My Diabetes Can Drink Green Beer

St. Patrick's Day 2009 marked my 21st anniversary of having type 1 diabetes. So, now my diabetes can drink green beer! Woohoo.

My mom gave me a sweet card and a present, as she's done every year, to commemmorate the day and say nice things about how I handle my diabetes. Every year, this makes me teary-eyed.

I had just turned 10 when I was diagnosed, so I remember a bit about the doctor's office. And the night in the hospital. And the nurses coming to our house with grapefruit and syringes to teach us all (me, my mom, my dad, and my stepdad) how to give injections. To be honest, though, most of it was a blur. In the span of just under two years, my mom and dad had divorced, we had moved across the country, my mom married my stepdad (who I adore), and I started at two new schools. Which means that there are many other memories of that time that are much more crisp. This may have something to do with the fact that my blood sugar was oh, 364 when I was diagnosed. My brain was probably not recording memories very well in that moment!

But my mom was an adult! And a mom! She spent the night with me in the hospital, and she says that she had a moment before she opened her eyes in the morning when she thought, "Maybe this was a nightmare." And then she opened her eyes to us in the hospital. She always managed her emotions so well that it's hard for me to imagine what she was feeling. I only know that her ability to let me always, always control my own diabetes and to support me in the ways I most needed her support was incredible. So, I think the tribute should be as much to her as it is to me.

Happy 21st Anniversary!

Stem Cell Victory

Yes, I am excited about the stem cell news!!! With three exclamation points. I already love Obama, and this makes me love him more.

Do I think it will lead to a cure in 5 years? Um, no.

Like many others, I was told upon my type 1 diagnosis that we would have a cure within 5 years. That was 21 years ago.

Let me be clear: I am not bitter.

I'm thankful for all the incredible advances that have come along in those 21 years. I'm thankful that I'm not dealing with diabetes 100 years ago or even 50 years. It was a very different Diabetes World back then. I'm thankful that I'm healthy and happy, that my family and friends are loving and supportive, and that when he sees me grab a baby Dr. Pepper out of the fridge, my husband doesn't think twice before saying, "Is your blood sugar low?"

But mostly, I'm hopeful for all the kids with newly diagnosed diabetes. Maybe someday stem cell research will help a little girl who is diagnosed on St. Patrick's Day, like I was. Maybe someday stem cell research will save the lives of my kids. Maybe it will improve life for my friend, N, who was diagnosed with MS at age 26.

Am I unrealistically optimistic? No.

Am I hopeful? Excited? Thinking this is a step in the right direction? Yes, yes, and yes.

Cousins and Friends

Who will be in our someday-to-be-baby's life? I was thinking about all of the permutations of our friends and family and their kids.....

In the past two years, my oldest friend from high school, K, and her husband have had two biological kids (now ages 2 and 2 months). In a sad twist of fate, her little sister has fallen on hard times and is addicted to drugs, so K foster parented and then adopted her sister's two kids, who are 3 and 7. All four kids are boys. She's also an internal medicine physician. In a super busy practice. I have no idea how she does it!


My best buddy from college, R, is single, dating, and wanting a long-term relationship and kids. All of her other friends have kids, so she's Tia to many, many kids, and they all love her. She listens to her friends talk about which pre-schools are best, how to potty train, sleep schedules, pooh schedules, and on and on. She takes photos of their kids. Creates nicknames for them. Takes them on field trips, babysits, and loves them with all her heart. She's also thinking about looking for some single friends. I love her for being so supportive of everyone around her finding love and having babies.

My wonderful friend, B, from grad school always maintained that she would never have kids. Even cringed when I talked about having a baby. Asked if she would have to touch it. Literally! Then she met an awesome woman, V, last summer, and for the first time, started considering the possibility of having kids. Since V is in her 40s, B would carry the baby, and they would ask V's brother to be the sperm donor. I'm trying to convince them to start soon so that we can go to Mommy Yoga together and raise our babies together!

Another close friend is adopting a baby boy from Korea, and is on a long waiting list for a baby from China.

In terms of family, my oldest sister, D, has three boys, each 7 years apart, so they're ages 24, 17, and 10. She works full-time and is super organized. You never see a toy in her living room unless it is actively being played with at this very moment. Her kids are smart and interested in the world.

My oldest step-sister, W, is married and never, never, never wants to have kids. She's a vet and has three dogs, two cats, six cows, and two horses. Even without kids, they have lots of babies to care for!

My other step-sister, L, has two little ones--a boy and a girl--and stays at home with them. Although I was shocked when she decided to quit her job (a full year before she got pregnant), she is an incredible mom! Those kids have more books than any other kid I've ever seen. They're smart, loving, and sweet. She takes them to the zoo every week, on long walks, and they play lots of educational games. The older one is in preschool a few days/week, and the younger one goes to swimming lessons and other activities. They are the ones who followed in my footsteps and call my stepdad Baba Dupie. Which I love, love, love.

I'm excited for our baby to have all these other kids in his/her life. And to call their grandpa Dupie!

Meds

I realized that I very nonchalantly said, "I went off of Symlin and Lisinopril." To continue or terminate meds during pregnancy is such a controversial topic. Are the risks worth it? My stepsister stayed on antidepressants throughout both of her pregnancies, and I believe it was one of the best things she could have ever done for herself and her (very healthy) kids.

But there are known risks with Lisinopril, and I was taking it as a preventive measure for my kidneys, so going off the Lisinopril made a lot of sense. Symlin was another story. Symlin is a class C drug, meaning that there is some evidence in animals that it could cause fetal abnormalities, but no studies in humans have been conducted.

My endo recommended (nay, strongly recommended) that I go off Symlin six months before trying to conceive, and was sort of fanatical about telling me so.

But when I met with Dr. Awesome OB (who's a high risk OB, specializing primarily in diabetes), she recommended (nay, instructed) that I stay on Symlin until I know I'm pregnant. She assumed that we would be actively trying and that I would do early pregnancy tests. That I would then stop the Symlin as soon as I got pregnant, and call her immediately for an appointment. Her sense was that we don't know yet what Symlin does to a fetus (perhaps it's bad, perhaps it's good), but we do know what high blood sugars do to a fetus. That if given the choice between high blood sugars or Symlin, we choose Symlin.

I don't absolutely love my endo, but I do trust him. On the other hand, I love Dr. Awesome OB. And I trust her immensely.

Many women will make this very personal choice (or a similar medication-during-pregnancy choice). I decided to go off of Symlin for two reasons. First, I would hate to do any intentional (albeit unknowing) harm, if it can possibly be avoided. And second, I felt like the pressure of leaning I'm pregnant, going off of Symlin, and needing to be in fabulous control without the help of Symlin might be too much. I figured that I would try to maintain (or improve) my blood sugars off of Symlin before even trying to get pregnant.

This seems to have worked so far, although my insulin needs have skyrocketed and I've gained a bunch of weight. My endo thinks this is a combination of going off of Symlin (on which I lost 15 pounds) and gaining tighter control. He says tighter control = weight gain. He looked me right in the eyes and said, without a twinkle of sarcasm, "You just have to eat less." This is why I do not absolutely love him.

But given the choice between some weight gain and better blood sugars, I'll choose better blood sugars.

Which is all to say that I went off of meds after some serious deliberation. No nonchalance to be found.

Turning 31

I turned 31 on Tuesday. My mom called on Monday to wish me a happy day before my birthday. So sweet! She also mentioned that she had been 31 when she had me. And that she thinks that 31 is a great age to have a baby. No pressure.

So, here's our timeline... I went off Symlin and Lisinopril (a preventive measure for my kidneys) in early December. I went off the pill in early January. I'm giving my body a few months to get back into the swing of things (does my body even remember how to ovulate?!), and then we're planning to start trying to conceive in April (next month!). Of course, life could always intervene, but that's the plan for now.

Baby or No Baby?

I met B five years ago. Fell in love. Planned to move away for grad school. Had crisis of priorities in life. Decided to stay here for grad school. For love. Best decision I ever made! Moved in together. Got a cat. Named her Pixie. Got a fish. Named him Pierre. Got a job. Finished grad school. Bought a house. Got married! Got another cat. Named her Cous Cous.

This was hard to fathom during previous relationships, but B is my favorite person in the whole world.

During all that falling in love and picking up cats from the Humane Society, as many couples do, we've had the what-should-we-name-our-babies dreams and the how-would-we-parent talk and the where-would-we-send-our-kids-to-school discussion. That last one is particularly important because B happens to be a teacher.

But lately, because I'm in baby-making range, we've had more serious conversations. As in, what would we do for day care? Will our baby be smart and kind? Would we let our kid play video games? What if we have a kid who grows up to be--god forbid--a Republican?! Are we sure we even want to have kids?

That last one is the tricky one.

I'm not the type who spent my childhood playing with babydolls and dreaming of being a mom someday. My mom went back to work one week (one week!) after having me. She worked and finished her dissertation, and two months after I was born graduated with her doctorate. When I had the chickenpox, she stayed home with me for a week. And painted the entire house. Go, SuperMom! My mom also has an amazing over-abundance of energy.

For many years, I thought (and said out loud) that I did not want kids. I couldn't even maintain a consistent schedule with my dentist. How could I possibly manage my own life and the life of some (albeit cute and cuddly) helpless baby?

As I was reassured that I would, I've found myself wanting a baby more and more. Maybe that has something to do with age. Or having found someone with whom I want to parent. Or finally having consistent dental appointments. Who knows?!

But B teaches eighth grade. And in terms of birth control options, teaching thirteen and fourteen year olds puts the pill, IUDs, and condoms to shame.

It is hard--nay, impossible--for him to imagine us having a wonderful kid who doesn't someday turn into one of his crazy eighth graders! He also has a whole host of other worries: the economy, daycare, parenting like his dad, parenting like his mom, having a sociopath, changing our lives, changing our relationship, never having sex again, never being able to retire, and on and on.

To be honest, I can't quite articulate why I want kids. I think B and I have resources and skills that will help us be decent parents. We have family and friends nearby who will be loving and supportive (and hopefully up for some babysitting). We'll read books on parenting and try to show the kid all of the wonders of the world. We will love a kid with all our might, and do our best.

But more than anything, having a child is simply an experience in life I don't want to miss. And B agrees.

Baby Love: A Review

A short review of Baby Love: Choosing Motherhood After a Lifetime of Ambivalence:

I love Rebecca Walker. Love her! I love her for all of the reasons most feminists my age love her. Third wave feminism? Ah, yes.

I also love that she's ambivalent and obsessive about the same things I feel ambivalent and obsessive about...at least when it comes to having a baby.

Since she wrote this journal-style, at times it feels a little too close to reading your own diary, which makes it fun to read (as in, what would I write if I were Rebecca Walker?), but also makes me wonder how much she edited and re-wrote. Perhaps there is pride in using raw material? Or perhaps I loved it because it feels so comfortable, like something you can slip into over breakfast or with a glass of wine. It's not in my top ten favorite books of all time, but it is interesting, fun, and deliciously real.

The issues that ensue with her mother, Alice Walker, are beyond heartbreaking. Because Alice was my first love of the Walker family, I feel like there must be more to the story. She must have suffered some sort of abuse at the hands of her daughter; why else would you disown your 34-year-old brilliant, amazing, feminist, book-writing, pregnant daughter? From Rebecca's perspective, it sounds absolutely insane. That while she was pregnant, Rebecca's father wrote a letter to her mother in an attempt to convince her to be reasonable supports Rebecca's version of the story. That they're no longer talking means that something major happened, and I tend to believe Rebecca. How sad for both of them, and especially for baby Tenzin.

Amazing

Yes, yes, yes, Dawn Friedman. Amazing post.

Baby-Making Range

Diabetes is all about the numbers.

Blood sugar readings. Hemoglobin A1c results. Carbohydrate to insulin ratio. Bolusing. Basal rates.

Seriously!

Lots of type 1ers say you have to be a mathematician just to survive. Of course, our fancy schmancy pumps do a lot of the work we used to do. But still, we spend our days thinking of maximums and minimums and insulin on board and time till food and time after food and on and on.

Pre-thoughts of baby, my HA1c's were somewhere in the 7 to 7.5 range. That's not true. In high school and earlier, they were much, much higher. But that was before Humalog and the pump and angels sang from the heavens.

But post-pump, pre-baby-thoughts, 7.5 was a pretty normal reading for me. I did a little celebratory dance when I got down to 7.

And then I met with Dr. Awesome OB, and she said, "Lady! You have to get your A1cs under 7 for six months PRIOR to conceiving. And once you're all preggers, your blood sugars need to be in the 60-90 range pre-meal, going up to 120 at the highest post-meal."

WTF?! I thought she was crazy. I thought How am I ever possibly going to be that super-human? Or to be more exact, How am I ever going to be that close to a non-diabetic human?

Enter Symlin and the continuous glucose monitor. The angels really sang from the heavens this time! With Symlin, my A1cs came consistently down to 7. But then Symlin has its own issues (for a later post).

I went on the continuous glucose monitor and love love love it.

Of course, when it's beeping at 3 in the morning because it says I'm at 200 when really I'm at 110, I don't love it. But for the most part, I love it.

In October, my A1c was 6.9. The lowest it's ever been!

And I thought I can do this. I can do even better.

In January, my A1c was 6.3. Did I ever do a happy dance!

So, now it's been 6 months of A1cs under 7. I am finally in baby-making range.

Woohoo!

25 Random Things

1. I was born on March 3 or 3/3. The number 3 has always been lucky for me. All number oriented things in my life have threes in them. Home address. Phone numbers (work, cell, and home). Number of letters in my first name. Wedding date (this one was by choice). Etc., etc., etc. I even have three parents.

2. The first time I met B’s best friends, they visited us from Pennsylvania . They’re both geologists and are a little on the odd side (which, I believe, is the highest compliment you can pay anyone). They play number games in their minds. For M, every number he sees has to somehow add up to, multiply to, or subtract to the number 3. See what I mean about the number 3?

3. My dad trained to be an opera singer when he was young, so I grew up with opera playing in the house (often very loudly and before the sun came up).

4. My mom is a school social worker and listens to NPR when she travels betweens schools. A good portion of her sentences start with, “I heard on NPR…”

5. Sometimes I define myself in relation to my parents. Maybe that’s an only child thing.

6. I actually have three sisters: a half sister and two stepsisters.

7. When I was 11 or 12, I started calling my stepdad Dupie. I never knew what my stepsisters thought of it. Now L's little ones call him Baba Dupie. That makes me super happy.

8. I’m absolutely addicted to Diet Coke. Coke Zero is fabulous. I once gave up diet coke for a year. And although I slept better and probably saved hundreds of dollars, whenever I passed a coke machine or a Circle K, I finally understood what it feels like to be a crack addict.

9. I’ve been on some amazing trips to Israel, Tibet, Morocco, and other faraway lands. But I’ve never been to Vermont. And most days, I’d rather be at home.

10. I fell in love with B on our fourth date. You’re thinking, “Shouldn’t it have been the third date?” Ah, yes, but I’m a little slow when it comes to love.

11. I think of myself as a poet, but haven’t written a poem in over three years. It’s hard to write happy poems.

12. I’ve read a lot of memoirs recently. I suddenly feel like the truth is more captivating than fiction. I’m sure I’ll start reading fiction again soon. Sometimes it’s easier to get lost in stories that don’t belong to real people.

13. I am crazy in love with the Obamas.

14. I am fiercely pro-choice and ardently feminist.

15. Five years ago, I thought I’d work forever. And ever. Now I’d like to retire at 50. Or 40. I’ve become a 401(k)/RothIRA expert. I’d like to travel and read and fish and play and generally have a good (albeit retired) life. I’d like to do these things while I work, too.

16. Speaking of fishing, I now get a fishing license every year. I know the difference between a bass and a trout and a northern pike. I even know what cowbells, powerbait, and spinners look like. We have a boat in our garage. It’s all very surreal.

17. I grew up on the bluffs of the Mississippi and spent a good deal of time at the beach in California. I’m a water kid who lives in the desert. Which is why fishing appeals to my most basic senses: being in a boat on a lake = heaven.

18. Although B was born and raised in the southwest, his family is all from Wisconsin. I think that’s why he feels like home to me.

19. I have way more pairs of jeans than any working girls needs.

20. I moved around a lot as a kid. All this moving around has made me, all at once, want to move every two years to a new, exciting place and stay in once place for the rest of my life. I know. It’s confusing to me, too.

21. We have two cats, Pixie and Cous Cous. During the day, they fight like mortal enemies. Hissing. Growling. Bopping each other on the head. Occasional biting. At night, they curl up in bed with us, purr like it’s going out of style, and lick each other’s bellies. Ah, sisters.

22. I have trouble sleeping in hotels now. I think it’s the lack of purring.

23. I decided I was an atheist at age 9. At age 10, I was converted to Judaism in my dad’s synagogue (necessary because lineage in Judaism is passed through your mother). At age 14, I was confirmed in my mom and stepdad’s church. I have relatives who are Hasidic and Mormon. I am still an atheist.

24. I do think we’re all connected to each other. That we have an obligation to take care of each other and of this planet of ours. I think there are many reasons why we can and should be good people. I don’t think god factors into that equation.

25. My favorite words are Kalamazoo and Okoboji. In espanol, I like pantuflas.

26. I’m deathly afraid of my parents dying. All three of them.

27. My dream of success is being able to afford a weekly massage.

28. My life has been super lucky. I also think luck is a state of mind. If only the lottery agreed!

29. I was diagnosed with type 1 diabetes on St. Patrick’s Day. I gave shots for thirteen years, but now I have an insulin pump and a continuous glucose monitor attached to me at (almost) all times. I am nearly bionic.

30. Every year on St. Patrick’s Day, my mom gives me a present and a card to commemorate the day. How sweet is that?!

31. My friends are the best.

32. I do not like being confined to only 25 things.

33. And the 3s have it. So, there are 33 things!

In the Beginning

Here I am, a kid with a shiny new blog in a sea of blogs.

Actually, I'm not a kid anymore. And I'm thinking about a kid of my own! Which is part of why I'm writing this blog.

I'm 30 years old and got married almost a year ago to the sweetest boy in the world. And even though we have our hesitations, worries, and many, many fears, we're thinking about having a baby.

The only hold up is that I have type 1 diabetes. Last May, I visited a high risk OB who came highly recommended by my gynecologist (who I love) and a Minimed rep (who often know the best in the business). I figured that combination must make her awesome! She's at the state university's teaching hospital. Which made me nervous at the time, because I worked in the building next to the hospital. I want friends and coworkers to visit me when I have a baby. But having a baby next door?! Kind of strange. Do you go into labor at work and walk to the hospital? Are your coworkers the first ones at the scene? Does your boss cut the umbilical cord? Too weird.

In any event, now I work for a nonprofit miles away from the teaching hospital and no longer have any concerns about delivering there. Of course, walking to prenatal appointments (which I hear are weekly for type 1ers) would have been nice.

Anyway, Dr. Awesome OB spent a good two hours with me. Going over my history. Talking about nutrition. Prenatal vitamins. Bloodwork. Risks to the fetus in type 1 moms. You know, the usual.

The bottom line is that she recommends (and most endocrinologists and websites I've seen concur) that while pregnant, you keep pre-meal blood sugars at 60-90 and post-meal blood sugars below 120. She also recommends (and again, the medical community concurs) that having a HA1c under 7 for six months prior to conception is the key to a healthy pregnancy.

"Oh, lord," you say. Or rather, I said. How am I ever freakin' going to get my blood sugars that low?! How will I ever be at 60 and not feel like I'm having a reaction? Dr. Awesome OB had lots of practical tips and advice, and a Minimed rep was there to go over my recent numbers.

I'm off to a good start, and decided to throw my hat into the blog world. Here goes!