It’s day one of the Australasian Diabetes Congress (#19ADC) which is being held in beautifully sunny and shiny Sydney over the rest of this week. Once again Diabetes Australia has brought together a team of diabetes advocates and bloggers to provide real time, on the ground updates from the Congress, which is a brilliant way for people with diabetes not here to keep updated on the sessions, latest research and new tech that is on display.

I have spent a lot of my advocacy life talking about the value of having people with diabetes at this sorts of healthcare professional events. I’ve defended our right to be here until I have turned blue in the face. I have said the words ‘Nothing about us without us’ so frequently that people have asked me if I coined the phrase (of course I didn’t – others have been saying this for years longer than I have). I have challenged people who have said that this conferences are a safe place for HCPs to talk amongst each other without concern that PWD might misinterpret what they are saying. We belong here – it is as much a place for those of us living with diabetes as it is for those working in diabetes.

Yesterday I was involved in two events – I gave a talk with Grumps at the Roche Educators Day (#RED2019), and then we co-facilitated the Ascensia Social Media Summit (#OzDSMS) – and there was a lot of talk about the importance of people with diabetes at events like this. I’ll be writing about both these sessions later on, but for now, I want to share a comment that came out of the Ascensia event when we were talking about what advocacy means and why we need to be present in all diabetes discussions. Kim Henshaw spoke about the importance of PWD being advocates and I think this just nails it.

The lived experience is critical for people to understand what diabetes is all about. It was so refreshing to hear Diabetes Australia CEO, Greg Johnson, say I’m a real believer in the power of the person with diabetes telling their story. It’s not just about organisations doing it, it’s about individuals doing it in all sorts of ways.’ 

This is why it makes sense to have us at these conferences. Our insights, ideas, thoughts and knowledge and expertise is valuable. That’s why we’re here.

Disclosures

My flights to attend ADC were covered by Roche Diabetes Care Australia. Thanks to the Australian Diabetes Society and the Australian Diabetes Educators Association for providing me (and the other #DAPeoplesVoices) with a complimentary press pass. My accommodation and all other costs have been covered by Diabetes Australia (which is where I work). My words here and in all my tweets and other social media activity are mine and mine alone. I’m trying really hard to not be sweary and these efforts should be rewarded with chocolate. 

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Today, the skies over Australian darkened, as a now familiar grumpy presence settled in. Grumps is back in town, and brought with him a new WWGD post for Diabetogenic. While he is here this time, I might explain to him that he doesn’t need to hand deliver these posts, and show him how email works.

 But for now, here’s Grumps thinking about making more changes to his diabetes management and why that is pissing him off.


Out of my almost 25 years of T1D following in my shadow, I will have stuck a syringe or pen needle into my skin a few times. I used to favour back of my arm in the old days as it took me years to get over a mental block of jabbing myself in the stomach. After a while I had to get over this issue as I was told to give my arms a rest as they were getting lumpy.

For my long acting insulin, I always injected into either my thigh or my arse, and let me tell you, forty units of Lantus can sting a tad…

I’d often get lumps that would take a day or two to go but I didn’t really pay much attention at that time.

I went onto a pump around nine or ten years ago, and since then I have only ever used my stomach for cannula sites. Clearly, I have well and truly gotten over my phobia of stomach injections. Also, as favour to myself, I have managed to grow my stomach in size and give myself more ‘real estate’ in which to rotate my sites…

A while back I noticed that absorption seemed to be getting worse: a few more lumps, more sites that were ‘bleeders’ when removed, and more leakages than usual.

So, What Would Grumpy do in this situation? (#WWGD)

Well, I didn’t want to try arm sites or even go back to thighs or arse. They just seem impractical and I am worried about ripping them out. So, I just moved to the sides. I’d seen PWD online using those areas and thought I’d try it out.

They have been working well. Actually, really well!

Until now…

Now I have the same issues.

I’m a lumpy Grumpy.

Raising the question again #WWGD?

I could of course just carry on expanding the gut and grow some more space. That’s the easy option, and more pizza and beer are always welcome…

However, I’m 50 years old. In a few weeks’ time I will have had T1D for 25 years.

Half my life…

I am increasingly thinking about my heart and how to look after it better, so I have, (way too sensibly for my liking), ruled this out.

It’s time to try more sites.

Time for something new, and that pisses me off!

I don’t like change.

I don’t like my diabetes forcing me to change.

I have fought against that happening for half my life now.

I know it’s not a big deal in the grand scheme of things and is totally a privileged, first word problem, but it still pisses me off.

Live Long and Bolus,

Grumps.

‘I’m bored with diabetes. So, so bored.’That was how I opened last week’s appointment with my endocrinologist.

She nodded at me. I’m sure it wasn’t the first time someone had commented on the boring nature of diabetes. It’s programmed into the DNA of the health condition we live with. She waited for me to go on (she really is the master of not filling silences).

‘What can I do to shake things up? What should I be doing?’

It was a repeat performance of my last appointment back in February. I walked in with this need to shake things up; do more; be more proactive; add stuff to my routine.

My endocrinologist, thoughtful as ever, waited some more for me to finish my brain dump. So, off I went…

‘I am doing so little to manage my diabetes these days. I’m not burnt out – that’s not what I am saying at all. I’m not doing that thing where I pretend I don’t have diabetes. I am doing everything I need to do, except these days, it seems I don’t really do much. Loop keeps Looping and I really feel that my only input is making sure there is insulin in my pump and a working cannula and sensor in place. I bolus as required.

‘But it doesn’t seem enough. There was time each day that I had set aside for diabetes that I don’t need anymore because managing rollercoaster glucose levels, or responding to countless alarms, or managing those hypos that resulted in multiple lost hours…these things just don’t happen anymore. Or if they do, they take so little time to address that it almost seems insignificant. 

‘I feel like I am not doing enough. So…what can I do?’ 

When she knew I had finished sharing my stream of consciousness, she looked straight at me and said: ‘You do exactly what you are doing. There is nothing more that I would suggest or recommend that you do. You asked last time about adding some different therapies to your current management, but there is nothing that would suggest any benefit to that. 

‘If you were not looping and doing what you used to have to do and all that entailed and telling me what you are telling me: that you are feeling well, you feel your diabetes is in a good place, you are not feeling burnt out and that you are happy with how and where your diabetes was tracking right now…and if that was accompanied by the A1c you are running, I don’t think we would be having this conversation. I doubt that you would be asking what more you could do. You would know that you are meeting all the targets you want to and are feeling overall great about your diabetes.’

Of course, she was right. That was my situation two years ago: I was feeling fine about my diabetes (or as fine as I ever was going to) and was thrilled with my A1c (which wasn’t as low as it is now). And I certainly wasn’t thinking that I needed to do more. I accepted that I was putting in the effort and for once was seeing the outcomes I liked. The idea of adding more tasks to my diabetes life would never have entered my mind!

‘I know you are right,’ I said to her and then mentioned the talk I’d heard at #DData last year when fellow DIY-er, Justin Walker, said that since using OpenAPS he saved himself about an hour a day. ‘An hour a day. That’s a lot of extra time I didn’t have before. I don’t know what to do with it,’ I paused. ‘Maybe I should take up knitting.’

‘You could learn a language in that time,’ she suggested, helpfully.

It has me wondering if this is a thing for others who have embraced the DIYAPS way of life. Have you all just embraced this renewed freedom and extra time and run with it, or are you too wondering what to do with your hands?

Nineteen years of constantly focusing on the minutiae of diabetes, and second guessing myself and having to DO SO MUCH diabetes is a really hard thing for me to unlearn. The last two years have been really, really different. Who knew that my response to finally getting that break that I so desperately wanted would be to not know what to do with myself and want to do more?!

Since Looping, diabetes has taken a back seat in my life because the daily demands are far fewer. Sure, the emotional toll is still somewhat there – especially when it comes to the fears I have about the future. But the daily frustrations and intrusions are not there. And that means that as well as having to physically do less, I think about it less. I had no idea just how much that all took until I stopped doing it.

I get that this is coming from a position of extraordinary privilege, and feel free to file it away under not only first world, but also first-class problems. And ignore me. (Seriously, I thought of myself as insufferable when I was having conversation last week.)

Or send me knitting patterns. In the meantime, I’ll be over in the corner conjugating irregular verbs.

I so love it when New Yorker cartoonists are able to provide me with a beautifully succinct explanation for something that seems to confuse people.

Sure, we can talk about prevention and what we can do to reduce risk. But sometimes, there are things way out of our control. Being able to explain that particular side of the diabetes coin may just go some way to reducing a little of the blame and shame that gets thrown in our direction…

(Click cartoon for details.)

 

As part of my role at Diabetes Australia, I am often a media spokesperson for the organisation and will do radio or television interviews to talk about … well … diabetes. I usually step in when our CEO, Greg Johnson, is unable to do the spot, or if it is more in-line with the lived experience work that I do.

In the lead up to National Diabetes Week, I was interviewed on a program on commercial TV that airs in the middle of the day over the weekend. I spoke about NDW, gave a quick diabetes 101, answered a few questions. And responded to a segment they’d run the week earlier where they had interviewed Dr Michael Mosley, where he had spoken about intermittent fasting, the 5:2 diet, and low calorie eating for rapid weight loss as management tools for type 2 diabetes.

When asked about Mosley, I started by saying there is a growing body of evidence suggesting that rapid weight loss and/or intermittent fasting is a way that some people with type 2 diabetes have found is useful in managing their condition. (You can read my thoughts on using words such as reverse, remission or cure here.) Building on this evidence is important – and so is seeing how people are going 5, 10, 15 years down the track. Plus, it is fantastic that this is a treatment option that works for somepeople with type 2 diabetes.

I added that we need to caution suggestions this treatment is something that will work for everyonewith type 2 diabetes. Some people won’t respond to these methods, and will need other options for how to manage their own brand of diabetes. They should not be made to feel that they have failed if one treatment does not work for them.

I said all of this in about 45 seconds, and didn’t think any more of it. I walked out of the studio, climbed into the back of a cab and got on a plane to Brisbane, settling in for a week or NDW-prep and then NDW itself. I completely forgot about the segment airing until a few people had mentioned seeing it.

I still haven’t watched the whole interview, but I honestly can’t remember anything that I said that was especially offensive. The hosts and the segment producer said it had gone really well.

But clearly, there were some viewers who took objection to what I said. I know this, because my inbox and socials DMs were infiltrated with quite a few comments from people who were more than happy to tell me that I was wrong. They told me that following a similar program to Mosley had worked for them, (I am always, always happy when people find what helps), and that perhaps I should be more open minded, (I am – I just don’t believe that there is a one size fits all solution to diabetes). I was told that low carb is the only way to go and that my comments about there being no such thing as a ‘diabetic diet’ were wrong and that I was a shill for Big Food (yawn).

And then, a few people took the discussion in a direction I’d not had to deal with before, with these choice comments:

‘It’s obvious you could do with some intermittent fasting.’

‘Stop believing food companies and your own organisation and start eating low carb to manage your own diabetes because at your weight you are doing yourself harm.’

‘You are an example that dietary guidelines don’t work. If you ate low carb and fasted, you’d lose some of that excess weight.’

‘Stop listening to your dietitian and eat low carb, high fat. You’ll lose weight and won’t get all the complications that are in your future.’

‘Do you add sugar to your coffee? You mention baking cupcakes and brownies. Do you add sugar to them? Do you eat all normal foods which have sugar in them?’  

There were others. They were equally tedious, misguided and, at times, laughable. (For example, ‘my dietitian’? As if!)

Now, I didn’t at any point during the interview say that I live with diabetes. I didn’t say anything about the type of food I eat or how I manage my condition. I didn’t mention baking or drinking coffee. If you know me, you would know that I do have diabetes, bake and drink coffee. And if you don’t know me, you can find that out quiet easily. If you went looking.

It seemed that some people went looking. I didn’t know any of the names that accompanied their useful and not-asked-for counsel. I assume they didn’t come from people I know, because I don’t know too many people who would send me this sort of advice.

But these folk (there weren’t many – maybe a dozen or so) took the time to find out who I was, how to message me and then tell me that I needed to lose weight and manage my health condition differently.

Please understand that I’m not asking for positive comments or reassurance about my body or my size. I don’t want anyone telling me I am a healthy weight, that I look fine and that I didn’t deserve what I got. NO ONE – whatever their size or shape – deserves this sort of unsolicited commentary from complete and utter strangers. Or people they know, for that matter.

This is about the idea that there are people out there who, if they disagree with something someone says, or if they hear someone suggesting that people manage their diabetes in a different way, get online and insult a person they have never met before by telling them to lose weight.

I know that this is a really tiny incident. And it’s the first time it has ever happened to me. I know that there are some people who face this sort of bullshit regularly.

It is not okay. Body shaming or commenting on someone’s weight or how they look is never, ever acceptable. And tying it up by telling them they are harming their health does not make it any better.

I totally had coffee and lemon cake I baked last night for breakfast. There was sugar in both.

If you’re living with diabetes and need some body positivity (and hey, who doesn’t), here’s another plug for Body Posi Betes which you should definitely follow on Instagram right now. 

Sometimes, something happens at a diabetes conference that I need to sit on for a while before I can write or talk about it. At ADA this year (almost six weeks ago now), there was a moment that has stuck with me and I think it’s time to talk about it.

I was sitting in the front row of the language session – because, of course I was – eager to hear from the all-star panel that was going to be looking at the language issues from the perspective of the PWD and HCP, as well as look at the role HCPs play in addressing diabetes stigma and how they can improve communication. I loved the well-rounded approach the session was taking, and settled in for a couple of hours of discussion.

The line-up was a veritable A-list of the best voices in the space. We had ‘Jane squaredhttps://diabetogenic.wordpress.com/2019/06/08/greetings-from-san-francisco-and-ada2019/, with Dickinson and Speight book-ending the program, Joe Solowiejczyk giving the consumer side and Kevin Joiner providing strategies for dismantling stigma.

Jane Dickinson has been an absolute champion of the diabetes #LanguageMatters movement in the US. And it was in her introductory session that the moment of today’s post happened. Jane was speaking about how HCPs see diabetes and people living with the condition. And she showed this slide:

I can’t remember if Jane read out the quotes. But I do remember how I felt as I read them and took in what they meant. I felt beaten.

As people living with diabetes, so many of us have firsthand experience of hearing these sorts of comments directed to us. Or we have had friends with diabetes tell us their tales. Or we have heard passing comments from HCPs expressing similar sentiments. The idea that we don’t care, have brought it all on ourselves, deserve what we have coming – and conversely, don’t deserve care – us pervasive through the diabetes landscape.

This is how diabetes and those of us are living with it are perceived. And it is heartbreaking.

There is no consistency as to who is making these comments – healthcare professionals from all different disciplines, at different stages of their careers, with different experiences. Some work in tax-funded settings, others in private settings. They are considered the best in their field, they are held up as examples of excellent care. Other HCPs refer PWD to them.

Often, I hear people say that these attitudes are really only ever the thoughts of ’old school’ HCPs who have been around for a long time; it’s a throwback to the patriarchal attitudes of healthcare – to days when doctor or nurse knows best and ‘patient’ does what they are told, and if they don’t, they get told off, while being written off as not caring for themselves.

But that assessment is actually not true at all. Some of the most sensitive and tuned-in HCPs I know have been working in diabetes for many, many years.

And some are yet to have even started their career. In exactly the same way that diabetes doesn’t discriminate, it seems that these horrid attitudes and stigmatising comments can come from people at every stage of their career.

Here is the whole slide.

That’s right. These comments came from future nurses. They hadn’t even set foot on the wards yet as qualified HCPs. But somehow, their perceptions of people with diabetes were already negative, and so full of bias. Already, they have a seed planted that is going to grow into a huge tree of blaming and shaming. And the people they are trusted to help will be made to feel at fault and as though they deserve whatever comes their way.

This – THIS – is why I am not stopping banging on about language and diabetes. THIS is why I get frustrated when someone responds to – and reduces – a discussion about this issue with ‘But I/my kid is happy to be called (a) diabetic’. THIS is why I constantly highlight when people or organisations or people in the media are using stigmatising or negative language.

The words we use shape the attitudes we have, and the attitudes held by many about diabetes are disgraceful. Imagine if instead of mindsets like this, HCPs came out of their training with the idea that people with diabetes need support, education, information, compassion and skills to best manage a condition that no one, but no one, ever asked for Just think about how different – and better – that could be.

The ADA session ended perfectly – with Jane Speight (my personal diabetes #LanguageMatters hero) playing the Mytonomy ‘Changing the Conversation’ video. So, here’s that video again. Watch it. Share it.

 

I am not really the type to analyse reports of glucose data. I’ve never been like that, except for a brief period where I was overly obsessive. Or, as it is more commonly known: when pregnant. Then, I was all about entering numbers into Excel spreadsheets, (hey – it was the early 2000s), and I searching for patterns in the 15-20 BGL checks I was doing every day, circling anything even closely resembling a common theme in green. (Oh – green circles may always have been my thing…!)

These days, even with reports and graphs and all sorts of other fancy pants data at my fingertips, I don’t really do any analysis.

The reason I love Loop is because of how it makes me feel in the here and now. By reducing so many of the tasks I do, and my diabetes needing less urgent attention, plus dealing with fewer lows, fewer highs and fewer pretty much all the other shitty stuff, it means that my in-the-moment diabetes is far easier to manage.

Sure – I occasionally have a look at what my Clarity app is telling me, but it’s only ever the snapshot page: TIR, average glucose level and hypo risk.

Since being on Loop, my hypo risk has always looked like this:

Minimal risk. Take that in for a moment.

Diabetes – the condition that demands so much of us in terms of being able to complete highly complicated calculations factoring in pretty much every single variable imaginable and a million more, dosing a potentially lethal drug and really, no room for error.

Diabetes – the definition of a high-risk health condition.

And my personal risk of lows? Minimal.

So, remind me again: How is Loop (or other DIYAPS options) unsafe?

I’ve been struggling the last week or so. It’s a combination of a lot of things. It’s the typical post-NDW slump. It’s the relentless Melbourne winter weather. It’s coming down from a few months of intense travel. It’s dealing with people doing annoying things. Plus, more annoying people throwing a bit of body shaming in my direction – new and fun. It’s the white flowers on the kitchen table, which wedded to the sadness that is never too far out of reach suddenly feels overwhelming, signifying that time of year.

It adds up. All of it. And people notice. ‘Is everything okay with your diabetes?’ someone asked me when I mentioned I was having a little bit of a tough time. I glanced at my green Loop, and my Clarity app and clocked my time in range. ‘What diabetes?’ I said, knowing that I was doing less than ever in my diabetes management, yet yielding results that just a couple of years ago would have taken attention, effort and energy that I just don’t have.

Then someone else asked me a similar question. ‘Are you feeling a little bleurgh (my word – not theirs) because of your diabetes?’

Well no. But yes. Or as we Aussies like to say ‘No, but yeah but…’. (For the record – I have never ever uttered those words in that order…)

Diabetes is not the source of me feeling over everything. I can’t point to any aspect of my diabetes that is playing up, giving me a hard time, being a jerk. But can we ever truly extricate diabetes from our emotional wellbeing?

I looked at the things that have been adding up. Post-NDW slump happens because the lead up to and then a week of solid diabetes-ing will always mean diabetes overload.  The weather means less time outdoors and doing things that take my mind away from the mundanity of diabetes – it’s seasonally affected diabetes and it brings me down because I’m far too much in my own head. The travel exhausts me, and the jet lag overpowers me and that means not sleeping which means diabetes behaves less predictably; annoying people are just bloody annoying and because of the playground I frolic in, are often connected somehow to diabetes. White flowers – something I have written about to share the personal way I mark the heartbreak of pregnancy loss – and the loss they represent, and grief they signpost is tied up with a body that is broken in part due to diabetes.

Diabetes may not be the reason for any of these separate pieces of a bigger puzzle, but it is there for each and every single one of them, no matter how small. And together, it really does start to add up.

We often want to shout from the rooftops that sometimes it’s not diabetes. The frustration we feel when everything – from a grouchy mood through to a broken arm – is blamed on our beta cell dysfunction. It’s not diabetes – rarely is it ever only diabetes. But it is never without diabetes.

I know there is light at the end of the tunnel – that I’ll be all good. NDW always gives way to the next thing and focus moves to that; blossom on trees and the daffodils in florists everywhere guarantee warmer days; the travel will start again and I’ll get back into it and just get through it; the annoying people will continue to annoy, but I’ll be better at ignoring it (at least, that’s what I tell myself…). And the white flowers? They will die and the vase on my kitchen table will instead hold something new and bright, and the grief will return to where it lives, burrowed there with the lost dreams and the memories I didn’t get to make.

And diabetes? Oh, that will still be there. Never the main thing, because I will never let it be that. But there, nonetheless.

Last week, Instagram got rid of ‘likes’. The company line was that it wants people to concentrate on content shared, rather than its popularity. Sure, Instagram, let’s go with that.

For the platform that is preferred by ‘lifestyle influencers’ (seriously – can you imagine putting that on your arrivals card?) it all seems a little disingenuous, but if not knowing who is liking content speaks to you, then perhaps this is a good idea.

I have a love/hate relationship with Instagram. I have mine pretty locked down and only share with friends and family. I only follow people who make me feel good, or make me laugh. I don’t follow anyone who makes me feel like I am not enough. Or anyone who drinks kale juice for breakfast. These good folks can namaste themselves elsewhere.

If you are connected with me on there, you’ll know that what you see mostly is photos of my family, the coffee I’m about to drink, the cookies I have just baked, and, depending on the season, blossom trees (hello, promise of spring) or jacaranda trees (hello, promise of summer). Plus, there’s diabetes spam…so much diabetes spam.

You won’t see me telling you about my perfect diabetes life though, because my diabetes life is not perfect. And you won’t hear me going on about how grateful I am that diabetes has given me so much, because really, I’m not. And you won’t hear me saying that others have it worse and that I am #SoBlessed, because … well … because #FuckThat.

I wrote once that I despise the concept of ‘At least…’ or ‘It could be worse’. Could it worse? Of course it could! But having a body that does what it is meant to would be a shed-load better!

Positive affirmations are great if they give us hope or something to hold on to. They’re not great if they start to make us feel like we are failing, or feel bad for not always being optimistic and upbeat. Sometimes, diabetes makes it really hard to walk on the sunny side of the street.

I frequently say diabetes sucks (because honestly, I am yet to hear someone tell me how it doesn’t), or that there are days that I truly hate diabetes (because I really, really do). This doesn’t mean that I am looking for someone to throw me a pity party. It doesn’t mean that I think my life is hopeless.

But some days, diabetes is especially challenging, and no number of positive memes or positive self-talk is going to change that.

I am a positive person by nature – annoyingly so at times. I see the good in people and in situations. But I refuse to believe that it is not okay to sometimes admit that my arse has been beaten that day by the health condition that is so difficult to live with, or to privately and publicly say that I truly, honestly, totally, absolutely despise diabetes.

I need the space to have those down days and the bad days and the days where I admit that I am not a superhero. I need the time to snuggle under a quilt on the sofa and watch some trash and not feel all positive or like I can conquer the world.

It is easy to believe that a lot of Instagram diabetes folks are all happy and accepting or grateful to have diabetes. Truly – if they are and are able to maintain that positive attitude all the time, that is wonderful. I’m not those people. I don’t resent them in any way. I just believe it is important to understand that not everyone is able to have that sort of outlook.

Sometimes, it’s not possible to ‘positive’ your way out of a bad diabetes day or try to convince yourself that you don’t hate diabetes, but really do love your body when it feels just so damn broken. And that is okay.

Really – it is okay to not be okay. It is okay for us to not be shiny, happy people* all the time.

What I will say is this: If your hard days are outnumbering the good days, please do see if there is someone who can help. It truly is okay to feel down about diabetes, but when you are feeling that way all the time and it’s affecting your day-to-day life, there is help.

When I find that the scales are definitely tipping that direction, my first port of call is my friends with diabetes. They never make me feel crap for not being positive. They certainly don’t feed my misery, but they do remind me that this is hard and that it is perfectly understandable and acceptable to have negative days. And closer to home, my husband knows that I don’t need a pep talk, or to be told to snap out of it, or a reminder that life could be worse. He tells me that diabetes sucks while passing me some chocolate. Smart, smart man.

I have come to learn the signs of when I need more help than that, and have a great psychologist I can link in with when I need to. I can’t tell you how much this has helped me. One of the first things my psych said to me was that it was okay to grieve my old life, and to feel that diabetes sucked. Being given permission to feel down at times felt like being able to breathe again.

And here’s the rub: knowing I don’t have to be Ms Positivity all the time – and saying just how hard things can be sometimes – actually has made me far more positive in the long run.

*I was talking about this with my beautiful friend Georgie yesterday. She is one of the first people I turn to when I am having a shitty diabetes day and we spend a lot of time just talking about how hard it can be. Her advice is always spot on. Or there is no advice – just an ear and a shoulder and a coffee date.  As we were chatting, I said the thing about it being okay to not be shiny, happy people all the time, when I realised (and told her) that REM reference was from before she was born. Oh, how we laughed and laughed. And then I felt old.

Right here, Georgie and I ARE being shiny, happy people.

The other day, I was standing in a noisy café, waiting for my take away coffee to be ready, not really paying attention to anything, other than a tree I could see that had what must have been Melbourne’s first promise-of-spring blossoms. Suddenly, a loud noise dragged me from thoughts of warmer weather and not needing to wear fifty layers of black to leave the house. The man standing next to me turned his head and I caught him looking at my phone.

‘Your Dexcom is wailing,’ he said to me.

‘Indeed it is, needy little shit,’ I replied, after I got over my surprise at his comment. Usually people just look annoyed at the disturbance.

‘So…you’re one of us?’ I asked him, pointing to the pump I’d just noticed on his waist band.

‘Yep. Hi! I’ve never, ever just come across another person with diabetes in a café or just out and about,’ he said. ‘Have you?’

‘Ridiculously regularly in the last few of months,’ I replied, and told him about the mum of a young woman with diabetes at the airport lounge, the security guard at the airport in Amsterdam who referred to me and my travelling companions as a ‘diabetes club’, the woman talking about Libre in my favourite local café, and now him in this café near work.

‘Maybe stay away from airports and cafes. That seems to be where PWD congregate,’ he helpfully suggested.

At that exact moment, my pump beeped its on-the-hour alert that it was sitting on a temp basal rate.

My diabetes-in-the-wild mate looked at me, his eyes narrowing. ‘Now your pump is beeping. Oh – are you looping?’

I was more than a little startled at that one. The noise my ancient Medtronic makes on the hour is not loud at all – three little beeps to gently remind me that a temp basal rate has been activated by Loop. ‘Wow,’ I said. ‘Your hearing is next level. And yes. I am.’

We did the usual diabetes stat check: length of time with diabetes; age of diagnosis; things that drive us nuts; inventory of our diabetes devices; a couple of amusing diabetes anecdotes. ‘I pulled my pump line out on the door handle of my office today,’ he said. ‘Have you ever done that?’  I laughed. ‘No – don’t be ridiculous! I am a smart and clever and always paying attention person with diabetes. Of course I’ve never done that… And by never, I mean once every couple of months for the eighteen and a half years I’ve been pumping.’

My Dexcom fall rate alert wailed again. ‘I’m ignoring it. Hoping it will go away,’ I sighed. ‘Yeah,’ he said. ‘I’ve been doing that with diabetes for the last 32 years.’

We looked at each other and mirrored in his face was the same expression I knew I was wearing – slight defeat, but also defiance. It’s the default expression that so many of us living with diabetes wear when we are feeling a little over it all.

The barista handed me my coffee, and juggling my phone and coffee and umbrella, I turned back to friend. ‘Lovely to chat,’ I said to him. ‘Always nice meeting one of my tribe.

‘Tribe? Is that what you said?’ he asked.

‘Yep,’ I said, a familiar feeling washing over me: The ease and comfort of talking with someone who absolutely understands. In the place of making our own insulin, we make connections. And I was reminded, once again, how these chance encounters, along with the time I get to spend with my friends who have diabetes, sustain me.

Find your tribe. Love them hard,’ he said. ‘Isn’t that how it goes?’

I nodded and took a deep breath, raising my coffee up to him as I started to leave the café.

‘Yes. That’s exactly how it goes.’

Blossom…

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