#DBlogWeek coincides nicely with Mental Health Awareness Week (see link below) so fittingly, today’s blog topic is all about the emotional side of diabetes.
As medical students we are taught about chronic conditions, many of which have distinguishing physical manifestations and potential complications. Rheumatoid Arthritis for example, can cause destructive and painful changes to the joints in the hands and there are many images in textbooks demonstrating the negative aesthetics of disease. Diabetes itself has a plethora of potential physical problems all of which I have been reminded of more often than I would have liked.
What is of perhaps underestimated importance, and something not so well illustrated to us in medical textbooks, is the significant psychological impact chronic disease can inflict. Upon receiving my diagnosis, I hurriedly filtered through any of the medical information stored in my brain and tried to recall all I knew about Type 1 Diabetes. My knowledge extended to the very basics of signs, symptoms, causes and management as well as the quite frightening potential complications. My body was deficient in insulin so I would have to start injecting insulin four times daily to replace it, maybe one day I would get an insulin infusion pump. Threats of eye, heart, kidney and nerve problems (amongst others) sprang to mind and lingered there. These physical considerations of the disease were overwhelmingly terrifying to say the least. However, what has been most enlightening since that day (18/12/12), is learning about and indeed experiencing, the mental complexities that accompany the disease.
Now, being a reasonably reflective person I could ceaselessly jabber away about the emotional side of diabetes so I thought I would limit this blog to a few anecdotes that illustrate just some of the multitude of emotions I have experienced since diagnosis.
Despair on Christmas Day
Christmas Day 2012 was a week after my diagnosis. First gift from Santa – awaking in cold sweats and trembling. Happy hypo Phoebe! The rest of the day went quite pleasantly and after injecting my bolus I enjoyed a rather delicious Christmas Dinner. A short while later I began to feel those all too familiar feelings that suggested a hypo was on the horizon. Full to the brim, I reluctantly had to take on board more carbohydrate and this was when the stark reality hit me and tears did ensue. This affliction of diabetes was never going to leave me. There would never be a holiday. Unlike Father Christmas, diabetes doesn’t care if I’m sleeping or awake, naughty or nice. It will be a part of me all day every day, for the rest of my life.
I was lucky enough to attend the Corpus Christi College 2014 Ball in Oxford a couple of weeks ago, and had an absolutely fantastic evening with some of my very best friends including my twin sister. The ‘getting ready with friends phase’ is one part of such evenings that is supposed to be enjoyed, but for reasons unbeknownst to me, my blood sugars were riding high. Perhaps it was excitement, perhaps it was stress but despite several correction doses those sugars just would not budge. When your blood glucose behaves with such stubborn resolve, it is easy to fall into a vicious cycle of frustration. The high readings are frustrating which dampens your mood. You get frustrated with your frustration and feel guilty to your friends that you are not in the party spirit. Fortunately, after some patience and a bit of my own stubborn resolve, the blood sugars came down to acceptable levels and the rest of the evening was full of fun and frolics with my chums.
Diabetes can have the impressive ability to evoke powerful feelings of anger and resentment. There are days when I loathe and despise the disease and inevitably wonder why did it have to happen to me? But life is not renowned for being fair and you just have to get on with it. Sometimes I try to channel any negative thoughts and feelings I have towards diabetes and use it to my advantage when exercising. One particular time I attended a ‘boxercise’ class, which unsurprisingly involved punching and kicking manoeuvres (not of other people I might add). It might sound a little odd and maybe a bit sad, but each and every punch I would imagine I was beating diabetes. Focusing my anger in this way really does make me feel better and I will be the first to advocate exercise as an integral part of successful glycaemic control.
Exercise exercise exercise. Just Do It.
Every single diabetic day in my diabetic mind, there will exist at least one anxious thought. Where’s my blood sugar at this morning? Was that REALLY Diet Coke they served me at that restaurant? Where are my glucose tablets!!? Am I going to have a hypo in the supermarket/gym/lecture/exam/elevator…? How much insulin do I have left? Do my friends know what to do in case I have a hypo? No really…was it Diet Coke?
Is it really diet coke they served me?
Now human beings are remarkably resilient creatures and have an extraordinary ability to adapt to new and different situations. And that’s what diabetes demonstrates. Testing your blood sugars every morning and evening, before and after meals and exercise, injecting four times a day, ensuring you have emergency fast-acting glucose supplies to hand at all times (I’ve got packets of jelly babies dispersed at readily accessible locations), checking your levels before driving, walking to the shops and during exams, ensuring insulin is kept cool in hot climates…it all becomes part of normal everyday life and tasks such as the relentless injecting and finger prick testing become routine. That’s not to say it stops you feeling anxious and for me, every single blood glucose test adds an element of stress to my everyday shenanigans. Sometimes however, it becomes so routine complacency can creep in….which I learnt last week on an excursion to Cadbury World (‘the world of chocolate delights’) by forgetting to take my insulin. Advice to fellow diabetics planning/hoping to visit Cadbury World one day: TAKE YOUR INSULIN.
Dealing with Diabetes
Dealing with diabetes has been an exponentially steep learning curve, arriving in my life in an unwelcome and disruptive fashion. It has changed my life. Taking the positives from the situation, I feel lucky in a way, as I have come to learn a lot about myself and gained an invaluable insight into the complexities that go hand-in-hand with chronic disease. All of these experiences will hopefully help me in later life, whether that be treating future patients or educating the general public about how there is certainly more than meets the eye when it comes to diabetes. I took a year out of my studies to come to terms with my diagnosis and learn more about how best to manage everything. This was a huge decision but a necessary one. Whilst I’m well aware there will be more trials and tribulations to face in the future, for now, I am in a much better place both physically and mentally. My friends and family have been absolute heroes and have had to deal with my mood swings, highs, lows and of course perpetual ramblings and reflections about diabetes. I would not be where I am today without you all and at the risk of sounding like one of those green aliens from Toy Story, I am indeed eternally grateful.
Thank you friends.
For more information about Mental Health Week: http://www.mentalhealth.org.uk/our-work/mentalhealthawarenessweek/