Careful Adding Weight: House of Cards

   Okay so I am super glad that the topic of this post is the one that I had already planned on for this week, because the past couple of weeks have been an adventure of sorts and are the perfect example of my main points for this topic. Even if I had been planning a different kind of post for this week, I would've had to abandon it to write about the past few weeks instead, because the past few weeks have been, as I previously stated... (*deep calming breath*) an adventure. So let's get into it, shall we? We've got a lot to talk about!

   This is part four of House of Cards: A Series, and we're talking about being careful with the amount of pressure you're putting on yourself (like how you'd be careful adding weight to a house of cards to avoid sending it crashing down). And what are the main points that my last few weeks exemplify so very well? Well, they all kind of boil down to one point, which is this:

   LEARN FROM MY MISTAKES. LIKE, SERIOUSLY.

   What was my biggest mistake? I tried to do too much! Or, I tried to do too much by myself all at once. Or I expected too much of myself while other things were going on. Or both? Well let's walk through this and figure it out. STORY TIME:

   So I had my A1C a few weeks ago (or a month ago? A month and a half? Curse the pandemic for messing up my sense of time!! *waves fist in the air dramatically*) and it was noted that I've consistently been going high after eating breakfast in the morning, which isn't the end of the world but can be improved, so my nurse was like "(*encouraging Nurse Voice*) you should try pre-bolusing for your food! It can be really helpful in keeping those levels steady! Just try taking your breakfast insulin five or ten minutes before you eat, see if it makes a difference!" And I was like sure, why not? I mean, what's the harm in giving it a shot, right?

   (*shakes head at the innocence of my past self*)

   I mean I guess that's actually not fair, there was no harm in trying it, and I'm sure in a different situation it would've worked well, but there are two factors that were not taken into consideration before I started this little experiment. First thing is the fact that I eat cereal for breakfast every morning, and cereal is a food that is extremely extremely difficult to control with insulin, so a pre-bolus time and dose that controls the after-breakfast high is pretty much unachievable. That would've been good to know beforehand, for me. The second thing is the fact that because I have anxiety and because I'm a very organized and meticulous person (except when it comes to keeping my room clean - I'm a regular teenager in that aspect), when I start thinking about solving a problem like this, obsessing over it tends to start to take over my life a little bit. I didn't consider this beforehand, which maybe I should have. But I also didn't anticipate the process of trying pre-bolusing to be as difficult as it was. I didn't think it was going to be a problem, so I didn't consider how my anxiety and my general organized-ness would factor into the equation. I wasn't ready for what I was getting myself into.

   So I started trying out pre-bolusing three weeks ago. First day, I think I tried taking my regular dose ten minutes before eating. After breakfast, I went high. So I figured, okay, not enough. Next morning I waited fifteen minutes. Went high again. Day after that I tried twenty minutes. High again. I tried twenty-five minutes. None of those worked. My mom suggested taking half of my dose ahead of time and the other half of it right before eating, sort of like a double punch. So I tried that dosing method with various pre-bolusing times - ten minutes, fifteen minutes, twenty, twenty-five. I thought maybe I needed something a little more creative, so I took a third of my dose fifteen minutes before eating, a third ten minutes before, and a third five minutes before. Didn't work. I kept going high after breakfast, or going high right after and then going low later, or going low right before breakfast and then going high for the rest of the morning. Either way it was exhausting. Every morning was really stressful because I had no idea why nothing was working even though I was trying everything I could think of. I would be high until lunch, unable to really pay attention to my classes in the morning because I was feeling the symptoms of my highs - thirst, tiredness, and inability to focus.

   My first mistake here was that I didn't ask for help when I was feeling helpless and confused and frustrated. I could have called my nurse to ask for advice and she would've told me much sooner that cereal wasn't something I could really pre-bolus for. We did eventually end up getting in touch with my diabetes team last week, after two and a half straight weeks of failure pre-bolusing, but I would've saved myself a lot of time and mental energy if I had asked for help sooner. And I wasn't actively like "NO I CANNOT ASK FOR HELP, THAT IS NOT AN OPTION," that's not what it was. It's not that I would've been opposed to asking for help, it's just that I didn't think to ask for help, like, it didn't occur to me that I could ask for help. That's an anxiety habit that I have - I tend to think that I have to do things myself. That's the mindset that I've always had, and I guess after thinking like that my whole life, even now that I'm aware that I can ask for help, doing so is never my first thought, and it doesn't occur to me to ask unless someone suggests it to me. So when pre-bolusing wasn't working, my first thought wasn't "huh, maybe I should ask someone who knows more about this for some guidance and help," it was more just me trying more combinations of different doses and pre-bolus times and panicking because nothing was working. So my first mistake, whether or not it was purposeful, was not asking for help when I could have.

   My second mistake was that I expected myself to be able to fix an already insanely complicated problem while also dealing with something else. What else was going on? My continuous glucose monitor sensor was going absolutely CRAZY.

   If you follow me on Instagram (@that.stupid.pancreas and @join_the_t1d_fight 😁) you've probably seen my many Instagram stories from over the past two weeks at times when my CGM randomly stopped working for an hour at a time and then came back for a while and then stopped again and so on. This first started about five days into my sensor session, maybe a week or so after I started pre-bolusing for breakfast, and at that point it only broke maybe twice over the course of the day. But these sensors are supposed to last ten days (for the Dexcom G6), so having any errors at all only five days into the session was not pleasing. As the days went on, the problems got more and more frequent, the sensor would be breaking six or seven times every day, and so I ended up changing my sensor early, on day nine.

   I wanted to change to a fresh, new, working sensor on day five, but since the problem had only happened twice on that day, I figured the sensor would start working properly again soon and I didn't want to waste the rest of the sensor's ten-day session just because of a few problems. CGM is an expensive technology, so I don't like to change the sensor prematurely unless I really have to. But by day nine I was just done, it was too frustrating having a sensor that just randomly bailed for an hour or two at a time, especially when having access to my blood sugar levels was so important for trying to figure out pre-bolusing.

  So dealing with the whole crazy sensor thing while also trying to perfect my pre-bolus time and dose was a whole ordeal that was very tiring and frustrating. I was high and confused and frustrated every morning because pre-bolusing wasn't working and I was confused and frustrated randomly during the day as my CGM randomly broke. Not a great experience, especially while also having other things to deal with, like school.

  So what do these events have to do with the topic for this post? Well, it's like I said, the main point of telling you this story was so that you would learn from my mistakes. My mistakes, whether or not they were purposeful, were that I didn't ask for help when I could have, I was frustrated and annoyed with myself for my inability to fix everything that was going wrong, and I expected myself to be able to figure out pre-bolusing while my CGM sensor was going haywire. Pressure to do things myself, pressure to do things better, pressure to handle unreasonable problems all at once, pressure pressure pressure. All the pressure that I was putting on myself - or the weight that I was forcing myself to carry alone - was my big mistake.

   This series of posts is about comparing the philosophies of managing type one diabetes successfully to the philosophies of building a house of cards successfully. This post is about being careful adding weight to your house of cards, and being careful putting pressure on yourself. If you're going to add a bunch of weight to the top of your house of cards, and you want it to stay standing, then you're going to also make the base stronger, and increase the supports that hold the weight, so the house doesn't fall down. If you're adding more pressure, the base has to be strengthened and the supports must be multiplied in order to accommodate that added pressure. Otherwise, your house of cards will fall. It's just inevitable. The same philosophy applies to type one diabetes management. If you, as a singular person, are going to be taking on added pressure, in order to keep yourself from falling apart, you have to be able to access more support. You need an increased support system, a plethora of people to lean on and to rely on for help and encouragement. You can't carry the weight of the world alone. You're just a human being.

   I'm just a human being. I'm a human being who, because of unfortunate circumstances, has been forced to play the role of an organ. This organ has like, two or three main jobs, and it was created specifically to do those jobs. I, as a human being, have hundreds of different jobs and responsibilities that I was made for, before you add Unpaid Full-Time Do-It-Yourself Pancreas to the list - I'm a daughter, a sister, a grandchild, a niece, a cousin, a friend, a student, an advocate, a writer, a singer, a reader, a volunteer, a Catholic, and a billion other things that I as a human being was created with the capacity to be. All these things that I love being and doing, that take up a lot of my time and energy and mental space, I was made, as a human being, specifically to be and to do those kinds of things. I was not made to be a pancreas or to do what a pancreas does. I just wasn't. So of course I can't do it perfectly by myself. I can't even do it perfectly with a bunch of other people, because I don't think that humans were made for that purpose - that's why typically humans are born with a pancreas! So that we don't have to worry about things that the pancreas is supposed to take care of. 

   Alas, as a type one diabetic, that life without diabetes-related worry just wasn't written in the stars for me. But I have to keep in mind that even though I have to take care of myself and keep on top of my levels and my settings and all that stuff, and even though I can't just give it up when I'm tired of it, I don't have to do it all myself. In fact, I can't do it all myself. But with the help and love and support of others, I can do it pretty damn well. That's the lesson I'm going to take from the past few weeks (in addition to the whole Don't Try to Pre-Bolus for Cereal thing).

   So the main message I want you to take away from this post? Don't put too much pressure on yourself, no matter what your situation is. You're just a person. You don't have to be everything for everyone, and you can't be everything for everyone. You just have to be you, and you have to seek support and encouragement and love from others when you're not feeling your best, or when you're trying to solve big problems, or if you're trying to carry a lot of weight. You can do anything you set your mind to as long as you take care of yourself and try to do the right thing wherever you can. Nothing is unreachable! (Unless you're trying to pre-bolus for cereal 😊)

   Here's a song that I really love, it's called Take the Weight. Another that I love, called Three. And while we're at it, also Human. Okay, that's it for the songs, I promise! Well, for this post at least. But anyway, I like these songs a lot and I think they all relate to this post's topic a little, so I thought I'd share them.

   And that's it for today, I think! I hope somebody finds this helpful. See you all soon with the fifth and final part of House of Cards: A Series, take care of yourselves!

   Till next time, Type 1 Warriors!