Wednesday, July 30, 2014

The Diabetes Registry/The Diabetes Shower


I’m trying to create a wedding registry, which is hard when you have lived together for ten years, have a tiny city apartment, and need less, rather than more, stuff. Thinking of consumables and stuff I actually needed, I clicked around Amazon, and suddenly found myself looking at pages of glucose tablets. There was even a case of them.

Could I…could I register for glucose tablets? That would be weird, right? I probably shouldn’t do that.

Then I started thinking: you have a wedding registry, to start a life and home together.

You have a baby registry, to come together as “a village” to raise a child.

Where’s the diabetes registry?

When you’re diagnosed with diabetes, you suddenly find yourself facing a life of needing a ton of stuff to stay alive, all of it costly. Sure, insurance (if you’ve got it) pays for some of it, but it’s amazing how big of a hole can be burned through your pocket at the end of the day (or month). Making such a big financial commitment is, in some ways (particularly in a country without socialized medicine), almost like taking on a baby, in that it’s expensive, capricious, unpredictable, you can’t leave it alone for a second, and it will probably need plenty of medical care. Even though diabetes isn’t a choice like marriage or a baby, unlike the former, it will be with you ‘til death do us part. (Don’t listen to the people who give it five years. They have all been wrong so far.) Even with a baby, you’re only legally obligated to provide money and care for 18 years. I will hit that milestone with my diabetes in March, and I will only be 30.

So my proposal is, with every diagnosis should come a diabetes registry and a diabetes shower. You can eat cupcakes and drink wine (depending on your age), and talk about what you’re going to do on your honeymoon and what you’ll do when it’s over.

There’s no shortage of stupid games you can play. “Guess the carbs on the plate.” “Pin the test strip on the meter.” “Wrap the diagnosee in pump tubing.”  “Label all the items in the D-kit.” “Lancet quick-change.” “Can you eat that?” is an easy one, because the answer is always yes, except for the poison.

Instead of giving you advice on marriage or babies, everyone can give the guest of honour one piece of unsolicited diabetes care advice, with the knowledge that it’s his or her last chance to ever do so.

Gifts would be deeply appreciated, and everyone could ooh and aah over the various baskets as they were opened:
  • A number of sharps containers
  • A crate of glucose tablets
  • An economy pack of insulin
  • Pharmacy gift certificates
  • Pump supplies to last a months, two months, or more, or insulin pen needles
  • A “Calorie King” carb-counting book, or other
  • Diabetes apps for your phone
  • An exercise club membership (packaged with juice boxes)
  • A case of Diet Coke
  • A “cake” made of bandages, wipes, and syringes
  • One month’s insurance premium
  • Batteries. So many batteries. AAs and As, and lithium.
  • An assortment of pump skins, for the fashion-forward
  • Gift certificates for healthier groceries
  • A bouquet of test strips
  • Coupons for “sick days,” where others will demand nothing of you and help you feel better
  • A pack of DOC-penned books
  • A Blunt Lancet CD
  • Tickets to FFL or another D-conference
  • Blue-circle jewelry and wrapping paper
  • Medic Alert bracelet
  • Coupons for “at-risk” specialists and co-morbidities
  • Comedy gift: 100 lancets (enough for the rest of your life) 
…well, you get the idea. All lovingly wrapped and presented for the adventure ahead. Stories would be told, love would be shared, and a few tears would probably be shed.

Perhaps it could even be a celebration of life and possibility.

Monday, July 21, 2014

D-Blog Check Day: Connect / #ShowMeYourPump

Hi all! Today (well, July 22nd) is #dblogcheck day, so I figured I should fight the summer laziness and check in (that is, post). It actually hasn't been a lazy summer; I'm teaching five class sessions a week to 130 students, I saw 36 plays in 12 days, and I've been socializing like mad, along with prepping for one of the biggest events of my life, but D-Block Check Day is worth stopping for. D-Blog Check Day is a day where we learn how many people we actually reach with our words. Many of us read blogs and, even if moved, never comment. Perhaps it feels intrusive, or time-consuming, or removes a layer of anonymity. The purpose of blogs, however, isn't only to work things out for ourselves on the page (though that is a large part of it - blog as therapy); it's to connect with others, to hear an "it's going to be okay," or a "me too." This day encourages us to step forward and be counted.

I used to have a very involved, nearly daily blog, through undergrad and most of grad school. It was over at LiveJournal, if anyone remembers that. Now, Facebook and Twitter have taken over the world of connection (so instant! So many "likes"!), and the LJ world has dwindled to the point where it's hard to convince myself to put in the effort to chronicle my life. I'm not disparaging Facebook, and I kind of wish there was a "like" function on this blog; after all, what's an easier way to "check in"? Most of us don't remember to comment day-to-day, which is why we have this event. However, LiveJournal seemed more permanent, less ephemeral in its own way, which is a strange thing to say about two websites that both essentially exist in the ether.

When I go back to my college years, I see them in full. Highlights, of course, but much less carefully curated. I see events and whole conversations reproduced. I cringe at my emotional meltdowns, but I laugh and admire the passion and creativity that I and my friends brought to each others' worlds. My blog, my life, my feelings were open to the world, for better or for worse. (Now, the journal is locked to "friends-only," so it's a bit of a time capsule.)

Why am I telling you this? I'm talking about connections and the importance of reaching out. Almost a year into my LJ blog, more than ten years ago, someone who I'd never met reached out to me. He was moved by what I'd written. A friend of a friend, he had never been introduced to me, but we would both be on campus in the coming fall. He felt like he knew me, a bit, after reading my writing. He wanted to get to know me more. He commented more. We started talking. We took a chance, and met after moving in to our sophomore dorms.

And we're getting married in six weeks.

So connect. Connect. Reach out. You never know what will happen.

--------

The new Miss Idaho, Sierra Sandison, has certainly gotten people around the world to connect lately. She decided to be bold and wear her pump visibly clipped to her swimsuit during the pageant, while worrying what people would think. She won, is what they thought. She has started a hashtag, #showmeyourpump, to encourage others to be "out and proud" when it comes to wearing a medical device. This stirred up all sorts of thoughts for me. The first thought is that I have come a long way from when I refused to even consider wearing a pump. I have such better control with a pump that part of me berates myself for not getting one earlier, but I wasn't ready until...I was. Forcing myself to be "tied down" to a pump when I would have resented it might have been an even bigger disaster than waiting to get it in the first place. It was the people who connected with me (that word again), online and in person, who even convinced me to give it a try.

Now I'm out, as far as pump-wearing is concerned. I blog. I'm proud, even though the pump still makes me question my fragility, my femininity, and my desirability. Sometimes it is still claustrophobic, even when you're out in the open. The questions arise: what does this attachment say about me? What do people see when they see it; do they think I'm taking charge, or that I'm less of a person? (Most probably think it's a pager and I'm a time traveller from 1995.) I'm not shy about my pump, but often I don't deliberately display it. Therefore, I find myself asking: am I proud enough? Do I show enough?

A friend of mine and I had a conversation on FB (the LJ replacement) about what showing or not showing your pump means. I'm glad we did, because it clarified a few things for me. Here's how my side of the conversation went:

I wear a lot of dresses, so it's actually hard to show my pump without tearing it through the dress or clipping it to the neckline and dragging the front of the dress off. I usually put it inside the waistband of my pants, too. Otherwise, though, I'm not shy about it (though I realize that seems like a big "otherwise"). When I'm wearing a dress (see: every day for the past month), what that means is that I am "hiding" my pump to avoid breaking the line of the dress. I still want to be pretty. Does the pump mean I feel I'm not pretty, though, and is that why I hide it, or is it just a fashion consideration? As much as, for example, diabetes will be evident and a part of my wedding, I'm not going to clip my pump to the top of my strapless dress. Does that mean I'm letting down the side, so to speak? Am I playing off shame as a fashion crime? (Is it a crime?) Ultimately, there will always be that frustration with diabetes, that frustration with bodily failure, that will in some way shape how I feel when I look at my pump. Of course, if I looked like Miss Idaho, I might feel differently.

Ultimately, I don't think that we should feel like we "have" to show our pumps at all times, or that we are letting down the cause if we don't, because that's as much of a trap, a pressure, as the pressure to hide. It's like running a marathon: you shouldn't let diabetes stop you if you really want to do it, but you shouldn't feel like you have to do it just to prove you can. However, I unabashedly love the #showmeyourpump campaign, because it provides a safe and open space; it might sound like a command, but it's really just an invitation, and one we can respond to in our own time.

So, when I wear a dress, it's both a practicality and aesthetic choice for me, and for the most part, shame isn't a factor (shame is when it starts buzzing No Delivery under my dress two minutes into an hour-long Fringe play). A pump lets me wear a dress without it being obtrusive, even something relatively tight and clingy, which is one of the awesome things about the pump - it doesn't have to be front and centre all the time. So, when it's easier for what I want to wear, I hide it. If it's convenient for me, I show it. Not letting diabetes completely control you, to me, means that I get to choose when I want to make a statement and when I don't. No shame, and no pressure from others either way. I do, however, think it's a good idea to occasionally have that reflection and ask those questions, just in case there's something deeper under the reason of convenience.

Having said all that, it's about time I showed you my pump.


Is that an insulin pump in your hand, or am I just happy to see you?

Yes, yes I am.

Wednesday, June 4, 2014

Revamping Tradition: Diaversary Gifts

I have weddings on the brain, as mine is in (gulp) approximately three months. I started thinking about traditional anniversary gifts (which are sort of silly in their own way) and thought: well, shouldn't diaversaries have their own traditional gifts? If a wedding anniversary is a celebration of life and hard work, so is a diaversary, even if you usually choose your partner and not your diabetes.

Year one: Paper. Instead of paper, why not have the traditional diaversary gift be test strips? They're some of the most expensive "paper" out there, and all people with diabetes need more. Message: may you experience better numbers and fewer Errors Fives in life."

Year two: Cotton. Clearly, a whole bunch of swabs for wiping away blood, because the farther you get from your second diabetes anniversary, the less you're going to actually care about things like wiping your fingers before and after testing.

Year three: Leather. This is the year you give some nice fresh lancets, because they should be changed at least annually to avoid changing the skin on your fingers to, well...tough leather.

Year four: Fruit. I think this calls for grape our sour apple glucose tabs. Aren't anniversaries supposed to function as a pick-me-up, anyway?

Year five: Wood. Five is a special year, because it's the year most of us were told would bring a cure. I imagine that no gift-givers have that at their disposal, though most would like to give it. If that's not a possibility, instead of Wood, I think I'd like to call it "Would" instead. For the diaversary, ask "what would you do if you didn't have diabetes?" Then, try to make it happen anyway (safely).

Year six: Candy. This is easy. You could go back to glucose tablets, but I think really this should be actual candy. Something the PWD really loves. Something that acknowledges, yes, you can eat that.

Year seven: Wool, or Copper. Don't try to pull the wool over a PWD's eyes as a present (see: cure in five years). Instead, maybe a knit pockets for a pump, or a nice, shiny penny from the diagnosis year (harder to find in Canada), to be used to twist open the pump cap to replace the battery.

Year eight: Pottery, or Bronze. Nice as it seems, most PWDs won't quite appreciate you bronzing their insulin pumps. Since we have so much on our plates, though, maybe we'd like a new one as a present.

Year nine: Willow. If your PWD is me, this means get me something Buffy-related or bring me my kitten. But most people aren't me. The bark sap of the willow contains salicylic acid, which is an important part of aspirin. PWDs could use a stock of painkillers. Willows are also known for "weeping," so this could really be an opportunity to tell your PWD to let it all out. Bring tissues. The chance to vent and cry once in a while is an essential gift.

Year ten: Tin or Aluminum. Curses, foiled again! You know what often comes wrapped in foil? Really good chocolate. It's much better than the tin ear most of the D-police have when they try to prevent us from eating really good chocolate.

Year eleven: Steel. What do you get for the world-weary diabetic who has everything? Boxes of infusion sets. The needle is made of steel, and it'll cost more than a nice dinner for two at a semi-fancy restaurant.

Year twelve: Silk. All those needles are hard on the skin, so something silky to wear or silky lotion sounds pretty good.

Year thirteen: Lace. The teenage years are hard, and many of us start to feel like we are also a pattern or design made mostly of holes. For the thirteenth anniversary, lace up your running shoes and join a fundraising run or walk for diabetes, to show solidarity.

Year fourteen: Ivory. Obviously, you don't want anything from an elephant. That's wrong. Instead, think about what might make your favourite PWD smile, and make those ivories flash.

Year fifteen: Crystal. Around this year, I really started to think about the future and get better control. A crystal ball as a gift signifies a few things: we want to be able to see into and predict the future, even though we really can't. In terms of complications, sometimes what we do matters, sometimes it doesn't. Good care doesn't mean good things, bad care doesn't automatically mean bad things (though it's much more likely to). A crystal ball may seem clear, but the future isn't, really. If this is too heavily symbolic for you, just get a nice wine glass, because she probably needs a drink.

Year twenty: China. A great gift would be to make a lovely (or many lovely) meals that have exact carbohydrate information, so that there are no surprised and your D-sweetie knows exactly what to do. Or perhaps you have the magic formula for not going high after eating Chinese food? Then share that.

Year twenty-five: Silver. Silver tells you how much you have achieved (twenty-five whole years!) but at the same time tells you that you still have a ways to go. You're not 100% on top and you can't rest on your laurels. Silver is great, and it's something to be proud of, but it's not time to retire just yet!

Year thirty: Pearl. Pearl jewelry reminds us that often irritants create something beautiful. Without diabetes, you wouldn't be who you are today. This is for better or for worse, but usually for the better. Resilience is developed, along with maturity. Friends have been made, and art created. We've made pearls with what we've got.

Year thirty-five: Coral. If you've lived with D this long, it's time for a celebratory trip. Just make sure your pump is cool and waterproof when you go snorkeling. Or maybe the gift won't be coral, but oral (say, oral insulin).

Year forty: Ruby. Let's say (conservatively) four tests a day, 365/366 days a year. That's around 58,440 blood tests. A faceted ruby looks like a drop of blood. You've earned it.

Year forty-five: Sapphire. A round, blue jewel is the perfect symbol as we reach the height of life achievement.

Year fifty: Gold: After 50 years, a PWD deserves a gold medal. There is actually a program in place by Joslin to give them one.

Year sixty: Diamond. Anyone who can survive diabetes for 60 years is tough as nails - or tough as a diamond - so this is appropriate. Diamonds seem rare, but are less rare than we think, and that's where diabetes care is leading us: a place where 60-year diabetes survivors aren't rare. If you don't want to support the diabetes industry, a lab-created diamond is also appropriate: we're alive because of synthetics, but that doesn't mean we sparkle any less, even if some doubt our worth.



















Sunday, May 18, 2014

D-Blog Week Day 7: My Favourite Things

As we wrap up another Diabetes Blog Week, let’s share a few of our favorite things from the week. This can be anything from a #DBlogWeek post you loved, a fantastic new-to-you blog you found, a picture someone included in a post that spoke to you, or comment left on your blog that made you smile. Anything you liked is worth sharing!



I'm still travelling and singing around the Maritimes, so I haven't been able to read so many days' worth of amazing posts. I decided to concentrate on some of my favourites from one particular day, my favourite prompt where I did manage to read every single post. I love poetry, wordplay and rhyme, and I was pretty excited to see what people came up with for the poetry topic. I'm especially excited because I created a new English course for my college which runs for the first time in the fall, and that means I get to really teach a section on poetry to undergrads for the first time! Though unfortunately I won't get to use any D-Poetry, I think these are all worth your time.

I love this week every year, and I want to thank everyone who wrote, who read my blog, and especially the kind people who have commented. You all warmed my heart. Thank you.

The first category is near and dear to my heart: parodies.

I love William Carlos Williams parodies so much. It's unhealthy. I'm going to teach that poem and use it to show how poetry is a living art form that we still constantly respond to. Here's another fun one for my collection of "This Is Just To Say" parodies, by Naomi at T1International. I always wondered why he ate those plums (was it spite? Assertion of power?) but a low makes total sense.

10 Things I Hate About You is a guilty pleasure, but one of my favourite movies of all time. It just hit that snarky Shakespearean sweet spot when I was in high school. Here's a parody of Kat's final poem that just works so well with diabetes, by Jessica over at Chasing Lows.

Scott at Rolling In The D did a Spongebob parody that I thought would make a nice companion to my "Under the D" Little Mermaid undersea parody, and My Lazy Pancreas also went Disney with her takeoff of a piece from Frozen.

The second category is limericks and humour.

I thought Laddie's post from the perspective of her dog Abby was just cute and funny, until it hit me with the image of diabetes being that big black dog that never leaves your side ("the black dog" also being a famous euphemism for depression). Loved it.

Pancreassassin's limericks just got better and better. I loved the unconventional rhyme about the insurance company, and the thought of a low causing someone to almost trip over their dog made me laugh, probably because it's true.

"My uncle's feet fell off/To everyone's surprise" and the "Can you eat that?" refrain wins this poem by Mike at Every Day Ups and Downs a spot on the list.

The third category is imagery and lines that took my breath away.

I love Christel at The Perfect D's comparison of an insulin needle to the needle on a record player. It's beautiful.

The use of the sestina form at Coffee and Insulin was really well done and unusual.

The last line of this poem at A Sweet Grace is just unexpected and brilliant, and the rhythm that the writer creates is so compelling.

Thanks to everyone for your hard work every day, and for an amazing D-Blog Week, especially Karen for putting it all together and tirelessly commenting on everything. Keep writing, keep talking, and I'll see you at #dsma!

Saturday, May 17, 2014

D-Blog Week Day 6: Saturday Snapshots

I wish I could send you pictures from Halifax, which is where I must be by now. But, since I'm travelling and posting is probably an impossibility, you get a shot from my apartment on Thursday.

Today's prompt:

Back for another year, let’s show everyone what life with diabetes looks like!  With a nod to the Diabetes 365 project, let’s grab our cameras again and share some more d-related pictures.  Post as many or as few as you’d like.  Feel free to blog your thoughts on or explanations of your pictures, or leave out the written words and let the pictures speak for themselves.

I call this: "The Agony and the Ecstasy." Or, "Insulin and Glucose." Or, "The Circle of Life."



It's like Ebony and Ivory, only they don't really work together in perfect harmony. Rather, they chase each other's tails around and around, like a yin-yang comprised of angry, excited puppies.

I've been having a LOT of trouble with lows lately. Those six bottles have all been emptied in the last few months, and they're not all I've used to treat. They come in four flavours (grape is obviously a favourite) and from four different companies, from two different countries and more than one state, as I've picked them up as I've gone along, to try something cheaper or new. Is it any wonder I've struggled with my weight loss goals? That's a ton of sugar, and none of it I wanted to eat!

The humalog is balanced on top of it to show the precarious balance between the two substances. They're not mixing together, though. They're separate. My pancreas and liver, were they working harmoniously, would instantly (or nearly) balance them, but for me, it's one, then the other, then one, then the other, in a ceaseless cycle.

The humalog also shows how blessed I am to live in a country where I can have so much healthcare provided to me, and how lucky I currently have to have (temporary) insurance for supplies. Much as I grumble about how temporary and capricious my insurance situation is, when I do have it contract by contract, I can go out and get a huge supply of insulin and nobody questions me.

One box is ripped open to show that this is current and a work in progress. It's ripped open messily, because, well, that's me, and ain't nobody got time for this shit.

Now I can probably get rid of these bottles, unless I want a permanent art installation.

Friday, May 16, 2014

D-Blog Week Day 5: Diabetes Life-Hacks

On the fifth day of D-Blog Week, Ms. Karen gave to me...

Five hacks of D!
Four portion shortcuts
Three clothing mods
Two carb counting tricks
With the warning that YDMV!

Share the (non-medical) tips and tricks that help you in the day-to-day management of diabetes.  Tell us everything from clothing modifications, serving size/carb counting tricks to the tried and true Dexcom-in-a-glass trick or the “secret” to turning on a Medtronic pump’s backlight when not on the home-screen (scroll to the bottom of this post). Please remember to give non-medical advice only! (Thank you Rachel of Probably Rachel and Kelley of Below Seven for this topic suggestion.)



On the “Diabetes Lifehacks” front, it occurs to me that either I have very few official lifehacks, or few that will apply to more people than me. Diabetes is such an individualized illness, which is ironic when you realize that the world even tries to lump the two types together (not even dealing with variants like LADA and MODY), let alone recognizes that YDMV (your diabetes may vary). So, most of the things that I do are either general (decreasing basal 50% an hour before a workout), or specific (I crash overnight most of the time, so if I’m under 8 or 9 I don’t correct, and if I’m anywhere between 4-7, I can essentially “eat for free” right before bed. (This is the opposite of a weight loss hack, unfortunately)

A few things that might be helpful:

  1.  Empty pill bottles or glucose tab tubes are great as improvised sharps containers on trips. They even fit infusion sets! This comes to mind, as I’m actually travelling across the country as you read this. My choir (The Amadeus Choir) is on tour in the Halifax area, and is the keynote choir for Podium, the national choir conference. I have never been to the Maritimes, so I look forward to scattering my sharps across the country!
  2. If you find the plunger on your pump cartridge is annoying to use or you don’t want to carry one, and you use insulin cartridges, you can use the cap of the needle to push down on the base of the insulin cartridge. I find that it gives a more controlled flow into the cartridge, and I’m far less likely to suddenly over-pull and leak insulin everywhere as the bottom comes out of the pump cartridge.
  3. Reuse and refill the small glucose tab tubes from the big bottles; it's cost-effective. Watch out for putting a different brand in without testing sizes first, and don't force it. I had tabs get permanently stuck, which is not good when you're desperate.
  4. For me, the thigh thing never works for pump clipping. underwear is the way to go when you're wearing a dress. Never wear a dress the day you fly, if you want to get out of security in a timely fashion with your dignity intact. (I flew on Thursday so it's on my mind).

Less, or possibly more, seriously, here are some other hacks that have helped me live my life:
  1. If you're contemplating quitting entirely, don't. (But you can ease up for a bit, as long as you maintain a baseline to come back to.)
  2. If you're frustrated, take a breath and count ten carbs.
  3. If you're about to tell someone off, consider telling them "on" instead, with positive information.
Least interesting/adequate life hacks ever? Perhaps. I’m not sure if I’ve discovered any magic. But there are probably things that I do as a matter of course that other people would consider “hacks” and vice versa. I just haven’t thought of what they are yet.



Thursday, May 15, 2014

D-Blog Week Day 4: Mantras and More (Telling Stories)


Today's D-Blog Week topic is Mantras and More.

Yesterday we opened up about how diabetes can bring us down. Today let’s share what gets us through a hard day.  Or more specifically, a hard diabetes day.  Is there something positive you tell yourself?  Are there mantras that you fall back on to get you through?  Is there something specific you do when your mood needs a boost?  Maybe we've done that and we can help others do it too? (Thanks to Meri of Our Diabetic Life for suggesting this topic.)

Telling Stories

There once was a girl whose pancreas didn’t work. One day, it just up and quit. The girl didn’t know what she had done. Was it something she said? Did her pancreas win the lottery and move out? Was it collecting unemployment?

The girl felt alone and affronted, and slightly unloved. To lose one’s socks may be regarded as a misfortune; to lose one’s pancreas looks like carelessness. Her life changed. Her world changed. Her frustrations mounted. The world was an ever-shifting morass of peril and uncertainty. When she saw a really terrible blood sugar result, or when medication made her nauseous, sometimes she just wanted to quit.

Sometimes, a voice in the back of her head disagreed with her defeatist attitude. It said:

Each drop of blood is a drop in the ocean
Each high and low is a wave in the sea
Each day you live represents forward motion
Each day you make it the best it can be.

The girl didn’t think much about this, as thinking in rhyme was not an unusual occurrence for her. She grew up, and her diabetes took it badly, and she took it on the chin.  She thought this disease was useless. She went off to school, leaving her big Canadian city for a small American Ivy college town, and diabetes came with her; or, rather, it came before her. It got in her way. It got in the way of being normal. Feeling sexy. Losing weight. What was the use of learning so much at one of the best schools in the world if she couldn’t even fix herself? Her care, not great to begin with, slipped further. She was at an institute of higher learning, and she used that idea to divorce herself from her body. She took solace in her mind, but her mind wasn’t content.

So the little voice grew a bit more insistent. It said:

Each disappointment’s a pledge to be kinder
Each piece of knowledge a root in the ground
Each bad result is a solemn reminder
Each thing that’s lost creates something that’s found.

The girl got her cap and gown and moved to New York City. She studied theatre, and communication, and the human experience, but still had no idea how to communicate with her own body. For the first time, she started seeing examples of people who did, but she assumed it was because they were naturally better than she was. Her life was always busy. When you keep busy, you have a constant in an inconsistent and chaotic world. The girl got some of her first indications of what life might be like without a safety net, and in some ways she remembered how lucky she’d been, and she grew up a little more. When she worked on a play, and a character felt loss, she knew what that meant. When she worked on a play, and a character felt longing, she knew how that felt. When she worked on a play, and a character felt a lack of control, she was right there with them.

The girl had spent a lot of time looking inwards – twisting inwards – but that’s grad school for you. She had nowhere left to go but out. Doing this, she saw that she’d gained empathy and understanding, and something that would come from her own voice. But she was scared to do anything about it. There was no way to take control.

The little voice wasn’t scared. It was excited. As the girl packed up to return to her hometown with a second cap and gown, it urged her forward. It helped that other voices had begun to join in, voices the girl had never heard in person, but had read for hours. Together, the voices said:

Each person’s sigh is wind pushing a boulder
Each person’s words are a forge in the deep
Each person’s link is a hand on your shoulder
Each day you wake is a promise you keep.

The girl realized that, as much as it seemed that she had little to no control over her body, in some ways she had more control than anyone she knew. She was the president of her blood sugar, since the previous one had resigned. Unfortunately, her endocrine system was not inclined towards democracy. But, as the Lorax left carved in a circle of stones, “Unless.” “Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not.” She found that, for the first time, she cared. She would not be a circle of stones. For the first time, when she spoke, the voice issued from her own mouth. She told herself:

Each test you face is a chance to do better
Each thing you miss is a sign that you’ve grown
Each chance you take means you’ve written a letter
Each page of text makes your story your own.

Sometimes I tell myself this story late at night, when the world shifts and the failures and small mercies of the day coalesce.  I wonder how much of it is true, and what details I’ve filled in to suit the demands of my own narrative. Anyone who has diabetes, though, knows that truth is relative. Anyone who has diabetes knows that getting through the day is the first step to finding the truth of yourself.

Each drop of blood is a drop in the ocean
Each high and low is a wave in the sea
Each day you live represents forward motion
Each day you make it the best it can be.