Dear Pancreas,

Dear Pancreas,

I need to start out by explaining how absolutely disappointed I am. You are completely fucking useless. I often wonder how much you weigh and figure the burden of having to carry you around. You had one fucking job and you failed.

This letter is coming to you exactly two years since I was informed you decided to quit your job, with little notice and no regard for the human being you had inhabited for thirty-six years. How very selfish of you.

The 9th October 2018 is a day I’ll never forget, your inaction won’t allow for it.

I figure you died in late August or September 2018, because I lost so much weight out of nowhere, felt knackered beyond belief and had a persistent stomach ache. I’d just started a new job and my colleagues tried to reassure me it was a simple case of stress. It’s a shame you’re not closer to my brain, because then you’d know that I am a constant ball of stress, always have been. So, I knew deep down it wasn’t the reason for these symptoms. Luckily, or unluckily, whichever way you want to view it, I was already seeing an Endocrinologist because of your random little outbursts every now and then. You really are a truculent little bastard.

At the end of September 2018 I sat in the endo’s office and explained what was happening. He chastised me for not going to my GP. He feverishly cried out that this medical problem would be nothing to do with him. He hit me with a barrage of health questions, “When did you start smoking?”

“When I was about eleven or twelve.”

“I didn’t think you were allowed to smoke at that age.”

“In my life there’s been a lot of things I’m not allowed to do, alas I have done them.”

To that end, he ordered a chest X-ray and a load of bloods which pointed to the fact he thought I had the big ‘C.’ But, I knew it wasn’t that.

On 9th October, I sat in my office at work and literally felt as though I may die. I was wiped out, exhausted and my stomach ached to the point I wanted to rip it out. I called the GP, because the endocrinologist had washed his hands of this ailment which has nothing to do with him. There were no results. They’d gone back to Dr Not My Job. 

Now I really would have to sneak in through the back door on this one, I’d hate to bother a Doctor when he said I should have gone to the GP. I’d have to ask a secretary, whatever. I called them and they said he’d ring me back. No fucking backdoor then. He was going to be mad I was making him do the GP’s job again. I figured I’d frequent the smoking shed at work because I’d be waiting for Dr Not My Job for quite some time. I’d possibly even be dead by then.

Five minutes later I arrived back to my desk to five missed calls and a frantic voicemail from Dr Not My Job. Fuck. My already aching stomach felt like it suddenly had a few dozen bricks dumped into it and quickly plummeted into my boots. I called back straight away, barely being able to speak his name due to all consuming fear of what he was about to tell me.

“Are you okay? How are you feeling?”

This was not good.

“Erm, tired and I have a stomach ache.”

“Lucy, you have diabetes.” His voice was strangled as though he was having to deliver the news to his nearest and dearest, not a patient he’d met three times at the outset. This distressed me further, because boy did he sound worried. He ordered me to the hospital right that minute.

I stood there, I had been sitting when I rang him back, but I must have leapt off the chair at some point but I don’t remember when. After I hung up, I must have screamed or done something because I had another doctor in my office, the psychiatrist I work with. That’s when I heard the words for the first time, I heard them many times after and each time they have left a bad fucking taste in my mouth. “At least it’s not cancer.”

Now, don’t get me wrong, in no way am I attempting to undermine cancer. It is a horrible, horrible disease. But, can you ever imagine telling someone who has just found out they have a life-long disease with more associated complexities than branches of a thousand year old oak tree that at least it’s not something completely unconnected? Imagine if someone told me they had cancer and my hand flew to my chest and I exulted, “Thank God it’s not type 1 diabetes!” I figure that would go down like a fucking lead balloon and my name would be dragged through the mud. Yet, everyone found it perfectly acceptable to say it to me. This was the first thing to make me angry after you packed up, bastard. Do you know what anger does to my blood sugar? I hate you.

I digress. I arrived at the hospital (after my mother said, “At least it’s not cancer,” as I was sobbing on the way to the hospital and my boyfriend hung up on me without letting me tell him I was actually dying.) There waiting was no less than a junior doctor, a trainee doctor and two diabetic nurses. If I wasn’t shitting myself before, I was at that point. I was ushered into an office, had my finger pricked my blood sugar was 28 and I had ketones of 2.9 (this is m/mnol.) Even Dr Not My Job had called into the consultation and was having everything relayed to him over the phone.

Now, it took me quite some time to figure out why there was such a fuss, surely people are diagnosed with type 1 diabetes without quite so much fanfare? Right? Ahh, but I’m quite sure they didn’t go to a whole endocrinology consultant who is a diabetic specialist, describe the symptoms of diabetes and were subsequently told to fuck off in the politest of ways, did they? I’m quite sure Dr Not My Job was clutching his GMC number in his cold, terrified, little hands for quite some time after that. In someway it’s really nice to know that at least one person was really fucking glad I didn’t die of DKA, even if it was for less than honourable reasons. The day after my diagnosis I had to go back to the hospital and he came to see me and said he’s never in his career seen a person go from reactive hypoglycaemia (that’s when you were being a little bitch) to type 1. Not ever. So, I’ll add medical fucking mystery to my list of shit I’ve done then, shall I?

In all fairness, people are vindictive and want someone to blame for everything that happens to them. I’m usually no exception to this. That said, I honestly for the life of me didn’t know what the fuck was wrong. My brother has lived without his turncoat, mother-fucker of a pancreas for years. I should have known you’d fucked off on a world cruise never to return. But, I didn’t think of it once and to be honest I thought I was too old. Also, I’ve always been really thirsty…especially for beverages of the fermented grape variety. If I, the Queen of know-it-all, didn’t know, I wouldn’t expect anyone else to either. 

So then, there I was with all the gear and no idea. I cried and cried for a week solid. This wasn’t helped by the little bitch in the pharmacy in my doctors surgery who refused to give me all the stuff I needed, including my insulin, because I needed a medical exemption certificate which takes four to six weeks to arrive. So I’ll just go home and die then shall I, twat features? I got her to hand it all over in the end but that wasn’t before she was so rude to me in front of lots of people and truth be told, I just couldn’t hack anything else.

I was a wreck. I wanted you back. I just wanted you to do what you were meant to do and stop pissing around. But, I knew you weren’t ever coming back.

I went through the stages of grief I can only see now. 

Anger was most definitely the first, and it rears its ugly head time and time again. It’s usually other people and how I feel about having you gone which causes it. It can be a colleague sending another colleague a ‘get well soon’ card or a bouquet of flowers when something tragic has happened and how in my time of lying at rock bottom I didn’t get a thing, not even a teaspoons worth of sympathy. It’s clear to me no-one understands even for a nano second what I went through and how dark those initial days, weeks and months were for me. I am a person who emotionally vomits. I can’t keep it inside. It’s obvious I feel really sorry for myself and therefore no-one else feels the need to. It’s only diabetes. I can’t help thinking that maybe if people showed a bit of empathy then perhaps I wouldn’t, still to this day, feel so angry that you left me. Alas, here we are.

Denial. Well, I came to terms with the fact that you had gone and were never to return to your fully fucking functioning self. I never woke up and thought, this is bullshit, it’ll just spring back to life and laugh, saying, “Fooled you, sucker!” No, my denial was much more dangerous than that. I’d treat myself to days of pretending I didn’t have type 1 diabetes. I wouldn’t test my blood sugar or take insulin. I didn’t get over this until April 2020, when during the COVID-19 lockdown, I went into DKA with a ketone level of 8. That was half a day of not taking insulin. Granted, I did lie on the sofa eating a packet of biscuits. However, when the stark realisation a packet of biscuits can and will kill you…well, it’s a cruel world. Funny, I only realised something was wrong when I couldn’t finish my cigarette because my respiratory system was shutting down. I’ve never done this since, and unless I’m feeling suicidal, I’m not likely to either. It was fucking horrible.

Depression. I lived most of my teens and twenties with crippling depression. In comparison to that, I guess this is nothing. It’s there, but in a different form. I can’t sit still, can’t stop to think about anything other than about the next most pressing task on the list. I don’t even really like myself or have a compliment to give to myself like I used to. I never feel attractive anymore. Especially not when I see what not having you did to my teeth. I mean, what the hell is that all about? Happiness comes in fleeting moments rather than being a state of mind. You know what? I just feel broken and damaged and I’m not sure that will ever change.

I dodged the bargaining. I know there was nothing I could have done differently to have kept you going. Or maybe I’m still in the stages of grief and this will come later? Who the fuck knows? Not me.

Maybe there’s a grain of truth in what I said because I haven’t reached the acceptance part yet. I mean, I accept you’re gone and you’re never coming back. I accept I will have to do your job myself. I accept I have to play a constant game of chess and be on top of everything lest become ill very quickly. I accept I’ll have a lifetime of insulin and blood monitoring. I accept the overwhelming feelings of envy when I watch someone put food in their mouth without having to make a ton of decisions before they do it. I accept all of that, but I can’t accept and embrace this. I can’t feel like some people feel about how type 1 changed their lives for the better, and some people really do feel like that. I’m not one of them.

I hope next year, when I write my annual letter to you, I might feel a bit better? But, for now…

With sincere hatred,

Lucy

A New Enemy!

 It’s been a bit of an odd month for me. Finally in the swing of writing my fantasy novella which is a spin off of The Falling series, I’m at least halfway though. Im still recording Falling to Pieces for audio, I have six chapters left! I was hoping to finish it this weekend, but I finally got my lockdown barnet sorted yesterday and Sunday was a bit of a washout in the being arsed department. Rest assured the work continues.

What I have really put my back into leaves me at utter risk of turning this blog into a diabetes blog. But, hey, it’s my blog and no bugger reads it anyway Lol. 

I have worked really hard on driving my blood sugars down and for the most part succeeded. I’ve seen my first, second, third and even fourth day of being one hundred per cent in range and trust me when I say it’s difficult to achieve because of all the things effected by blood sugar, my main failure is stress.

So, how did I get there? I put in a lot of research on how to combat post meal spikes for starters. Since starting with the libre freestyle I’ve noticed just how bad they really were. My initial research delivered the gloom of everything and told me that postprandial spikes contribute drastically to the onset of kidney disease and speed along retinopathy, eye problems mostly related to patients with diabetes. Sugar seriously fucks up your body, that’s what I already knew, but how the hell are you meant to stop it? The article is here, along with some ideal ranges and clues about how to achieve them: https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/manage-high-blood-glucose/

What I’m about to tell you seems so freaking obvious you’ll want to roll your eyes at me, I don’t blame you at all. In my defence, when I was diagnosed a dietician sat me down and told me unoquivically that I could eat whatever and whenever I want. I did not misunderstand the instructions by a healthcare professional and smiled when I read Adam Browns’ Bright Pots and Landmines, describing the exact same advice being given to him at the time of his diagnosis. Both Adam and I toddled off and carried on as normal, giving huge insulin doses and eating the very things we know raises our blood sugar in abundance, carbohydrates. 

The next thing I discovered, from the aforementioned book, from YouTube and other information rich resources is that…wait for this huge fucking bombshell I’m about to drop on you, you won’t believe it… If you limit your carbohydrate intake you also limit the rise of your blood sugars, thus causing more stability and reducing the post meal spikes. Duh! Again, I refuse to take the entire blame for not realising this sooner, because lots of us are advised not to avoid carbohydrates. I recall a Diabetic Specialist Nurse informing me, “Carbs are not the enemy, Lucy, they are what gives you energy.” Well, Mr fucking know it all, I’ll tell you what takes my energy, smacks me around the gob and assists me with doing nothing other than taking to my bed…high blood sugars caused by fucking carbs. I know they’ll be people out there screaming at me that I’ve been doing this wrong, you’re taking the fast acting insulin at the wrong time! I tried everything to get that right, even when the CGM told me, my blood sugars were falling quickly, I still suffered a spike regardless of the type of food. 

I quickly realised throughout my research there was only one way to go and that was to reduce my carb intake. For the most part I limit my carb intake to 30g of carbohydrates per meal. Until you really start to look and weigh your food you cannot fathom how much carbohydrates is in everything! 

Excuse the bags, it was an early morning stroll getting rid of high blood sugar!

Aren’t you really tired with having so few carbs? Let me tell you a little secret…if I have no carbs at all, I still have to take some insulin to cover the protein, this is done post meal and you have to work out when and how much is the right time for you. This is because protein produces glycogen in the blood stream too, meaning energy! I feel so much more energised it’s unbelievable. I have been working out on a daily basis, high impact workouts to raise blood sugars and walking to lower them. What’s more I’m really enjoying doing it, too. I feel so much better now I’m not suffering with elevated blood sugars on a thrice daily basis. That was energy zapping to say the least!

I have changed my entire families diet. Sometimes you would think I’m starving them to death and yet when each of them come to me happy they’ve lost some weight it serves as a reminder that fewer carbs is a good thing! Lots of salad and vegetables is the key to getting full, not pasta, potatoes, bread and rice!

This process has served a learning curb for me in the management of my diabetes. This won’t work out for everyone, of course, but it absolutely works for me! If you’re a diabetic suddenly discovering that your post-prandial spikes are effecting your life I urge you to at least give reducing your carbohydrate intake a go. Feel free to contact me if you want to discuss it.

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