Wednesday, October 26, 2011

National Health Blog Posting Month!

Last November, during mid-terms, GRE preparation, application sending, finals preparation, and an overall academic monsoon, I (accidentally) took place in NaBloPoMo. Last April, heading into finals, I was a loyal HAWMC-er (hammocker if you’re nasty) and, what do you know? I won

Following with tradition, this November as I finish midterms and head face first into finals, I’ll be taking part in Wego Health’s National Health Blog Posting Month. For more information and to sign-up and get the blog prompts e-mailed to you by week's end, follow the link. I look forward to blogging on some great topics with all of you! 

Wednesday, October 19, 2011

Love Your Body Day 2011

I’ve eluded to and carefully tiptoed around this before, but it’s about time I just said it: 

My name is Ashley and I’m recovering from an eating disorder. 

I would be considered “healthy” by any specialist you ask, but I will always be in recovery. It is always in the background waiting to sneak back up on me .

When I was little, I knew I was smart and I knew I was pretty. If you asked my teachers or parents, they’d tell you I was confident. As I got older, the teasing started. I’d hear that I was stupid, fat and ugly most of the day. My parents tried to impress upon me that boys were teasing me because they liked me, but I thought they were full of it. Once I hit middle school, the girls started teasing me too. And it never stopped. There were days I’d fake sick so I didn’t have to go to school. There were days I’d sit in the parking lot of school crying my eyes out because I was so afraid to walk inside and deal with the torment. Mom would tell me they were teasing because they were jealous and it was best to ignore them. I thought she was full of it and was just saying that because she was my mother and she had to. When you add that to the preprogramed insecurity and suffering self-esteem of the teen years it was a recipe for disaster. Sure, I had my group of friends but my high school was 45 minutes from my house so I went to school, went to my after school activities when I had them, and came back home to my safe place where I was alone with my thoughts and viciously scribbled down angst-ridden poetry for hours at a time just to try to clear my head. 

When I started college I left the teasing and name-calling behind, but the damaged self-esteem came with me. I thought everything I’d heard all those years was the truth and I hated myself more than any of the people who were teasing me did. It was in that weakened emotional state that I got into an emotionally abusive relationship and not only did I not see it, but once I did I couldn’t seem to pull myself out of it. The worse he made me feel about myself, the more I couldn’t believe anyone would even want me, and the more i felt like that, the more I held onto him so scared that he’d realize I wasn’t worth it and walk away. And he knew it. He knew that the worse he could make me feel about myself the more control he’d have over me. 

The summer after my freshman year of college, I joined the gym. The mental benefits of working out were almost instantaneous for me and soon enough I found that my outlet had become my addiction. The more stressed out I got, the more time I spent at the gym. The more time I spent at the gym, the worse I’d feel about myself when I couldn’t put in 4 hours at a time. The more weight I’d lose, the more I’d hear “you look great,” and the more I’d want to lose. I’d watch everything I ate. When I started taking chewable calcium supplements, I counted the calories. I was restricting my eating for months at a time, and there’d always come a point where I couldn’t keep it up anymore - the stress and the temptation would be too much - and I would completely binge on whatever I could get my hands on. I’d feel guilty, ashamed, weak, inadequate, and the cycle would start all over again. 

Within that emotionally abusive relationship and drowning under the stress of my course load and honors project at school the one thing I could control was how I looked. I could control what I did/didn’t eat, how many hours I spent at the gym, and what I wore. I could make everything look fine on the outside when I was falling apart on the inside. I lost my fire. I lost my fight. I turned into a shell of myself and I barely recognized who I saw looking back at me in the mirror.

It was a rude awakening when I was sitting in an Abnormal Psychology class going over diagnostic criteria for eating disorders and realized that I met them. But it was an awakening I needed. School had free services for students who needed help and I went to their office directly from that class in the summer of 2003. 

It wasn’t easy to admit that I needed help, but I knew I was on a dangerous road and could be doing irreparable damage to my body. And I still falter from time to time. I honestly don’t think I was fully on board with recovery until I was diagnosed with diabetes in May of 2008. The way I looked at and utilized eating and working out changed from being ineffective methods of coping with stress to just another part of a healthy lifestyle and my diabetes management. I do have to be careful - sometimes living a healthy d-life can tangle itself in a disordered relationship with food - but at least I’m aware of that and try to stay alert to when I’m getting obsessive and unhealthy. 

Now? Well now I like myself for the most part. I’d go so far as to say that I’m comfortable with myself and confident. Of course there’s things I’d change if I could but now I have a boyfriend who loves all of those things. I still have my moments of extreme insecurity and moments where I get obsessive and unrealistic about my weight (ie: ZOMG I’M GONNA GET SO FAT IN GRAD SCHOOL!!) but I know how to handle them better. When life gets stressful and things get out of my control I know what I need to do to keep myself as mentally healthy as I possibly can. 

This blog post is my entry into the NOW Foundation’s Love Your Body Day Blog Carnival. For information about the NOW Foundation and Love Your Body Day visit their website

Blue Fridays - 2011

If you were keeping track of things during NaBlPoMo around here last year, you know that I jumped right on the Blue Fridays bandwagon and this year will be no exception. 

From the Facebook Page

"Blue Fridays is an initiative to bring attention to World Diabetes Day, and to advocate and bring awareness for diabetes and the people living with it. Diabetes is more than a national issue; it's a world epidemic. This year, I want to rally the diabetes community to celebrate World Diabetes Day and Diabetes Awareness Month by asking people to wear blue every Friday during the Month of November and on World Diabetes Day (November 14). Please help spread the word"

Saturday, October 15, 2011

Diabetes Angel - One Year

A year ago today the world lost one of the most amazing women I've ever known. Below is a repost of what I wrote about my Diabetes Angel after her service on 10/21/10.

Today I said my goodbyes to a wonderful woman. As I was thinking of different memories I have of her, one stuck out in my mind.

When I was diagnosed just about 2 ½ years ago, I was really worried about what I was going to do over the holidays. We usually celebrated Thanksgiving with her family and her husband had a knack for making meals inordinately fancy.  Turkey gravy was never just gravy – it had to be something I couldn’t pronounce with hidden carbs and sugar that was a nightmare. The first Thanksgiving after my diagnosis, she quietly added things to the meal that she knew I could eat. When I was the only one going for the whole grain options people started asking questions and commenting that I needed to “eat more to get some meat on my bones.” I didn’t really know what to say as I wasn’t quite used to how to explain diabetes to people but without missing a beat, she chimed in and said “Ashley’s a pro - she saves her calories for dessert!”

I hadn’t really been that concerned about how to manage my diabetes on any particular day until last night when I was preparing for today's service. The service in which I’d watch her husband and 8 year old son say goodbye as my mom said goodbye to her best friend, and I said goodbye to someone I’ve always looked to as an aunt.

What would the overflow of emotions do? Would I be high? Or low? Should I have more than one juice box in my purse or would one suffice? Should I have a good source of protein on hand to intervene in case I felt myself getting too high? I loaded every possible precaution into my purse and crossed my fingers hoping there wouldn’t be any blood sugar catastrophes.

I woke up today to 92 mg/dl.

After the service and before the cemetery I was 85 mg/dl.

After the cemetery I was 94mg/dl.

We’ve all talked about moments of blood sugar nirvana before but that wasn’t what happened today. You see, I had my own diabetes angel by my side. The wonderful woman we were celebrating was very familiar with diabetes. Her own father was a T1 and she lost him when he was 52 years old to diabetes related complications. She was only 24 and she was the one taking care of him, giving him his insulin injections, and managing his diabetes near the end. Today she managed mine.

And I felt the entire D-OC holding my hand through all of it.

Friday, October 7, 2011

No D Day 2011!

You know what I love about No D Day? I can blather on and on about what I’ve been doing in school and not feel as though I’m tainting my blog with things no one’s interested in. 

Granted, I don’t expect you to have a vested interest in this but at least today I don’t have to feel bad about putting it out there :)

So... school. I’ve been in for a month. I’ve never been so frustrated, annoyed, and content all at the same time. 

The commute is a nightmare. Administration doesn’t have their act together. I can’t stand 3 our of 4 of my classes, but my clinical experience is what’s saving my sanity. I have 2 of them this semester. My first is on an Inpatient Child Psychiatric Unit which, if you’ve been following along, is exactly the kind of environment I want to be in. As you’re reading this, I’m having my first day of my second clinical experience - on the Cardiothoracic Surgery floor of a world-renowned hospital. 

There’s days when I honestly dread going to class. Administration is a mess and we're getting shuffled around, stuffed into classrooms we don’t fit in, and just getting in each other’s way. My lectures are long and boring - most days I feel as though I just wasted my day when I could’ve just stayed home and taught myself the same material in an hour. But the hospital days? The days I have to get up at 4:30 or 5 am? Those are the days I look forward to. Those are the days when I wake up before the alarm goes off ready and rearing to go and dying to throw on my scrubs. 

Those are the days that let me know that, finally, I’m exactly where I’m supposed to be. 

And I’m happy. 

Thursday, October 6, 2011

The Surgery

When I’ve mentioned my surgery in past posts, I’ve always said it was a story for later because I was very emotional about it. Since having a bit of a breakdown in my doctor’s office during the follow up, I think my head is clear enough to finally talk about it. 

Growing up a lot of little girls dream of being princesses or ballerinas. They dream of being the first woman president. They dream of their wedding and plan the day down to the very last detail. 

I was never that little girl. 

My dream was always to be a mother. 

When you look at my extended family most of the women are childless. For those who do have children, it was never an “oh it just happened” story. It took years and years of trying. 

So when I started having serious menstrual issues at 14 (dizziness, nausea, extreme pain, excessive bleeding - fun!), it was apparent that I was heading down the road to reproductive issues like the rest of the women in my family. 

I was resistant to going on birth control but my symptoms worsened and my mother told me I wouldn’t be allowed to enroll in driver’s ed if I was so dizzy all the time. Needless to say, I went on the pill at 15. And it worked well for me... until it didn’t. My symptoms slowly started to come back and during my freshman year of college, I found myself starting the birth control process once again trying to find another one that would work. 

None of them did. The side effects were extreme, uncomfortable, and a huge pain in the ass so I decided to grin and bear it for as long as I could. 

At 20 I decided to try it again and found myself crying at the drop of a hat. I went back to my grin and bear it technique. 

At 24, I saw a new (male) doctor and through bloodwork and ultrasounds he diagnosed me with PCOS. He was adamant about the fact that if I wasn’t on top of the situation my “old ovaries” wouldn’t yield children and I wouldn’t be able to “do what God intended for me to do with ovaries like that” (see also: quack).  

At 25, I tried some of the newer birth control options and once again, the side effects were severe (nausea, migraines, leg cramping - yay blood clots!) so I went to a surgeon to get a fresh perspective. She suspected that I also had endometriosis. She told me that the only way to confirm that for sure would be to do some exploratory surgery to see what they could find. Call me crazy, but I was NOT ok with the idea of being put under anesthesia on a hunch. She then presented the option of doing monthly hormonal injections to put my body into a state similar to menopause and then use hormone replacement therapy to give me some of my estrogen back. 

Uhm... WHAT?! 

So I’ll admit it. I gave up. I had no hope of this ever getting fixed. I figured the pain would increase until I had no choice but to have a full hysterectomy and that would be the end of it. And increase it did. Every month the pain intensified to the point where none of the pain medications I could take lessened the pain enough for me to even be functional. At times I found myself awake for 36 hours straight because the pain was too great for me to fall asleep. I was stuck in it and there was nothing I could do to help myself out of it.

So when I saw my PCP in June for my physical, I was surprised that she mentioned Mirena. I had always heard IUDs weren’t recommended in women who haven’t had children because there’s a risk of infection and subsequent sterility. My doctor told me the risk was slim and the recommendation stems from the lack of research done on women who haven’t had children yet. Long story short (but still kinda long) she got me to a doctor who agreed to take care of the suspected Endometriosis and implant the Mirena at the same time. 

I’ll spare you the details of the surgery itself. I tweeted and posted about it and my recovery... and my inability to wear pants for a while. 

The follow up visit after my surgery was when I started to get emotional. I don’t know what I was expecting - if I’m being honest with myself, I was anxious and probably expected to hear some bad news. I’d never heard good news in that kind of doctor’s office. I was ready to hear that my uterus had been perforated or that I’d gotten an infection. So when my doctor looked at me after the exam and said: “I’m hopeful that someday there will be a little Ashley clone with her daddy wrapped around her little finger” I just started to cry. In that moment she was telling me that the one thing I’ve always known that I wanted was possible. Despite diabetes and reproductive issues, it could happen. No doctor had ever given me that kind of encouragement before. And in that moment, I had the slightest glimmer of hope. 

And sometimes when you’re a patient, hope is the most powerful thing you can have. 

Yes, this is yet another post that was supposed to be finished and shared back in August. Yay for catching up on blogging backlogs!

Wednesday, October 5, 2011

Lizard Spit Part 2

Now that I’ve owned up to the fact that I owe my health to this handsome devil, it’s time to share what it was like getting used to it. Byetta is notorious for its side effects and my Endo wasn’t shy about letting me know she’d never had a patient experience them as severely as I did. 

Not knowing how I’d react to the Byetta - or even if it would work - I decided to move out of my place and stay with my parents while I adjusted to my new life with diabetes. My Endo decided it would be best to slowly work up to the maximum dosage if it was what I needed. 

I started on 5 mcg. 

I remember the first time I took it. When I was priming the pen I noticed that it smelled HORRID. I think all injectables should smell like cupcakes. I was nervous and kept doing what I call “a swing and a miss.” As soon as the needle touched my skin, I pulled it back. I had 4 or 5 different spots on my stomach that were bleeding before I was actually able to take the plunge and put the needle in. It hurt and I instantly felt as though I was going to pass out from the anxiety of it (side note: there was no education on how to inject - the pharmacist went over the instructions inside the package and sent me on my way). I ate dinner within the hour as instructed but it was a battle - I had no appetite to speak of - and I just felt weird. My poor mother was sitting on my bed with me listening to me say nothing but “I feel weird” and managed not to outwardly freak out. (Mother of the year 28 years running!) As time went on the dizziness increased and I got a touch of nausea. I took it easy for the night and figured that the morning dose would be easier because some of the anxiety surrounding the injection would be gone. 

The next morning, my parents were at work and I was ready to give myself my second dose. That’s when the fun started. As I suspected, my anxiety over injecting - though still present - was much less than the night before. But within 5 minutes of that injection, I was hit with dizziness and nausea like I’d never experienced before. I spent 30 minutes laying on the bathroom floor afraid that if I tried to get up and walk, I’d fall. I managed to get down some toast but the nausea worsened because it wasn't enough food for the dose. The nausea didn’t go away. It was constant and it was vicious and had me wishing I would just throw up so that I might feel better. But that never happened. The nausea just hung there like a black cloud over my head. 

I called my Endo’s office and within 30 minutes she was on the phone. I explained what was going on and she told me that Byetta is notorious for the dizziness and the nausea. She suggested that I try to take it easy and see if the side effects lessened within a few days. Before she hung up, this exchange happened: 

“You don’t have to do this. There’s other options if this doesn’t work for you” 
“If I was your daughter, what would you want my doctor to prescribe?”
“Then I’m going to do it. I don’t care how nauseated I am” 

Every time I felt like I couldn’t stand another day on this medication, those words echoed in my mind. My Endo and I decided to titrate the dose even slower. For the first 2 weeks, I took 5 mcg once a day. For the next month, I took it twice a day. Then for the month after that I took one 10 mcg dose and one 5 mcg dose. Then finally, after being on it for about 4 months or so, I started taking a 10 mcg dose twice a day. 

I was violently nauseated for 4 months. With time the nausea would start to lessen and as soon as that happened, it was time to go up to the next dose. Each time I stepped up the dose the nausea was back with a vengeance. The impact on my blood glucose was remarkable and rapid, but I felt low most of the time since I wasn’t used to those new numbers and my new range. From the nausea I lost 25 pounds in the first month and a half. For a while, it seemed as though the Byetta was making me worse instead of better. But the benefit showed in my numbers and eventually it showed in my A1C.

And it was all worth it because now I’m the healthiest I’ve ever been. 

Clearly I meant to finish writing this and post it soon after I wrote Part 1. Better late than never?