Tuesday, January 14, 2014

Games and War

Type 1 diabetes is a game, and I am a party pooper and hate games in the first place. Only 5% (according to the American Diabetes Association) of people living with diabetes have type 1. Those of us who have developed this goofed up disease have no choice but to play.

 I think I started thinking in this direction today when my co-workers were talking about the movies Braveheart and Gladiator. Guys were talking about wanting swords and going into battle after seeing these movies and getting all riled up and ready to be all guyish and aggressive. When I looked at my Dexcom receiver a short time later I started thinking about the battles that we have with “D”.  It really is like a game, or a war if you will, at times. There are times like a few days that I had last week when it’s pretty smooth sailing, no steep ugly highs and no drastic bottoming out lows. Those are the days that are few are far between, but are as close to a break as we will ever get. Days like that help to refresh and make us think we are ready for the next impending battle. Then comes the onslaught………….. Hormones act up causing a spike in BGs, an insulin pump site in the upper thigh that was in a blood vessel and wouldn’t absorb insulin and splurts out blood when it’s pulled out.  A site that  kinked or just goes bad for no good reason and it takes hours to correct the high that you believe should never have happened in the first place. Or the carb count on the package of burger buns cannot possibly be right because you know you ate plenty of carbs besides that bun but for some reason you are now plummeting down like Niagara falls and must eat everything in sight to feel like you are not going to pass out and die. There is the work out you did that you had a small snack for beforehand and you were so sure that if you set your temp basal rate on your pump down any lower you would end up as high as Mt. Kilimanjaro but instead you had to stop the bike ride because you still dropped to 42 and really feel ready to kill over.  These are battles that make us feel defeated.

Then there are the games. These games are a bit easier, yet more intense when there is a CGM (continuous glucose monitor) involved.That's the point of view that I'm going to take here, but I did play this game before, only with my meter alone. When the arrow on the screen of the CGM receiver is going straight east and you’re at a happy number, and it’s been that way for some time and you are just cruising along not going high or low, this is intermission during the game. 

Then it’s game time again and the game changes. That’s when the arrow starts to steadily point slightly due north or south. 

Depending on how steady  that number is changing when it updates with a new reading on the screen every five minutes, depends on what move you should make to win the game, or if you even get to make a move. You can feel like your are sitting on pins and needles. Then, if it turns into a straight up or down arrow or even double arrows, then you really have to get ahead of the game and take action. It’s feels at times like I’m trying to beat the graph on the receiver screen and not just control my BG from going haywire. It really does feel like some crazy game when I see straight up arrows and I keep checking the screen most likely less than every five minutes and then putting that number in my pump to see if it’s my “move” in the game and I can get more insulin in my system or if I have to wait my turn until I see an even higher number. Those long stretches of seeing a number like 286 and it’s just steadily going straight forward, not up or down, but according to the pump I have too much insulin on board (in my body) at the moment to do a correction bolus to get that number down. That point in the game is torturous! Waiting for my move, but then………… it changes, but not the way I thought. Instead it starts to drop, I feel a short lived sigh of relief at finally seeing 198 instead of 286, because before I know it, it’s gone from the straight arrow that was at 286 then dipped to 220, then 198 to a double falling arrows and “Dang really? That’s how you want to play the game? Now I have to eat fruit snacks because I’m falling too fast and I’m going to reach 60 before I know it?!” Yep, that’s how diabetes like to play the game. I just have to try my best and keep up.

Even though a lot of this seems like defeat, and there are plenty of tears, plenty of screaming inside, plenty of mentally cursing my body, Dexcom, food and whatnot, really, each and every day I’m alive I’ve won the game, I’ve won the battle. Every doctor’s appointment with an A1C that is even slightly close to my goal is a battle won, and when I have my A1C right where I want it it's a victory in the war. Every insulin injection is like a sword stuck into my enemy's side even if I don't think it's making an impact because I can't see the results right away, it's twisting that high sticky glucose like a sword in my enemy's side. Every healthy food choice, every work out no matter how short, each of these is another part of the game I must play with every thing in me. These are hard fought battles, and even though I will feel defeat, I will not be defeated in this ugly war of T1D.

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