Santa brings a New Type One Plan

I had tried to leave my diabetes at home when I went on holiday. This was the start of the end, just before the New Plan. Reading my journals back I can see now that I was in denial. It had been two months of up and downs. I wanted off the rollercoaster ride, refused to accept what was happening to my body, wanted life to carry on as normal.

The week preceding the New Plan we had been away. I had been hopeful, as you are just before a holiday, that the rest would be good for us all. We had been through a tough few months, even our three year old was being affected by my diagnosis. But instead I returned after a few days’ break, battered from trying to balance diabetes with wine consumption and the usual West-of-Scotland holiday food of fish and chips (fat = very bad for diabetes management). My holiday suitcase full of this dawning realisation that I couldn’t leave my condition behind and perhaps slowly realising that hiding from it would only make matters worse. A good friend said to me later while listening to how my life was now, that perhaps diabetes was one of those things that the more you paid attention to it, the less you had to. I live by this now.

In the week that followed, I was as unsteady in myself as a Christmas drunk on the festive night bus home. I was beginning to realise I couldn’t carry on being me but wasn’t sure who I was. I knew I needed to accept Type One diabetes into my life. I just didn’t want to.

The nurse told me she’d thought I was going to throw in the towel, stop testing and hide under the covers. That’s how people end up with amputations and blindness. It’s the road to ruin. I had reached a cross roads. I would reach a few more over the coming months but that one in particular highlighted two choices. Acceptance and moving on, learn how to manage my new condition, pick up a new life, like a fresh skin, find ways to be happy amid the rollercoaster. Or a long road to ruin, beset by troubles and angst, forever angry and troubled.

I never like to walk in the dark too long.

So I walked into the hospital on December 6, two months diagnosed, hopeful that the nurse’s New Plan would herald a new beginning. It did – but equally it wasn’t the overnight fix I was looking for. From this I began to realise that there wasn’t a silver bullet. Sadly with diabetes for every first after diagnosis – the first walk, cycle, ride, pizza, pasta, shopping trip, sex, dancing, drinking – there is a learning to be taken. Frustratingly this is also to be combined with looking at other factors, eg injected insulin in your system, previous activity, food eaten, etc, etc . But this intricacy, the minutiae of Type One management, was all still to be understood.

At that point the New Plan was simply to start me carbohydrate counting, in simple terms to match injected insulin to food taken. Prior to this I had been on set doses of injected insulin for breakfast, lunch, dinner. This system wasn’t working for me, with a varied diet, activity levels, the Boy Child to look after (see above on minutiae), it had meant the lows and highs of the rollercoaster, the hypos in the supermarket. I wanted off and the nurse and dietician started working towards that.

My part in the deal? A strict diet initially to help them work out what ratios of insulin I should be on for every 10g of carbohydrate, restricted activity to ensure other factors weren’t impacting on my blood sugar levels, simple foods and no alcohol. I was also to do carbohydrate-free days to ‘test’ background insulin levels. I went back to speaking to the nurse every day until slowly a pattern began to emerge, of ratios of units of insulin to 10g of carbs for meals (3-4 injections a day). On top of this, just days before Christmas, there were significant changes to my background insulin, moving to a new type and from once daily injections to twice daily.

I have pages and pages of notes from that period, covering everything, types of foods, impact of activity, of stress, constant changes to ratios, doses of insulin to correct high blood sugars, what ‘stacking’ was (taking too many doses of insulin on top of each other), on splitting doses of insulin for certain types of foods, what to do about snacks, alongside drawings of insulin profiles (how long short acting insulin works for and its impact on bloods). I had questions upon questions upon questions. I stopped trying to work and focussed on trying to understand what was happening

It’s not a wonder I didn’t write any Christmas cards.

Medical professionals acknowledged that apart from a few days here and it hadn’t been an easy ride. This meant a lot to me. Diabetes can be lonely, constantly assessing the situation in your own head, responsible for your own life or death. If I verbalised my internal diabetes dialogue when we met we’d never talk about anything else.

So amid all of this (as I knew now diabetes doesn’t take a holiday), we went into the next holidays, our Christmas 2014 break, feeling like I’d been given just a little of the controls for the rollercoaster, with a plan for festive food and wine, the number for the diabetes doctor oncall and a belief that I might actually, at the end of the day, be okay.

It lasted a month.