Friday, August 5, 2011

Things Were Simpler Then

I was diagnosed with diabetes on February 5, 1986. I was 4 years old. The home blood sugar meter had only been available for a few years. They were still the size of a brick, and horribly complicated to use. A finger prick was done by a lancet device that we in the D-OC affectionately *cough*sarcasm*cough* call “the guillotine.”

Insulin delivery was by needle (and thankfully, not by glass needles that need to be sharpened….I’m not that old yet) only. We had no clue how to count carbs. Only that we were supposed to stay away from sugar and that we needed to eat three meals and three snacks per day, following the exchange program (anyone remember the red exchange book??).

We tested four times per day. Breakfast, lunch, supper, and before bed. We only checked other times if I was feeling bad. When I was first diagnosed, I only took one shot per day. Within a year or so I was taking 2 shots per day; one at breakfast and one at supper. There were no sliding scales or insulin to carb ratios. Cake was only an indulgent few bites on holidays and your birthday.

My mother never did middle of the night testing, though I know she slept with one eye open. She could hear me having a low (whining, thrashing, etc.) in her sleep no matter what. I’m sure my blood sugar ran higher than anyone would want their child running nowadays, but it was a protection for us.

Over the past several weeks I’ve been thinking about diabetes burnout. I think a large part of the burnout that I am dealing with comes because diabetes is such an all the time thing. I have a CGM that lets me know if I’m too high or low (or even if I’m rising or falling too quickly). I test numerous times per day. I rarely sleep all night without an alarm happening. Though I don’t do middle of the night checks on myself very often anymore (thank you GOD for the CGMS), I end up checking in the night from alarms more often than I’d care to admit.

Sure, I can eat sweets more often, skip a meal if I’m not hungry, and not worry as much about the timing of my meals anymore. I can test my blood sugar in 5 seconds, I have an insulin pump that allows me only a couple of needle insertions a week. My control is better, which I know will ward off long term complications.

But at what cost? I wouldn’t trade my diabetes technology for anything (other than BETTER technology). But sometimes the continual grind of diabetes can be so frustrating. At least when I was a kid, diabetes didn’t rear its ugly head more than a few times per day (meals, injections, and the occasional low). Now diabetes is always around.

I know this post sounds like I’m complaining. I’m not. I’m eternally thankful for all of the strides in diabetes care and all of the amazing technology that I have at my fingertips (no pun intended), it’s just an observation about how different the care of diabetes is today than it was 25 years ago. And my thoughts on how that “micro management” can lead to diabetes burnout.


kim said...

i absolutely agree with you. i was diagnosed in 1974 at age 12, and was on 1 shot/day for 26 years!! i am sure my control was horrid, but i was less comsumed by my disease then, than now. and with that, comes burnout, and depression. somedays i wish i was a kid again!!

Mike Hoskins said...

So completely agree, Cara. Was diagnosed in 84 at age five, and we had a meter in the house not too long after I was diagnosed (thanks to my mom's use of it). But it was a different world of less testing and less tight control, and it seems as though we could step away from it a little easier and not be as overwhelmed with constant management as we are now. Again, so totally thankful as you are for what we have, but it is a lot more information to deal with. Thanks for sharing this, and hope the burnout balances out soon my friend.

Fiona said...

I've always been grateful I was diagnosed 2 years ago vs. 20 years ago but I have to say that my CGMS makes me irritable and cranky. I can handle the constantness of the pump but I have to take periodic breaks from the CGMS or I get irritable and I also overmanage as a result of hte constant information. I've discovered there's a fine line between enough information and too much information.