The Diabetic Roller-Coaster
I have come to the conclusion that the best thing to compare diabetes to is one of the classic roller-coasters. Remember the ones with the straight patches followed by steep climbs to the very high bits, equally steep descents that sent you crashing down into troughs and times when you went round and round in circles.
The only problem is that, unlike a roller-coaster, with diabetes one can never get off. You are on this ride for life.
When we are first diagnosed we go through a period of initial shock but this wears of reasonably rapidly and then we become very conscientious, often determined to be 'the best controlled diabetic around'.
This is quite easy for a while, we are on the 'straight patch' of the roller-coaster. As we normally have had very high blood glucose levels when diagnosed, the medication or diet and exercise drops them nicely and we get a sense of achievement. We may even get praise from our medical team for doing so well.
But as time progresses things start to oscillate - we are in the roller-coaster's 'ups and downs' section . We begin to worry and try harder, eating less to lose more weight, taking more medication, changing to a more restrictive diet and pushing ourselves into yet more exercise. And frequently with little or no results - we have got to the 'going round in circles' bit.
It is often at this time that the fact that we are diabetics really begins to penetrate.
Before, though we may have paid lip service to the fact, we had not really understood all the consequences. By now we have had time to talk to other people about it, read up on it and maybe visit online forums where others talk about their situations. This, though good as far as educating us goes, has a down side.
Suddenly we are made aware of all the complications that can develop, and worse, we begin to realise that it is with us for life.
Now I know that many may think "But we knew this before" and yes, intellectually you did, but now it really hits home what this means - this is a forever thing, you cannot get off the roller-coaster. You are going to be forever different, you are never again going to lead what one would term a normal life. Everything you do is done within the context of 'I am diabetic'.
This is not a choice thing or one feeling sorry for oneself, it is a simple fact that makes life dashed complicated and can lead to feelings of frustration, anger, depression, and the final and dangerous decision - "Blast this, nothing I do makes any difference, I might as well stop trying". If you reached this stage in a roller-coaster you would probably try to climb out of the car somewhere near the top!!!
Sometimes it is a little thing, seemingly unimportant by most peoples standards, that can push one over the edge. A woman told me how she reached this stage when going home on the train one night with a group of colleagues.
They had all had a particularly hard day at work and a universal decision was taken that they would stop off at a fish and chip shop on the way home and buy take-away for the family dinners. They could then put their feet up and relax with a drink.
The woman knew she could not do that, there was nothing her local 'chippy' (the only available take-away) sold that did not send her blood glucose soaring.
She was just as tired as her mates but she was going to have to go home, check her blood sugars, take her medication and then prepare a suitable meal before being able to relax - and without that drink as that was another thing that she could not have, it did not agree with her medication!
To add insult to injury, despite all she had been doing to date, her Bg's were still high. It was all to much and she decided she had had enough.
You seem to live diabetes 24/7. All sorts of 'little things' bring it home to you.
Every shop you pass seems to sell stuff you liked but can no longer have, your friends at work have a birthday and bring cake you cannot eat, your kids want ice-creams at the beach but you cannot share this with them, however hot and sticky you may be feeling, holidays come around and suddenly you are made aware of how often the occasion is tied into special foods.
Even planning a day out means remembering to take stuff you can eat in case there is nothing available and also your medication and BG meter and so on. As I said, nothing is simple anymore and the stress builds up.
Now lets consider those roller-coaster fanatics who can't or won't understand that you are terrified of heights and speed and hated your last ride on one years ago.
They insist that if you just stop being such a wimp and try it yet again you will get over your fear and love it. Basically they seem to feel you could 'get over it if you only tried'.
They are on a par with the folk who just don't or won't understand about diabetes.
This is worse if you are a type 2 diabetic who is not taking insulin injections. The concept out there appears to be that this type of diabetes is nothing much, just loose a little weight, get off the couch, swill a few pills and everything is dandy.
When you are battling with diet, exercise and meds to keep your disease under control this attitude is enough to make you want to commit murder.
One of the main complications as I see it is that unless you are one of the lucky ones for whom everything falls into place and the hard work you put in pays off it is almost impossible NOT to get depressed about your life.
Consider this - who would apply for a job that offered them ongoing boring work with minimal immediate reward, no recognition or appreciation of what they actually did, all for a suggested, but not certain, reward, ten to twenty years in the future, of the same dull job but without any added complications? Applicants would hardly be queuing up!!!
Most things are bearable if you were getting good results. A reward of some sort gives one the incentive to carry on. However diabetes is an inconsiderate disease, it so often gives us little return for our efforts and therefore many of us just throw in the towel and think "This is all just to much. Nothing I do works and I am sick of trying. I am just going to lead a normal life and to hang with everything".
The standard advice given for this, as far as I have found, is to talk to other diabetics or go onto the diabetic forums and see that you are not alone. This is all well and good but when we are in this state we hear, or read, but we filter it through our own frustrated, angry state and so instead of seeing the people who, like us, have problems and are maybe worse off, we only see those who are better than us.
We compare ourselves to the best, not the worst and our feelings of frustration and hopelessness grow.
If we are honest with ourselves we know our situations are all different and that everyone's results will be different. The fact of YMMV - which stands for Your Mileage May Vary - is pretty much drummed into us, but that is not one of the things we consider when having a "nobody loves me, everybody hates me, I am going down the bottom of the garden to dig worms" patch.
We are not all created equal. Think about the roller coaster analogy - some folk love the whole ride, others just grit there teeth and get through it, some clutch the seat in terror while others scream their lungs out for the whole trip and vow never, ever to go near one again.
What works for some may not for others.
One person may get perfect numbers on a standard ADA prescribed diet but for others it may need tweaking, or a totally different approach. That is why there are as many different diets as there are diabetics. And as if that is not enough our bodies change over time and what works for us today may well not work in a couple of months. And what does this mean - more complication, more stress.........
Many people have told me that not in their wildest dreams did they think that having diabetes would take such an emotional toll. In actual fact there have been figures quoted that say managing diabetes requires 30% physical effort and 70% emotional. I would say that sounds about right.
There is one factor that I feel a need to warn you about. That is the tendency we have to pile all our negative emotions onto our diabetes. We tend to forget that prior to our diagnosis we were not always the life and soul of the party.
We had good days and bad days, days when we felt great and days when we felt ill - that is what normal life is like.
Once we found out we were diabetics it became hard to separate the diabetic issues from the everyday ones.
Remember it is possible that you may be being treated in an unfair manner because someone is being unfair, not because you are diabetic, you may be tired because you are working very hard, not because you are diabetic, you may be stressed because there is a situation in your life that is stressful but that has nothing to do with diabetes.
Don't make your diabetes the whipping boy for all your problems in life - learn to separate the different issues. Easier said than done, I know, but keep the thought in the back of your mind anyway.
The next suggested read - The Five Stages Of Grief.