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[IP] recent diabetic and "psychological crap" [long]

Hi Michelle,

I've been offline for awhile, just now getting back to reading email.  My
apologies in advance to all if this is long, and in particular if it's blunt.  I
tend to be blunt about things that make me angry, and I get angry that we all
have to deal with this disease.

(...And having caught up a little further on my digests since drafting this
mail, I see you've decided to move forward.  Good luck!  I think you'll find
it's worth it....)

>>>Wondering if those who are pumping have been diabetic for a long time.

I was diagnosed at age 18 -- 17 years, eight months, and 16 days ago.  Give or
take... :-)  I started on the MiniMed 508 last November, three and a half months

>>>... I was diagnosed just last July and I think my
hold up is that I just went through all the crap you go through when you
first find out and I'm afraid to go through some of that again after getting
the pump.  So I guess my hold up is being afraid of the psychological

Look at it this way.  The pump is currently *the* best answer to the problem of
tight control (barring transplants?).  Using a pump gives you the best shot at
avoiding complications.  Eventually, as more and more doctors learn about it,
the pump will become the first line of treatment for newly diagnosed Type 1s.
Sooner or later, your medical team (current or future) will suggest you make the

I submit that it might be better (tho' not necessarily easier!) to make the
switch now, while you still have fresh in your mind how it felt and how you
coped with your diagnosis.  The longer you put off switching to the pump, the
larger and more scary the psychological crap will grow in your mind, the longer
you'll put it off, and the more risk that you'll start running into
complications that could be prevented with the tight control a pump provides.

When you have a cut or scrape, are you the type of person who peels the
Band-Aid(tm) off slowly, a hair at a time, or do you grit your teeth and rip it
straight off?

>>>What are the psychological aspects of going on the pump? Did going on the
pump bring back any emotions you had when first diagnosed?

I didn't have any emotions when I was diagnosed.  None that I remember feeling
or showing to anyone.  I was in the hospital for over a week, where they showed
me and told me what I had
to do and eat.

My parents didn't get involved -- I was 18, and an adult, and therefore capable
of managing things on my own.  Other than asking me what and how much I wanted
for dinner, and letting
me know 15 minutes beforehand so I could take my shot, they stayed out of it.  I
went through all the motions, testing my blood sugars (but using visual-read
strips for far longer than necessary after meters came out) and taking my shots,
but I never really managed my diet the way I could have or should have.  I'm
sure it looked to most people as if I knew what I was doing... but I didn't.  I
lived a fair amount of time in my own form of denial.  I was lucky more than I
was in control -- I had a somewhat lax endo, but reasonably good A1Cs, and to
date I have no complications (fingers crossed, prayer heavenward).

Long after my diagnosis, my parents told me that the nurses on the floor were
worried about me, because I wasn't showing any of the usual reactions, anger,
grief, denial, etc.  Other than one nurse who went walking with me one afternoon
to figure out what I was thinking and feeling, no one really did anything to
suggest some kind of counselling.  And I was 18, so I was  perfectly capable of
managing, thank you, and didn't need any help from anyone....

I'm currently under treatment for depression.  I do *NOT* believe switching to
the pump *caused* the depression, but I think it acted as a catalyst to bring
out a lot of stuff I've had carefully hidden away behind closet doors in the
dark corners of my brain.  Making the transition has been difficult for me, no
question.  It's more work than what I was doing before, but most of that is work
I *should* have been doing anyway.  And *that's* what I have to face --
accepting that part of diabetes, not accepting the pump.

I now have a great team -- dr, CDE, dietitian, and a counsellor who is helping
me work through lots of psychological crap (I like that term!) that I've had
carefully bottled up all these years.

I'm still measuring food and tweaking basals and boluses and learning how
different things like exercise and foods affect me, and my CDE has told me
several times that that will continue.  Every day is different.  But every day
on shots is different, too, and far more stressful.

If I had it all to do over again, knowing what I'd go through... I would still
choose the pump, and I would do it much sooner.

If the pump hadn't triggered what I'm going through now, something else would
have, most likely my first bout with serious complications.  And now I have more
freedom than I did
before.  I can sleep late if I want to, without having to feed my insulin.  I
can skip a meal if I'm not hungry.  I don't have to worry about business trips,
or snowstorms, or vacations with friends who have to work around my meal

They'll pry Max out of my cold dead hands before I go back to shots.

>>>I still hate all the crap that we have to do, I still do it, but I
hate it.

I hate it too.  I hate it more now than I ever have, especially since I'm now
really living with diabetes, instead of denying it.  But the way I see it, I
really have only two choices:

1) Deal with it, cope with it, cry and scream and rage at the heavens every so
often, lean on family and friends and IP as needed... and then keep on living.


2) Pick out a nice pine box and a tasteful headstone.

I'm not ready to pick option 2.

Ask your medical team if they can refer you to a counsellor who can help you
with the emotional side of living with diabetes.  Ask specifically for someone
who specializes in patients with chronic illness, or, even better, someone
experienced with diabetes.  Get them on board when (before!) you start your
training and prep work for switching over to the pump.

Then... tear off that Band-Aid.  We'll be here for you, and with you.

-- Cathy

P.S.  Next time I cry myself to sleep, someone remind me I wrote all this...?

Cathy Lavey
"Living in the laidback lane...."
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