I have college on the mind these days, as my oldest daughter is filling out applications (yikes!)
So I'm very happy to introduce Michelle Rosolie, who was diagnosed with type 1 in January 2007 and now, on the heels of graduating from college, is going through that school-to-real life transition. This 20-something in New York City certainly hasn't let her diagnosis serve as a limitation, as she's hiked the foothills of the Himalayas in India and prowled swamps in the Amazon Rainforest in search of anacondas.
She connected with the fabulous College Diabetes Network while in school, and joins a growing number of young PWDs (people with diabetes) who are sharing more of their D-worlds during their college and post-graduate years, writing blogs and just generally being plugged in to the Diabetes Online Community (DOC).
With that, we'll let Michelle share her perspective -- and some practical tips! -- on moving through these stages of young adult life:
A Guest Post by Michelle Rosolie
Hi! I was diagnosed with type 1 diabetes halfway through my sophomore year of high school. It was pretty textbook, in that I had all of the usual symptoms (of which I then Googled, which led to a self-diagnosis via WebMD). After a few days in the hospital I transitioned to managing my diabetes at home and at school.
Every day there were new tasks and challenges. It was honestly weeks before I started giving myself insulin injections. Oranges were my first practice targets, as I would practice filling syringes with water, flicking out the air bubbles, and injecting them into whole oranges (still squeamishly I might add). From oranges I graduated to my parents. Yup, my amazingly game and unflappable parents actually let me poke their arms with needles again and again, so I could get the hang of how to poke myself when the time came (if that's not love, then I don't know what is). Eventually. my parents were freed from their role as human pincushions, and I transitioned to giving insulin injections to myself. Around a year later I switched to the Omnipod insulin pump, and last August I also started on the Dexcom G4 continuous glucose monitor.
Enter the college years.
Upon entering college, I not only accepted but embraced the fact that my life was going to be four years of a stressful and irregular schedule. During my first two years of college, my BGs (blood glucose levels) reflected this. Naively, I fed myself the excuse that it was OK that my blood sugars were erratic because "it's college!" and trying to maintain control was a losing battle. With my newfound college attitude of "just go with it," I told myself that upon graduating I would achieve perfect control (ha!). This wishful future thinking was a faÃ§ade for my own laziness and inability to factor myself into the equation. Because diabetes is an illness in which you are constantly striving towards a perfection that you can never achieve (because perfection would mean non-diabetic BGs), I think diabetics, myself included, often overlook their own agency regarding their chronic illness. Yes, we are striving for the impossible, but that doesn't mean we usurp all control to diabetes.
Gradually, and with much help from the Dexcom G4 and Gary Scheiner and his team of savvy diabetes educators at Integrated Diabetes, I learned how to achieve an A1c under 6.5 while in college. Here's the thing: there's never a good or convenient time to achieve the best possible control of your diabetes. Type 1 is inconvenient. And here's something else I had to come to terms with: it's ALL a grey area. There's no such thing as "diabetes-related," "school-related," "non-diabetes-related," or "work-related." Nope, it's all one and the same because it's all my life, a life of which diabetes is an integral part.
This past May I graduated from Vassar College with a bachelor's degree in English, and I'm currently working part-time as a live-in nanny in Brooklyn and interning at a literary agency. It's an odd combination of jobs, but I figured that I would capitalize on the chance to live in New York City and explore and pursue different interests, sans rent. I hope to pursue a career in literature whether that be in publishing, editing, or academia. Until then, or at least for the next few months, my plate is full juggling diapers, basal rates, and manuscripts.
And so this is where I am: making this transition from college to the "real world." Diabetes is, of course, all about transitioning. For starters, there's transitioning from life with a fully working pancreas to one with a pancreas that's now part-time. This entails a multitude of sub-transitions: carb-counting, insulin shots, and endo appointments, and then the eventual transitions (often but not always) from shots to pumps and from testing solely with a meter to introducing a CGM into the regimen.
Concurrent to these "diabetes transitions" are the larger life transitions, made trickier with T1 thrown into the mix (starting college, graduating from college, new jobs, and so on). In my experience, it's these life transitions that are the most difficult to maneuver because they're disruptive. Insulin shots and BG testing may never become as rote as say, brushing my teeth or washing my face (though this is a frequent assertion of mine), but they're straightforward in the same manner as my morning routine. I'm able to file these everyday tasks under the "diabetes portion" of my life and go about my day. The navigation of larger life transitions with diabetes cannot be as easily labelled. It's almost like diabetes is the big elephant in the room, so to speak, and I'm trying to navigate all of life's disruptions without it interfering.
As if graduating college isn't enough of a foreign and terrifying transition in itself, diabetics get the added adventure of doing this while trying to maintain blood sugars that aren't equally as terrifying.
This challenge carries over into my most recent transitions of graduating college and moving to and living in a city for the first time. Once again, as I began this new life adventure, I prepared myself for what I believed to be the necessary adjustments: set three alarms — don't oversleep!, have insulin shipped to new address, buy an unlimited metro card, pack enough test strips, wear comfortable shoes and change into your heels once you arrive at your destination. My checklist reveals a disjointed thought process that fails to acknowledge the intersection of "my life" and "my diabetes." Though I was able to anticipate change (and I have yet to oversleep), I failed to foresee how my type 1 would pervade all changes that I would encounter as I transitioned from graduating college to working and living in New York City.
As it turns out, living in a city with type 1 is vastly different from living in a suburban area, and I have found myself having to rethink simple everyday tasks like grocery shopping, going for runs, and public transportation. Suddenly I found these tasks as situations in which I could potentially go low and was therefore anxious. Rather than chock my BGs up to the inevitable and let my anxiety run rampant, I decided to do something about it.
I've come up with some diabetes life hacks that I've shared with you below. Many of these "hacks" appear to be common sense but it's common sense that I was apparently lacking, so I figured they could be helpful for others who like me often overlook the obvious. Rather than "just go with it," my new mantra is "just go with it, but not at the expense of diabetes."
1. Grocery shopping: I was used to driving to the store, wheeling my cart of groceries to the car, and driving home (paying happens in the process too, in case you think that I'm condoning shoplifting). The biggest physical exertion in this process is carrying the carton of milk from the driveway to the fridge, so... it's minimal. In Brooklyn, you walk however many blocks necessary to the nearest grocery store, fill your cart, and then schlep your bags home and up the three flights of stairs to your apartment. If you're shopping for a family with two babies like I am, this entails lugging multiple gallons of milk among your five or six bags of groceries and making multiple trips up and down the stairs to put away all of the groceries. I moved to Brooklyn at the end of May, so I was also doing this in 90-degree weather. The result: plummeting sugars.
- Diabetes hack: When you're going grocery shopping in a city, lower your basal rates (or bolus if you eat before) in anticipation of walking those many blocks and then walking back carrying heavy grocery bags. Of course, always keep some form of glucose on hand. Also, don't let your pride keep you from purchasing an "old lady cart" to transport groceries home. This isn't diabetes-specific but I think it's just a good tip in general.
2. Going for a run: For the past four years I was accustomed to running around my campus where I had the security of knowing my apartment was nearby as was campus security in case I ever dropped too low and had to call for help. I never anticipated using this safety net, but of course it was comforting to know that help was available if I ever needed it. I'm lucky enough to live right by the Brooklyn Heights promenade and the Brooklyn Bridge, which are incredibly beautiful places to run. However, when I first moved here I was definitely hesitant to run long distances out of fear of being stranded with a low blood sugar and without enough emergency carbs.
- Diabetes hack: Always carry at least a $5 bill on your run. This is probably glaringly obvious, but if you're accustomed to running in suburban or rural areas this probably isn't something you've done in the past. In NYC however, sugar is only a Duane Reade drugstore away, and those stores are EVERYWHERE. So in addition to carrying a power bar or glucose tabs on my runs, I also always carry a $5 bill which eases my anxiety about what I'll do if I run out of available sugar.
3. Public transportation: Subway platforms are oppressively hot in the summer. Not to mention they're packed, and during rush hour you find yourself jostling a bunch of sweaty strangers for a spot on the train. The heat, combined with the disorienting crowds, creates the worst possible environment in which to have a low blood sugar. Not to scare anyone, but it's also potentially dangerous to have a low blood sugar on a subway platform in case you were to ever pass out.
- Diabetes hack: It's not a bad idea to check your blood sugar before heading down to the subway. Really, take a minute to do it! This way in case you're low not only can you treat it in a less crowded area, but you can also run to the nearest drugstore (see hack #2) in case you need to grab some fast-acting carbs.
So, these hacks are a little common sense paired with some strategic planning. They're not going to change your diabetes, but they just might make it a little more manageable. And anything that helps with transitioning to a new phase of life (with diabetes) is a plus in my book.
Thanks for these ideas, Michelle. We love hearing about how PWDs of all ages deal with big transitional times in our D-lives.