Tuesday, February 19, 2013

Guest Post: 17 Years

I met Rose this past year via the DOC. We clicked quickly -- not only because we both have Type 1, but because we are both knee-deep in medical training as well! Rose is almost half-way through medical school and is working out how diabetes shapes her and her medical experience, so her post fits here perfectly. If you'd also like to connect with her, she is @diabud on Twitter!

17 years ago tomorrow I was told that I could do anything I wanted to (except be a commercial airline pilot), but I was going to have to be more careful.  Because of this idea that I was not limited, I did not realize how much having diabetes has shaped me. I really had no idea when I applied to medical school, how much my personal experiences with health care shaped my ideas of medicine and how I want to practice.  The time around my diaversary is always a time of reflection and this year is no exception.

It was not until one of my medical school interviews that I was asked, “what is the hardest part of having diabetes?” that I began thinking about it.  I was completely stumped.  I had not thought about it before. I had spent so much time convincing people around me that it wasn’t a bit deal, that I never acknowledged that it was. It probably took me over a year to figure out the answer to the interviewer. Now I know my answer is that, no matter what I do and how things go, I’ve got to do it again.  I can have a really rough exhausting week, where nothing goes well, I feel crummy way to often and I do not know why.  But there is no vacation from diabetes.

For me the barriers to my health are not knowledge or access.  For that I am very grateful.  For me the barriers are time, mental space and an inconsistent lifestyle.  The barriers are daily management. I do not need help interpreting my A1C or handling a sick day.  I need help when I sleep through my alarm and need to rush out of the house so I can get parking, I skip testing (my blood sugar) because it doesn’t seem as important as getting to school faster.

The problem is, on those mornings where I am in a rush or distracted for some other reason, I want to trust the CGM and postpone testing.  Sometimes the CGM is very accurate and so it is easier to ignore my dry mouth and other symptoms of high blood sugar and get on with my day. The problem is it takes more than the 30 seconds to test.  It takes time to interpret the result, figure out an action plan, not judge, not get distracted by an inaccurate continuous glucose monitor (CGM) that looks perfect, but is off by 150points. This is the part of my health that I need more help with. The part where I realize that taking care of myself is part of my homework.  I need help figuring out how to fit D in to everything else.

I have never been that big on resolutions but with the boards coming up, it seems like some goals were in order. I have always had academic goals to keep me motivated. Last year I set my first ever A1C goal (which I met!).  This year I decided to set one complete goal that includes my school, home and diabetes lives.  In June I hope to be happily married, with a Step 1 score I like and my best A1C since high school.

I hope that considering my total life, and not just my academic achievement will help me with “work life balance” in a setting where that sometimes seems impossible. I also hope that my effort to figure out something that works for me will give me new ideas about how to help other people manage the daily practical challenges of their chronic illnesses and own health in the future.