A Little More About Me

Today is the last day of November, recognized as Diabetes Awareness Month. Whoever knew this raise your hand. Anyone? Anyone?

See, it's ludicrous that the only people who actually know about Diabetes Awareness Month are people who are already aware of diabetes. Those of us with it, who live with it every day, minute by minute, are all too well aware. And those who aren't affected... have no idea.

I know lots of people with diabetes who have been posting this month, but their blogs are mostly read by other diabetics, or parents of diabetics. You, dear readers, are mostly (and thankfully) not diabetic. So this is my chance to spread awareness.

Also, it's been almost exactly eight years since I was diagnosed. It was Christmas season, and I remember this because I am a huge fan of baking Christmas cookies, and that year I baked hundreds of cookies and ate not one. For the first and only time in my life, I didn't feel at all like cookies. Or pies or cakes or anything sweet. All I wanted was grapefruit and water. And more water.

As the weeks in December trickled on, I became addicted to water in a way that became obsessive. I felt constantly like I'd walked through the Sahara. My mouth was like sandpaper, my throat like a dried sponge. I needed water in a way I'd never known.

I couldn't leave the house without it, at first just keeping a bottle or two in the car, but eventually having to carry it with me. I had to get up in the middle of church service because I'd run out and needed to refill it from the water fountain as though my life depended on it. I woke in the night to drink.

I lost weight. In less than three weeks I lost 10 pounds. I figured it was the combination of water and grapefruit.... sounded like some diet I'd heard of years ago, and here I was just craving it. I'd given up most other foods, so of course I'd be losing weight.

I suppose I was tired. Then again, I had three children under the age of five, one of whom was only seven months old. What mother of kids that age isn't tired? To top it off, with the last child I'd become very anemic and bled out during delivery and had to get several blood transfusions and have never really recovered. I'm sure if I noticed I was particularly tired, I attributed it to that.

It was my mom, my mom who'd seen my sister go through the very same thing nearly twenty years before, who suggested on Christmas day that I go to the doctor. Just to make sure.

That doctor appointment was brief... I glibbly told my symptoms, sure it was nothing but still concerned because the water thing was getting out of hand and downright disabling. He nodded, said I probably had diabetes, pricked my finger for some blood, tested it and in two minutes my life had changed.

So in a nutshell, this is what I've learned over the past years:

There is an organ in your body called a pancreas. Like the heart, stomach and lungs, it has a specific purpose. That purpose is to produce hormones that control the amount of glucose in the blood stream. When you eat, almost anything you eat, has something in it that can be turned into glucose for your body to use as energy. Sugar is the obvious one, but anything that is considered a carbohydrate - like bread, or corn, or peas, fruit or milk - is high in glucose, but even meats and wine has glucose. The pancreas produces two hormones that regulate the delicate balance between too much and too little glucose in the body. Glucagon increases blood sugar when it falls too low. Insulin stores it when it gets too high.

Diabetes is when there's a problem with the insulin.

There are two types of diabetes. It's surprising to me how many people don't know this, but since 95% of people with diabetes have the Type 2, it's easy for the type 1 to get misunderstood, even though they are really very different diseases.

Type 2, the more common type of diabetes, is when the body can't use the insulin that's being produced. A lot of times an excess of insulin is pumped out by the pancreas, but the cells can't use it to store the glucose, and as a result, there's lots of extra sugar floating around in the bloodstream, damaging all the other organs it passes through like a poison. Sometimes, even though the pancreas is making the insulin, there is a higher need for it and it just can't keep up.

Type 1, which is what I have, is when the pancreas just gives up altogether. Type 1s make no insulin at all, which is why one of the first symptoms is severe fatigue. If the cells aren't getting any glucose at all, there is nothing to use as energy. So it uses its stored fat as energy, hence the rapid weight loss. And water is needed to flush all that extra, poisonous glucose out of the blood stream, hence the extreme thirst.

Despite sharing the same name, the two forms of the disease are hardly the same. Causes are different. Treatment is different. Type 2 might be caused by weight gain, stress, genes, poor diet, lack of exercise, high blood pressure and certain drugs. A type 2 can often take pills that help them to use the insulin their body is already making. With certain lifestyle changes ( which are by no means easy!), sometimes the disease can be put into reverse.

Type 1 is an autoimmune disease that may be caused by a virus that sets off a genetic predisposition. The whole pancreas-dying-thing isn't really the root of the problem. The problem is that the immune system sees the pancreas as foreign and harmful and attacks it. This is why pancreatic transplants haven't been successful in curing diabetes. You can replace the defunct pancreas, but the immune system is going to attack the new one as well, and pretty soon you end up back where you started: insulinless. You can't take pills. There are no insulin pills as insulin can't be processed by the stomach. Pills only help a person's natural insulin to be more effective, and as the type 1 doesn't produce any insulin, the pills are useless.

The only way for a type 1 to control their blood sugar is by taking shots of insulin. Every day. All day. When I first was diagnosed I was taking two shots a day just to stay alive, and then another shot for everything I put in my mouth. Thankfully, I've since gotten a pump that I wear all the time. The pump has a needle that I shoot into my stomach once every three days, and then just stays there, dripping insulin into me all day, more the way my pancreas might. (That photo isn't me, but my pump looks just like that)

Still, it's not a pancreas. It doesn't know what I'm eating, or how stressed I am, or how hard I'm exercising, or what infection I might be getting... all of which increase my blood sugar. All the pump knows is what I tell it. So I prick my fingers ten times a day to test how much blood sugar is floating around, and then I either give myself more insulin if there's too much, or I have to eat something if there isn't enough.

Being my own pancreas is hard work. And tiring. And frustrating. I know sometimes why my pancreas just gave up. It seems like I am always off by something.... there's too much glucose and I'm tired and thirsty and not seeing very well and slowly killing off my nerve and kidney cells, or there's not enough glucose to make my brain function well and I'm fuzzy-headed, dizzy, sweaty, confused, volatile, and headed towards a coma. If I pump in too much insulin, I die. If I pump in not enough, I die. I'm not melodramatic about it. That's just the way it is. It's a tightrope to walk.

But I'm thankful that I've become much more aware of my health since I've been diagnosed. I exercise more faithfully, I eat better, I get medical tests every few months and know that my cholesterol and blood pressure are outstanding, that I'm still anemic and vitamin D deficient (who knew??) and now I can take vitamins for that.  I'm thankful for the advances that have been made in the past twenty years that allow me to live a normal life, with the prognosis being long.

This is a long post, but I wanted to somehow recognize this month, and all the people that I know with diabetes who struggle daily, minute by minute with it. And so that you... if you or someone you knows, starts drinking a lot, going to the bathroom a lot, sleeping a lot, losing a lot of weigh fast... you will know. And you can be the one to save their life. Or your own.

MFA Monday: 1st, 2nd, and 3rd Books

When I was accepted into the Pacific University MFA program, one of my first goals was to read at least one book by each of the fiction faculty before I left for the residency in January. Part of the reason was because I had to list my first choices for advisors, and I wanted to make sure I picked people whose writing style was closer to mine... at least for the first semester. The more personal reason was that I wanted to be able to have conversations with these authors about their books. Now that I've read nearly one of everyone's and sent in my advisor choices, I'm circling back to reading second books.

One of the first books I read was Tayari Jones's Leaving Atlanta. It's a story told from the point of view of three children in Atlanta during the Atlanta Child Murders of the 1980s. I was a kid, then, myself, and so it seemed strange to me that I'd never even heard of the murders.

The book itself is not really about the murders, but about how the uncertainty and terror of that time affected the fifth-graders who were just trying to get through a rough year in their lives.

The thing that struck me so much about this book was the uniqueness of the idea and the way it reminded me so much of the sniper attacks here in the DC area just a few years ago.

In 2002-2003 two men terrorized my town, and the suburbs around us. Like ghosts they picked off their victims, random people walking into a store, pumping gas, sitting on a bench waiting for a bus. From the quiet streets, from nowhere it seemed, a bullet would fly through the air and find it's target, killing these strangers across several counties with no motive, no connection, inciting fear and eventually dictating behavior. Like in the book Leaving Atlanta, school recesses were cancelled, football games postponed, the stores and streets and parking lots like a ghost town. People ran, literally, from their car to their destination if they had to get out. No where was safe. No one was safe.

As I read this book, that fear was palpable again.

The book I'm reading now is The Untelling. Sophomore books are so hard, I think. There is, after a successful first novel, such pressure to get it right again. I think more often than not, the second novel is in general disappointing.

That is not the case in The Untelling. While I'm not finished with it yet (I expect to be by this evening), it's even better than Tayari Jones's first. The writing is better all over... more beautiful and lyrical and haunting. It reads more smoothly, the word choices vivid and distinct. Although it isn't the kind of book that races from beginning to end with a breathlessness, it is still what I would call a page-turner, one that I found hard to put down last night at midnight.

Just this past week, Tayari posted a blog on SheWrites about her third novel, Silver Sparrow, due out May of 2011.  Her article, titled Writing in the Wilderness, is a worthwhile read for any writer, and you should head over to read it yourself. But in short, the post is about her experience writing that third novel, and how, in the midst of the writing it, her agent sent it out to dozens of publishers who all rejected it. With a hundred pages done and an overwhelming negative response, Tayari stopped writing. Why, after all, finish a book no one will buy?

It took a while to get back to it, but eventually she did. This is what she said the rejections did for her:

I also wrote in my journal like crazy trying to remember why it was that I wanted to write this novel. It was a tricky thing because I had to think of why I wanted to actually experience it as an author, not why I thought the book needed to be in the world. What did I hope to get out of the process? Any reward would have to be in my own heart, because I had been pretty much assured that SILVER SPARROW wouldn’t see the light of day.

Oddly enough, this “guaranteed rejection” freed me up. I remembered what it was like when I was a young writer putting words down just to satisfy my own need to write. I started feeling my momentum coming back. I started talking to my friends about the characters as though they were actual people.

When the book was finished, she not only had one publisher interested, but multiple publishers.

There is a lot to be learned from other authors.... from watching their writing progress and following their journeys as closely as they'll allow you. It's good to know as writers that we aren't alone in our struggles.

"I've Already Written The First Page. It's Really Awesome."

The book, the day, and me

In May of 1996, I was still newly married, following my husband's job half-way across the country from southern California to San Antonio, Texas. I arrived two weeks after him, in this city where I had no friends and no job, and nothing to fill my days but a stack of books.

I can't remember too many times in my life where there was nothing to do but read, but we had few things to unpack, and as a teacher I was still a good month away from schools beginning to post openings.

And so, with the warm summer sun already starting, I pulled an old wicker chair onto our deck and began to read. And for four glorious weeks, I did nothing but read. Sometimes on the deck in the glorious colors of the sunset; sometimes by the pool with the wavy aqua afternoon light bouncing off the pages; sometimes curled in the corner of the couch with the rain dripping down the windows. Breakfast bagels, lunch sandwiches, afternoon chocolate covered pretzels... and a book.

Book after book. In this foreign land of San Antonio I was in my own foreign land of Austria and Germany and the bone-yards of Tennessee. I devoured a book a day... 700 pages often times, no doubt; each one a step closer to the realization I would make in less than four months that I wanted to write a book myself.... and seven years from actually attempting that feat.

In those pages I fell in love, was scared breathless, ached and laughed and cried. I disappeared and became someone else.

And then, in a flash, it was gone.

I got a call that a neighbor's baby was sick and they couldn't put him in child care; the father was an anesthesiologist and the mother an ophthalmologist, and neither could skip work. Could I come and care for the hacking, sneezing child?

And so I did. And when the mother came home, creeping up the stairs to find her son, there we were, him and I, curled in a chair in the nursery with a stack of book, reading Mother Goose and Dr. Seuss. And so I was offered a job.

I nannied for three months, until I began teaching English at the local middle school, and then there were other moves and other schools and my own children and life. And somehow, those days of lazing around reading vaporized like dust in the wind.

This past week, my latest novel was done, my school work turned in, my children well and in school. I bought a book I'd been wanting to read forever - not one I should read or needed to read - but one I just plain wanted to read. And on Monday, I did.

Curled in the couch, five hours straight until the kids came home from school, then four hours after they fell asleep, I read. And read. And read. I read Francine River's Redeeming Love. Glorious, indulgent, submersive reading.

What is it about reading that makes me feel so guilty for spending time doing it? Reading and writing... I love them too much for it to feel like a job.

I wasn't going to write a Thanksgiving post today. But then again... maybe I just did.

MFA Monday: MMR mania

True story: I got my new student packet from Pacific University and in it was a form saying I need proof of a second MMR immunization. I must have looked totally stricken, because my husband asked:

"What's wrong?"

"I have to get a shot. The last time I got a shot was thirteen years ago when I had to get a tetanus shot and hurt like crazy! I hate shots!"

Total look of confusion on his face. "Um... you're diabetic, hon. You give yourself shots everyday."

Touche.

So I had to get an MMR shot. I finally sucked up the nerve to call my doctor to make an appointment, only to be told that he doesn't give them.

"Excuse me?" I asked.

"Oh, most general practitioners don't give them. You can try the emergency care center, or maybe CVS or Safeway."

So I proceed to call the pharmacies of every drug store, grocery store, and mass-market warehouse within 30 miles, and no one gives MMR shots!  What the heck? I considered trying to bribe my kid's pediatrician to give me one, since I KNOW he does them.

It turns out the only place I can get the shot is at the county public health clinic. Oh joy.

Our local office is open twice a week, for an hour and a half. No appointments. And a warning on the website not to show up before the doors open.

So I show up, a half hour after it opens, and find one of the last of the 45 seats in the waiting room (Yes, I had time to count how many there were). I was one of the only non-hispanics in the room, and probably one of the few who spoke English. The funny part of this was watching the nurse who came out to call families back and then had to ask the desk clerk to translate. It sounded exactly like this:

"Lopez family? Lopez family?"  No response. So a little louder: "Lopez family?" Everyone just stares at her, so she practically yells, "Lopez family?"  When no one answers, she turns to the desk clerk and says, "Hey, can you translate for me?"

At which point the desk clerk would say, "Familia Lopez?" and a family of three stood and walked to the nurse.

Seriously.

The room was nearly empty when I was finally called back an hour and fifteen minutes later. The nurse rolls up my sleeve and picks up a huge needle, swabs my arm and says, "You've had your flu shot, right?"

Is this a prerequisite now for an MMR?  I say back, "Um, no. I didn't get a flu shot this year."

"Oh!" she says, surprised and somewhat put off. "You want to get a flu shot?"

"Um... no," I say. "Just this one is good."

So she sticks me, hard, and the shot hurts like crazy. It takes about 15 seconds. I then go back out to the waiting room to wait for another 15 minutes until they have the records for me to send to school. So an hour and a half for a 15 second shot. And I had to pay, because while the public clinic doesn't charge for all people on medicare and medicaid, it does not bill people with private insurance.

Nice.

So not all grad school work is scholarly, but it is all educational.

BTW - I was the only one in that waiting room with a book. That hurt worse than the shot.

I'm Not Lazy; I'm Just Busy Setting Things on Fire

I've degenerated far from my daily blogging habits! My five a week posts whittled themselves down to three, and now two, and even that is a struggle sometimes. I feel lazy for not posting every day, but it's not because I don't want to or have something useless to say; I'm just incredibly busy.

I was going to write a post about how, when things are going really well with writing, I don't want to do anything else. Not shower. Not eat. Not go to the gym or pick the kids up from school or even watch TV. When the kids are in bed and I sneak to the basement with the intention of writing a blog post, I always end up opening my WIP instead and working on it until my eyes are blurry. I was going to write about that, but then Kim Derting beat me to it.

So instead, I'll tell you why I didn't get around to blogging yesterday.

I got up, woke three kids up, took the dog out, threw in a load of wash, fed three kids and packed their lunches and hemmed a pair of pants because my daughter's grown six inches since last fall and looks like one of the farm kids on Little House on the Prairie with her too-short jeans. Then, eventually, I got them all out the door and to the bus stop (at different times, because their schools start an hour apart).

I drove 20 minutes to the gym for a workout. This is not normally a Thursday thing, but Monday my son had an ortho appointment (where they changed his rubber bands to orange, which I asked why in the world orange since Halloween is over), and Tuesday I had a sick little girl at home and Wednesday I spent two hours in the public health clinic getting a 15-second MMR shot that I need for school in January (oh you can bet there will be a post on THAT experience!!), so Thursday it was.

I showered. I drove 20 minutes to a store to return a shirt I bought that had a hole in it. I stood in the customer service line for 15 minutes playing Angry Birds on my itouch because I'd forgotten to pack my Nook in my purse the night before. After that, I went grocery shopping, because we were completely without milk. The horror!!

I came home and had time to get the cold stuff put away before turning around (without lunch) and going to pick my kids up at school. One is fifteen minutes one direction. The others are 25 minutes in the other. I played more Angry Birds waiting on them in the carpool lane because again, I'd forgotten to grab my Nook in the ten minutes I'd been home.

All kiddos gathered, we headed to the library, because swim team practice (which is why I picked them up) is 25 minutes in the opposite direction of the house. They crammed down a snack on the way to the library, where we set up shop for 20 minutes doing homework, before we turn around and get back in the car and go to swim practice.

On the way home, at 6:40 pm, I realize I'd forgotten to put the lasagna I'd set out for dinner in the oven. So instead of arriving home to an aroma of Italy, it still smelled like wet dog and Febreze. Fine. We'll have bratwurst instead. I'll pop them on the grill and they can cook while I help the girls with the rest of their homework.

Except we got caught up in rushing up and down stairs, me mostly muttering and faux-cursing my youngest's teacher for giving her an assignment she couldn't possibly do (like finding pictures of her ancestors, artifacts of family importance, pictures of cultural customs our family does regularly, flags and maps of where we hail from....you get the idea)... I forgot about the bratwurst.

Until it blew up.

The whole grill was a ball of fire, and somewhere in there was our dinner...blackened to a crisp.

By now it's almost eight o'clock. I've run out of decent food choices I can make quickly. We have hot dogs. With broccoli and mashed potatoes, because they didn't burn on the grill.

So by the time we eat, I clean the dishes, feed the pup and take him out... it's nearly ten. And yeah... I didn't feel quite like blogging. I did, however, find my Nook and cuddle under electric blankets and read.

So today it's Friday, and I usually do my thankful things. So this is what I'm thankful for:

• That only my grill exploded in a ball of greasy gaseous flames, and that my house is entirely unscathed.
• That my kids were gracious enough to laugh and ooh and ah over the fire, and not complain that we had hot dogs instead of lasagna (my son's favorite dinner) or bratwurst (my daughter's favorite dinner). 
• That my husband has a great sense of humor, and when he got home at eight-thirty he didn't complain about eating hot dogs either, but did ask if I felt lonely enough with him working late that I needed some lame ploy to get the fire department over. 
• That I didn't actually need the fire department.
• Bun warmers. Seriously. I was in the car more than out and sometimes it's the little things that make it all worth while
• That my book is finished. Complete. Done. Revised three times, edited, proofread, beta-read, and done. And ready for it's next step, whatever that might be.
• That my MFA assignment is done and handed in, and now I have the holidays stretching in front of me with little pressure but to make them special for the kids. And that the assistant director wrote me and said, "We got your package. I can't wait to meet you in January."  Small things that make me joyous!

What things made you happy this week?