Wait and See

As you may know, I’m a recovering perfectionist. Often “recovering” looks like slipping back into old patterns and then praying and accepting my way back to a place of surrendering and peace. I sometimes ponder which came first (as in “the chicken or the egg”), my desire for control or my diabetes. When you have diabetes, the hallmark of good care is “well-controlled blood sugars”. Truly, there couldn’t be a higher virtue than “control” in diabetes management.

Over the years I’ve used a continuous glucose monitor (CGM) several times. As I’ve discussed with my endocrinologist on countless occasions, the constant information on my blood sugar often felt overwhelming. I felt like I was riding a blood sugar roller coaster on days I used a CGM. Over the years, I realized that the issue wasn’t the information, but how I processed it. Psychologically, seeing a high blood sugar after a meal would prompt me to correct with insulin, even if I’d just given an injection an hour earlier. I couldn’t handle seeing the high blood sugar (and the feelings of failure it triggered) for an hour or so while my meal bolus brought my blood sugar down.

What happened when I stacked two injections close together? My blood sugar would plummet and I’d have to consume more carbohydrates to raise it. I’d then monitor the CGM data carefully for the rebounding high, which I’d then aggressively respond to with more insulin. See how the roller coaster feeling arose?!

In contrast, with finger stick blood sugar monitoring, my blood sugar might rise between meals, but I wouldn’t see that information until I tested a few hours later, so I wasn’t triggered to give extra correction doses. The downside? High blood sugars wouldn’t be detected for a few hours. Also, I couldn’t anticipate low blood sugars unless I became symptomatic.

As I’ve dealt with retinopathy the past few years, my desire to keep my blood sugar even more tightly controlled grew. I knew that the Dexcom provided the best standard of care for diabetes but was tentative to try again. So, I prayed for peace and a renewed understanding for how to interpret and respond to CGM information.

A couple months ago, I had one demo Dexcom sensor handy and decided to wear it for 10 days. Something finally clicked. I was able to receive the continuous glucose readings without overreacting to the information! Somehow my years of experience and awareness of how my body responded to food, insulin, exercise, etc. comingled with the continuous stream of blood sugars. I was able to watch the trends, allow for a reasonable “turnaround time” and wait (somewhat patiently) for highs and lows to return to range.

The timing of this breakthrough was fortuitous. Dealing with retinopathy impressed upon me how important tightly controlled blood sugars would be for my long-term health. With the CGM information, I could correct highs more quickly and keep my blood sugar “in range” more consistently. It’s not inexpensive, but again the benefits for my health and quality-of-life in the future makes the investment more than worth it.

As the weeks turned into months, I noticed a side effect of using the Dexcom. My cell phone was always within arm’s reach! The data is available through an app, which is obviously more convenient that using a separate receiver. However, once the phone was in my hand, I reflexively checked my email, instant messages, and social media much more than I’d like.

So, last week I got an Apple Watch so my blood sugars are constantly available right on my wrist! I’m being diligent not to start using other tracking features of the watch, because I know from experience that they are triggers for my performance orientation. When I start tracking things like the amount of water I drink or walking 10k steps a day, I feel like a robot ticking off all the “to do” items from my daily list.

But, it’s nice to glance down and see my blood sugar level and trend arrow without having to pick up my phone. I imagine it’ll be very helpful during classes! It’s funny how this constant stream of information used to feel overwhelming and burdensome, but now it feels freeing. The trick is constantly reminding myself, “wait and see what happens” before reacting to a potential high or low. Just because my blood sugar is 110 mg/dl and dropping right now doesn’t mean I’m headed for a low that I need to preempt. Likewise, a 160 mg/dl and climbing may not need intervention, depending on the timing of my last meal, when I’m planning to exercise, etc.

Over the years, “wait and see” has been a helpful reminder to stay in the moment instead of trying to control my future feelings. Just because my mind is telling me that I should act now to avoid feeling something unpleasant in the future, in reality I can “wait and see” how I feel in the moment, when it arrives. This life strategy only really works when you know that you can trust God for his grace and provision in all the moments of life, especially when things are out of control.


The gift of acceptance.

Last month was the 29th anniversary of my Type 1 Diabetes diagnosis. As each year goes by my feelings about “celebrating” or just acknowledging this anniversary changes. It used to be a source of pride, as in “Look how well I’ve lived with diabetes for 15 years… 20 years… etc.” But, as I’ve been dealing with my first diabetes complication for the past couple years, the reality of longevity with this disease feels more daunting.

About a month ago my doctor examined my eyes and indicated that more laser treatment was needed, particularly in my left eye. He discovered more vessels in my retinas that were starting to or would likely bleed. Based on my prior experience, the treatment wasn’t urgent so I confirmed with my doctor that it was okay to schedule the laser treatment after we returned from vacation.

Well, turns out that wasn’t the best decision.

On the evening of July 5th I started to notice some floaters in my left eye. It was late and I was hopeful they’d improve overnight. Instead, the next morning my vision was very blurry due to a large amoeba shaped floater just in my left eye. We had a beautiful hike planned in Fern Canyon that day, so we headed out there as I awaited a response from my doctor regarding the urgency of examining my eye. It seemed obvious that one of the vessels had bleed, but I was 800 miles away from my doctor and didn’t know the severity of the situation.

When we got back to cell phone range around 4:00 p.m., I was able to schedule an appointment for 2:00 p.m. the next day. Fortunately, we’d packed up the kids for their stay with my mom that morning. So, everything they needed was in McKinleyville, whereas Dennis and my things were still at the ranch. We huddled as a family and decided Dennis and I would drive home right then, while the kids remained with our family in Humboldt. We’d coordinate a plan to retrieve them later.

When challenges arise in life, it’s so comforting to have the support and care of people who love you. Dennis had a wonderful attitude as we embraced the 10 hour drive that night, arriving just north of the Grapevine (along Interstate 5, for the uninitiated), at 2:45 a.m. We listened to classic rock and enjoyed the drive, just the two of us. After five hours in the hotel we were back on the road to San Diego, in plenty of time for my appointment.

I fully expected the doctor to do the laser treatment after he examined my eyes. So, I was really, really disappointed when he explained that the blood in my left eye was blocking the retina, making it impossible to laser the vessels accurately. I’d have to wait for the blood to reabsorb or dissipate before treating the left eye. We’d go ahead and treat the right eye fully, as planned.

“What do you do for exercise?” the doctor asked. “Oh, run. I’m a runner.” I replied.

“You shouldn’t run until we can treat the left eye. Those vessels are fragile and the pounding from running could cause more bleeds.”

“Okay,” I replied. Internally my mind said, “No!!! Don’t take my running from me!”

Many, many tears were cried that afternoon. As I sobbed into Dennis’s shoulder in the waiting room and again, later at home, I mourned the loss of running and anticipated weeks or months of this annoying obstructed vision. How would I get all my summer reading and school prep done? Why did this have to cut our vacation short? What would I do without my weekly long run? How would coaching cross country this fall work if I couldn’t run by then?

It’s been five weeks since that day. Today is my follow-up appointment. Originally, I expected we’d be able to do the laser treatment today. However, as I’ve done some research and lived with diabetic macular edema (that’s the technical term) for over a month, I don’t anticipate he’ll be able to treat it yet. The floater has moved up in my vision, which means it’s moving down in my eye, and it’s gotten a bit fainter. But, it doesn’t seem to have changed enough to be out of the way for the laser treatment. I’m praying I’m wrong, but not having high expectations for a resolution today.

Instead, I’m marveling at the gift of acceptance.

I’ve prayed a lot about this situation and God had faithfully come alongside to remind me that freedom comes from surrendering. Instead of saying “this is driving me crazy!” as I did the first couple days, I’ve had to accept that there’s a weird amoeba shaped image floating around in my left eye. I’m able to read, study, drive, watch TV, and basically do everything I’m used to doing. Well, except run. We rejoined the YMCA so I’ve been swimming and using the machines at the gym. They have a cool elliptical machine where you can vary your stride length and actually mimic running really well. I love it!

Each day my eye bothers me less and less. It’s been like a mindfulness exercise. My accepting it’s there but recognizing I don’t need to pay attention to it, I am able to basically ignore it for long periods of time. When I become conscious of it again, I just think, “Oh, there’s that floater” and put my attention back on what I’m doing in the moment.

I’ve figured out little coping strategies. For example, bright lights make it worse, so I’ve been wearing my sunglasses inside brightly lit places. We went to the Giants/Padres game this week with my Dad and Moni, so I kept my sunglasses on for most of the game, until it got hard to see!

Dennis and I were home for a few days after the eye appointment. As I realized that my eye condition wasn’t going to improve anytime soon, it seemed silly to miss the fun with our family up in Humboldt. So, our amazing dog sitter agreed to come back and we made the return trip in 13 hours of driving, starting early on a Tuesday morning. It was a lot of extra driving for only five days, but they were very fun and special days! Dennis and I enjoyed some sunshine and swimming at the ranch, celebrated our nephew’s 12th birthday with a big family party, and got to connect with our sweet family who took wonderful care of Sienna and Mateo.

Even though our summer trip didn’t turn out as expected, in some ways it was better. In our original plan, Dennis was going to fly home early to relieve the dog sitter so the two of us enjoyed time alone together, which is always precious. I came to be “in the moment” more deeply after surrendering and accepting my vision issues. It’s amazing how much more present and connected I feel when I stop striving to control my feelings. Letting myself really mourn the situation and feel the disappointment of it was so important. I had a session with my counselor on the Monday afternoon before we drove back to Humboldt. She helped me sit with the sadness and truly feel it.

Life is hard. It throws us curveballs all the time. I feel like God is working to deepen my acceptance of all emotions. There’s such grace and peace in surrendering and allowing yourself to feel what you feel.