For the first week or two after being diagnosed, things were pretty surreal. It was tough to figure out when and where to test my blood sugars and inject myself, since I still was not very comfortable doing either in front of people. From Monday (D-day) to Thursday, I only took short acting insulin before meals, and I only took a correction dose - nothing to account for how much food I ate. (I also took and still take long acting insulin once a day to account for all the internal functions that can raise blood sugar throughout the day) For those few days my bg was running mostly in the 200-300s. I felt better, but the change was not very drastic. During hockey I was feeling a ton better. I felt like I could skate forever, and my whole mindset changed. Before that week I felt like everything was going against me, and now I was finally making some real progress. I met with a diabetes educator on Thursday who gave me a lot more (true) information about diabetes, carb counting, insulin, injections, blood sugars, lows, highs, etc. At this meeting, we decided that I should begin to take a dose of short acting insulin to account for food as well as blood sugar level before eating.
So Friday, November 5, I started the new regimen and immediately saw results. My bg levels were in the 100s for the entire day. My hockey coach (and I agreed with this decision...) was not confident that my bg was quite under control yet. So I was scratched for the first time in my collegiate career for our first home game of the season. I experienced another 'low' of 88 during the game (it might have been 80, I remember that there was at least one 8 in there and that it wasn't actually a low for a normal person). When the low came on, I realized that it was probably good that I wasn't playing on day one of adjusting insulin for carb intake. We won the game, but it was much different to be in the stands and watch the team play. It wasn't where I wanted to be, and I told myself that night that I wanted to do everything in my power to be on the ice for every game from then on. I also learned how 5-10 of our teammates feel during every game because we can only dress 20 players and have almost 30 on the roster. Every time I glide around or feel myself getting lazy when I'm playing, I think of how it feels to be in the stands and about how much those guys would give to be on the ice representing our school. As if I needed any extra motivation, this experience gave me that much more.
On Saturday I got a phone call, "How are you feeling?" "I'm good." "Ok, you're in..." YES! So many thoughts raced through my head... How much food should I bring? Do I need juice? How many carbs are in gatorade? How is a bus ride going to affect me? What about nerves? (The Diabetes educator told me that) I should be between 150-250 before skating.. What if I'm not? It's not ok to take insulin before playing, right? Then I thought, screw it, I'll prepare normally and see how it goes...
I did everything normally. I was in the low 100s before our off ice warmup so I ate a banana. I was also slightly low before the on ice warmup, so I drank a capri sun. Before the first period? Exactly 150! I was so excited that I couldn't stand it. Perfect for my first game back! I felt pretty good for the entire game. And I scored! What a comeback! I felt that my energy got low towards the end, but my blood sugar was not - actually it was slightly high - it got up above 260 by the end of the game.. I guess I ate too much to correct those readings around 100 before hand - oops. After the game I bolused for our post-game pizza on the bus. For some reason, though, I got pretty low (legitimately low this time) even though I had actually eaten more carbs than I planned for. Why could this be? (Now I know that after hockey, bg tends to fall pretty quickly and insulin sensitivity is high. Also, pizza is digested more slowly than a lot of other carb sources, so the insulin may hit before the carbs do.)
Following the directions of every person who had given me advice that week, I did not participate in the celebratory festivities with my teammates. That sucked, because it is always fun to go out after a sweep, but hey, I had diabetes now, so drinking was totally off limits... Oh well, there are bigger tragedies in life than not being able to drink.
The next week was a lot of the same. Actually, the hockey part was the same - Have a good bg upon waking, eat a little before practice, and have a high bg afterward. Hmm, hockey makes my bg go up. I thought everyone said that exercise would make it fall? That's weird. What was different this week is that my mother was in town. Coincidentally she had planned a trip to visit and watch our games that weekend. I was so happy to have her there and be able to talk about what was going on. Surprisingly though, I didn't find much to talk about. I had done tons of research on the internet, and had learned a lot from the people I had met the previous week. I also had spoken to her and my father over the phone a couple times since being diagnosed, and everything was going pretty well. So we talked mostly about normal stuff. How's home? work? school? yada yada.. Of course, at meal times I would ask, "hey, how many grams of carbs are in (insert carb-containing food here)?" and she usually wouldn't know the answer. Whoa, this is my mom, she has fed me for almost a quarter century, and she doesn't know about this (common food item)? I have to figure all this out by myself? Thank God for smart phones, because at least I can do a quick search on Calorie King for baked potatoes while sitting at the table!
We had another home-away series that weekend. During the game on Friday, I was struggling much more than I had the week before. My bg was in the upper 200s and even in the 300s (I check between periods). I told an assistant coach that it was high, and I ended up sitting for most of the third period. The next day, after going to breakfast with my mom, I was in my car when I got another phone call from my coach. "Hey, it seems like you don't quite have things under control yet, and I'd like to give some other guys a chance. You won't be in the lineup tonight." I think this was the first time I cried in a couple years. Just broke down. I had been working so hard to manage everything in stride, had been successful until the day before, AND my mom had flown across the country to watch me play. "Well this sucks." After a few minutes, I called my coach and asked if I could warmup with the team and see how my bg was after warmups, and we could decide based on that. I prepared the same way. After the bus ride I was a little high, so against every recommendation I had received, I took some insulin! What an outlaw! Are the D police going to find me and deliver a super-turbo low so that I never ever do something this STUPID again?? Nope. I figured I might go low during the team stretch, but I didn't. I also figured maybe I would go low during warmups, but I felt great. When I checked before the first period, I was right around 140. This is awesome! I spoke to my coach, who told me, "Hey I'm going with someone else tonight, just like I told you before." Well, my impression was that he would decide after hearing what my bg was, but it was obvious that his intention was never to do that. So I sat in the stands and watched my team (win another game!) with my mom and the other scratches (two of whom lived in the town in which we were playing, so it's unfortunate that they did not dress either). I decided not to eat anything and check my bg after every period to make sure that the insulin was the right idea. It was great for the whole game. Thus, I decided that since hockey usually made my bg rise, I would combat it with insulin. I was not going to let that high blood sugar situation happen again.
Sunday, January 23, 2011
Sunday, January 16, 2011
Background story
I was diagnosed with type 1 diabetes on November 1, 2010. A few weeks later I found out that November is in fact Diabetes Awareness Month...
In January - February of 2010 I lost 15 pounds. Now, I had started to drink coffee (lots of coffee, encouraged by my roommate Colin) in the fall of 2009, and hockey season ran from October to March. So, I attributed the weight loss to a combination of the intense exercise for hockey, caffeine, and stress. I also woke up almost every night at least once or twice to use the bathroom beginning in mid-January. I play sports and stay hydrated, so this too seemed natural to me.
During the summer, no matter what I ate or when, I couldn't gain weight. I've been around 185 pounds for the last 4 or 5 years, and suddenly I had somehow managed to get below 170 for the first time since high school. I thought, 'Wow, I must have a great metabolism... and without all that bulk I'll be faster than ever on the ice!' At the beginning of the summer I would wake up around 6:30 or 7 to go for a 1-1.5 mile run before work, then bike and lift weights after work. Running 3 days a week, lifting for 2 hours 4 times a week, and playing hockey once a week was not helping me gain any weight, and I felt that I was somehow losing even more weight! So about halfway through the summer, I decided to cut out the morning run. Around that time I determined that there was definitely something wrong physiologically and I knew exactly what it was - too much coffee! So, on a family vacation near the beginning of August, I cut out caffeine completely. That was a tough couple weeks! No caffeine and an irregular workout schedule left me feeling extremely groggy and irritable for almost the entire vacation.
When school started back up in September, I was committed to gaining back some weight. I wasn't feeling any better on the ice at the lower weight, and had always been pretty successful around 185, so I ate as much as I could at every meal and loaded up on the carbs between meals. I gained about 5-7 pounds, but for some reason I felt even worse on the ice. After a stride or two, my legs felt like they were made of concrete, and I couldn't hold my own in the corners or in front of the net. I spoke to my family about how much I was struggling and about my lack of a full night's sleep in almost a year. They had plenty of suggestions - don't drink water before bed, maybe you have mono, there could be a parasite in your intestines cannibalizing your protein... I knew it wasn't mono because I had tons of energy throughout the day and had none of the other symptoms. But, just to be safe, my father suggested a blood test.
I went to the school nurse one morning, had some blood drawn for 3 or 4 different tests and gave a urine sample. That afternoon she said that there was concern because the level of sugar in my urine was far above normal. I thought, 'well I had a recovery drink after hockey practice, so that could easily cause my urine to have too much sugar in it.' The nurse suggested returning on Monday to take a fasting blood test... great, I have to go to hockey practice without eating anything beforehand (not telling my coach, because I don't want him to think I have a medical problem if I don't) and then give blood - just how I want to start my week! The nurse said she would contact me by the afternoon to let me know the results.
I had a huge breakfast and lunch per usual, then got a phone call right before my 12:30 class.
-Hi is this Ben?
-Yes.
-Ben I have some bad news, it looks like you have diabeetus.
-(1. What the hell is diabeetUS? 2. Fuck.) Um, ok.
-We'd like you to come to the office right away to meet with a nurse who will tell you more about it.
-Ok, well I have class right now so can I come in after? (What the hell is wrong with me, I'd rather go to an INTRO spanish class than get healthy right now???)
-Sure, you can come in any time.
After my class I called my family and let them know what was going on. We all knew it was a possibility because of the symptoms, but none of us actually thought I had diabetes. I work out almost every day and try to avoid unhealthy foods. How could I have diabetes?
The next call was to my hockey coach, who I wanted to tell in person because we both knew that I wasn't playing to my potential. Unfortunately he couldn't meet in person, so I had to tell him over the phone. Basically I told him what I had just found out and that I might have to miss our team workout that evening, and he said that he would do anything to help.
At the doc's office I met with a nurse whose son had diabetes his whole life. She taught me how to check my blood sugar (527 mg/dl), how to give myself a shot (10 units of Humalog), what a hemoglobin A1C test is (12.8% - meaning my mean blood sugar for the previous 3 months was 373 mg/dl), and the difference between long and short acting insulin. She also had plenty more advice for me:
'The only time my son ever got into trouble was when he drank in college. If you drink too much, you can confuse a low blood sugar with drunkenness and have to go to the hospital." (Wonderful, I can't drink anymore! -not true)
'When you eat, be sure not to eat only a simple carb, if you have cereal or a banana, eat some peanut butter with it because the fat will make you digest it more slowly' (Great I can't eat any of my favorite foods anymore -not true)
'Don't take insulin before hockey or a workout because your blood sugar will go way too low' (not true)
'Try to eat at the same time every day to keep your blood sugar stable throughout the day' (not true)
I could go on and on about the things I learned in the first few days that were not true at all, but this nurse (Liana) was extremely nice and informative and was a great person to introduce me to life with diabetes.
That evening before dinner I started to feel sweaty, shaky, and dizzy. I checked my blood glucose (bg) before eating, and it was 95 (this is above normal for most people if they haven't eaten for a few hours - evidence that my body had been used to a super high bg for a long time). When I saw my teammates at dinner they wondered why I had missed the workout and I just told them that I had an appointment. I still woke up to use the bathroom that night, but I noticed that my sleep was much more sound than usual. The 5am wakeup for practice still wasn't easy. I ate my 1/2 banana and peanut butter and went to practice. Hockey was strange the first few times I played. I felt stronger and faster, but I was pushing my muscles much harder than I had in a long time, which left me pretty fatigued. I was extremely happy that I was finally making progress after struggling for so long.
We had a team meeting (more like meating) and video session that evening. I told the coach that I wanted to tell everyone at the meeting, so when we arrived, he said 'all right, I have a couple items to address before we get started...'
'FIRST, I have an extra dollar from a fine that was assessed last week and I'd like to know what we should do with it. Should we use it for the next fine or does the person want their money back?'
(Um, why is this the first item on the agenda? And why does it matter?)
'Next, DiMo has something he wants to say'
'Hey guys, as everyone knows I haven't been myself on the ice lately. I feel like I'm giving everything I've got and am getting no results. I've talked to a lot of you about how much I have been struggling lately, and...' (I'm sure some guys are thinking, Is he going to quit right now?? - No way, Jose) '... I just found out yesterday that I have diabetes. So please bear with me as I learn to manage it - I'll keep working my ass off, and you guys keep beating the shit out of me.'
'Thanks, DiMo. Ok, well now we have that problem figured out. Next item...'
In January - February of 2010 I lost 15 pounds. Now, I had started to drink coffee (lots of coffee, encouraged by my roommate Colin) in the fall of 2009, and hockey season ran from October to March. So, I attributed the weight loss to a combination of the intense exercise for hockey, caffeine, and stress. I also woke up almost every night at least once or twice to use the bathroom beginning in mid-January. I play sports and stay hydrated, so this too seemed natural to me.
During the summer, no matter what I ate or when, I couldn't gain weight. I've been around 185 pounds for the last 4 or 5 years, and suddenly I had somehow managed to get below 170 for the first time since high school. I thought, 'Wow, I must have a great metabolism... and without all that bulk I'll be faster than ever on the ice!' At the beginning of the summer I would wake up around 6:30 or 7 to go for a 1-1.5 mile run before work, then bike and lift weights after work. Running 3 days a week, lifting for 2 hours 4 times a week, and playing hockey once a week was not helping me gain any weight, and I felt that I was somehow losing even more weight! So about halfway through the summer, I decided to cut out the morning run. Around that time I determined that there was definitely something wrong physiologically and I knew exactly what it was - too much coffee! So, on a family vacation near the beginning of August, I cut out caffeine completely. That was a tough couple weeks! No caffeine and an irregular workout schedule left me feeling extremely groggy and irritable for almost the entire vacation.
When school started back up in September, I was committed to gaining back some weight. I wasn't feeling any better on the ice at the lower weight, and had always been pretty successful around 185, so I ate as much as I could at every meal and loaded up on the carbs between meals. I gained about 5-7 pounds, but for some reason I felt even worse on the ice. After a stride or two, my legs felt like they were made of concrete, and I couldn't hold my own in the corners or in front of the net. I spoke to my family about how much I was struggling and about my lack of a full night's sleep in almost a year. They had plenty of suggestions - don't drink water before bed, maybe you have mono, there could be a parasite in your intestines cannibalizing your protein... I knew it wasn't mono because I had tons of energy throughout the day and had none of the other symptoms. But, just to be safe, my father suggested a blood test.
I went to the school nurse one morning, had some blood drawn for 3 or 4 different tests and gave a urine sample. That afternoon she said that there was concern because the level of sugar in my urine was far above normal. I thought, 'well I had a recovery drink after hockey practice, so that could easily cause my urine to have too much sugar in it.' The nurse suggested returning on Monday to take a fasting blood test... great, I have to go to hockey practice without eating anything beforehand (not telling my coach, because I don't want him to think I have a medical problem if I don't) and then give blood - just how I want to start my week! The nurse said she would contact me by the afternoon to let me know the results.
I had a huge breakfast and lunch per usual, then got a phone call right before my 12:30 class.
-Hi is this Ben?
-Yes.
-Ben I have some bad news, it looks like you have diabeetus.
-(1. What the hell is diabeetUS? 2. Fuck.) Um, ok.
-We'd like you to come to the office right away to meet with a nurse who will tell you more about it.
-Ok, well I have class right now so can I come in after? (What the hell is wrong with me, I'd rather go to an INTRO spanish class than get healthy right now???)
-Sure, you can come in any time.
After my class I called my family and let them know what was going on. We all knew it was a possibility because of the symptoms, but none of us actually thought I had diabetes. I work out almost every day and try to avoid unhealthy foods. How could I have diabetes?
The next call was to my hockey coach, who I wanted to tell in person because we both knew that I wasn't playing to my potential. Unfortunately he couldn't meet in person, so I had to tell him over the phone. Basically I told him what I had just found out and that I might have to miss our team workout that evening, and he said that he would do anything to help.
At the doc's office I met with a nurse whose son had diabetes his whole life. She taught me how to check my blood sugar (527 mg/dl), how to give myself a shot (10 units of Humalog), what a hemoglobin A1C test is (12.8% - meaning my mean blood sugar for the previous 3 months was 373 mg/dl), and the difference between long and short acting insulin. She also had plenty more advice for me:
'The only time my son ever got into trouble was when he drank in college. If you drink too much, you can confuse a low blood sugar with drunkenness and have to go to the hospital." (Wonderful, I can't drink anymore! -not true)
'When you eat, be sure not to eat only a simple carb, if you have cereal or a banana, eat some peanut butter with it because the fat will make you digest it more slowly' (Great I can't eat any of my favorite foods anymore -not true)
'Don't take insulin before hockey or a workout because your blood sugar will go way too low' (not true)
'Try to eat at the same time every day to keep your blood sugar stable throughout the day' (not true)
I could go on and on about the things I learned in the first few days that were not true at all, but this nurse (Liana) was extremely nice and informative and was a great person to introduce me to life with diabetes.
That evening before dinner I started to feel sweaty, shaky, and dizzy. I checked my blood glucose (bg) before eating, and it was 95 (this is above normal for most people if they haven't eaten for a few hours - evidence that my body had been used to a super high bg for a long time). When I saw my teammates at dinner they wondered why I had missed the workout and I just told them that I had an appointment. I still woke up to use the bathroom that night, but I noticed that my sleep was much more sound than usual. The 5am wakeup for practice still wasn't easy. I ate my 1/2 banana and peanut butter and went to practice. Hockey was strange the first few times I played. I felt stronger and faster, but I was pushing my muscles much harder than I had in a long time, which left me pretty fatigued. I was extremely happy that I was finally making progress after struggling for so long.
We had a team meeting (more like meating) and video session that evening. I told the coach that I wanted to tell everyone at the meeting, so when we arrived, he said 'all right, I have a couple items to address before we get started...'
'FIRST, I have an extra dollar from a fine that was assessed last week and I'd like to know what we should do with it. Should we use it for the next fine or does the person want their money back?'
(Um, why is this the first item on the agenda? And why does it matter?)
'Next, DiMo has something he wants to say'
'Hey guys, as everyone knows I haven't been myself on the ice lately. I feel like I'm giving everything I've got and am getting no results. I've talked to a lot of you about how much I have been struggling lately, and...' (I'm sure some guys are thinking, Is he going to quit right now?? - No way, Jose) '... I just found out yesterday that I have diabetes. So please bear with me as I learn to manage it - I'll keep working my ass off, and you guys keep beating the shit out of me.'
'Thanks, DiMo. Ok, well now we have that problem figured out. Next item...'
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