see how much JOY and PRIDE they place in accomplishing these soon-to-be-daily routines.  They know diabetes is a big deal, no matter how you slice it.  Give them some credit for knowing the seriousness of their disease in everyday life, and celebrate to recognize their hard work.

Living with diabetes is difficult in its simultaneous unpredictability and pervasiveness in our lives.  That’s simply the nature of the disease and NO ONE IS TO BLAME for it.  We don’t get any satisfaction from finding someone to blame someone for it, but we get to deal with it on our shoulders all the time.  So take a break from the difficulties when you can recognize a milestone for yourself or for your child or for your friend and celebrate that accomplishment.

When we stop the flow of life to ring the bell and announce a special moment for all to savor, not only do we deepen our awareness and appreciation of life, but we publicly proclaim the place and accomplishments of those we are celebrating.  (Will Glennon, 200 Ways to Raise a Girl’s Self-Esteem)

We don’t have much of a choice when it comes to living with either type of diabetes.  (Do it or die doesn’t seem like a choice to me.)  But we can chose how we deal with making it through a rough spot or a change in management or a goal accomplished. 

I choose to celebrate as much as possible.  Celebrate!