As I put in one of my posts, I am interviewing people with special conditions once a month from now through Spring. Since no one spoke up, I handpicked a few for now. I will make this statement regardless of who I interview: The views expressed by those I interview may or may not be the same as the views of Totally Fit 4 Life or myself. These individuals were chosen based on conditions of interest to my readership, lifestyle with the condition, and their faith. The views presented here are their own.
This month's focus is on a young public relations professional working business-to-business. She was recently promoted to the head of her department. She belongs to the PRSA a professional organization, as an adult in Public Relations,and was featured in the Cleveland Plain Dealer in the February 1, 2015 Lifestyles section. She is also married. This young woman balances a lot of things while managing Type 1 diabetes. She is my youngest daughter, Rachel Kerstetter.
Rachel was diagnosed with type 1 diabetes at age 22 in the Spring of 2011 almost immediately after her wedding. The triggers may have been stress-related. She was working, finishing projects to graduate from college, planning her wedding, and her dad was dying. She felt absolutely awful, ending up in the emergency room. Her blood sugar count was dangerously high. She was sent home with no training from the hospital how to take care of her autoimmune condition, just insulin and a sheet of paper. It was rocky at first, but she has it under control now. Here's Rachel:
You are a young adult, married, and have a full-time career. How do you balance your diabetes care with these parts of your life? How does it affect your husband? How does it affect your work?
Diabetes is kind of like having another full time (or rather all the time) job and an unwanted gremlin as a companion at the same time. But there is no other option but to handle it, I can't quit nor give it away. Accepting that made it easier to balance. I don't know that there is a good way to say how to balance a chronic condition with "normal life" because every person with diabetes has to care for it differently.
Diabetes is tough on my husband, he worries about it when I travel, he's made me eat when my blood sugar is low and I can't seem to make myself do what I have to. He's my best supporter and an advocate for better understanding of diabetes, however for as much as he tries to understand, there are aspects of living with a chronic health condition that just can't be grasped without living with it. My pancreas stopped working very shortly after we were married, so he learned to live with it as I learned to live with it.
Balancing a career and diabetes has been a delicate dance. Most people who live with a disease as stigmatized as diabetes have to decide whether to disclose their condition and if they do, when. Everyone who works closely with me knows that I have diabetes, I was hospitalized shortly after I started at my current company, so I drew the concern of many. What I appreciated was when my colleagues have asked what they should know. My clients are another story, I deal with enough issues being young and female in my industry the last thing I need is to be seen as a sick person. In general, I do what I need to do as discretely as I can. I test when I need to, eat when I need to and do my job as well as I can while grasping every opportunity to learn and grow.
What is the difference between type 1 and type 2? When were you diagnosed?
There are several types of diabetes, more than just type 1 and type 2. Type 2 diabetes is the most common type of diabetes and it is caused by the body's inability to use the insulin it produces (known as insulin resistance), although it's linked to lifestyle factors such as weight, there are other factors including genetics and previous occurrence of gestational diabetes.
Type 1 diabetes (formerly known as juvenile diabetes) is the body's inability to produce insulin. It's caused by an immune system attack on the beta cells of the pancreas. I liken it to organ failure to many. Although it's often diagnosed in childhood, it can happen at any age.
There is also a type of diabetes call Latent Autoimmune Diabetes in Adults, called LADA or type 1.5, this is a slow progression of type 1 where the immune system is slower to kill off the beta cells, many with LADA are misdiagnosed and mistreated as type 2. Here's a link to a resource on some more diabetes basics: http://www.diabetes.org/diabetes-basics/?loc=db-slabnav
I have type 1 diabetes and was diagnosed at age 22. I'd had the symptoms for a couple of months, but no one recognized them, not even my doctor. It was an accidental diagnosis with a pregnancy test that indicated extremely high glucose and ketones. Had they not found it, I would have died. It sounds dramatic, but often people don't consider diabetes to be serious.
How has this affected your faith?
My diagnosis gives me a strong sense of purpose for my life, God wants me here. There were and are days when I want to know why, why, whhhhhhhhhhhhhhhhhhhhhhhhy me? But He doesn't give us more than we can handle, so I have to trust that He created me with what I need to handle it.
What do you have to do to balance your carb intake and your insulin? How do you inject your insulin?
My insulin to carbohydrate ratios throughout the day vary because every body is different. Thankfully I have access to the technology that helps me manage my diabetes, I use an insulin pump (mine is tubeless but some have tubes). Basically, I have to take insulin two different ways, my pump is programmed to give me a basal rate of insulin, which is basically likes consistent small doses of insulin given to me all day every day to keep me stable. The other way I take insulin is in a bolus, that's when I take the insulin to cover the carbohydrates that I'm going to eat or to bring a high blood glucose level down. Insulin has to be taken subcutaneously, for some that's with an injection and for others that's through a pump. When you use a pump, you insert a small tube under your skin.
How does exercise affect your blood sugar levels?
In general exercise lowers blood sugar levels. Regular exercise has a stabilizing effect on blood sugar as well due to how it impacts metabolism. And because nothing is easy with diabetes, post-exercise high blood sugar resulting from the natural hormone responses and your body trying to give you more fuel. Glucose, or sugar, in your body is fuel and you have to have the right amounts of insulin (which is a natural human hormone that I have to take a synthetic version of) to turn the fuel into energy.
When you gather with family and friends for holiday celebrations, what foods can you eat and what should you avoid? What is off-limits or limited?
Holiday gatherings almost always center around food or some sort and still pose challenges to me at times,when it comes to making decisions and the actions of others. Since I need to know the carbohydrates in my food to take the right amount of insulin, I usually have to guess when someone else has made the food. I try to balance protein, carbohydrates and fats. Both fat and protein impact how quickly carbohydrates break down into my blood stream, which can change when I take insulin. And of course there are sweets, which are not off limits to someone with diabetes. I just have to be smart about what and how many I eat. No food is off limits to a person with diabetes unless they are allergic to it! And just because a food is considered "healthy" doesn't mean I can or should eat it at different times, A lot of people want to give me fruit for dessert instead of cookies, cake or whatever else is being served. But the problem with most fruits are that they have a lot of natural sugar without anything to stabilize it, so it can cause me to spike then plummet which makes me feel ill. Often having a small piece of baklava (a holiday family staple on my husband's side) is better than a bowl of grapes because the proteins and fats in the nuts slow the breakdown of the carbohydrates in the honey and pastry in my system.
I'd advise you to not scold or judge a friend or family member who you see enjoying a treat because you don't know how carefully they planned their diet and/or medication that day with the plan to enjoy that treat.
I know you don't normally talk about alcohol on your blog, but it's another element that many encounter at the holidays. I can have alcohol as a person with diabetes over the age of 21. But I have to know how it impacts me. Many cocktails have sugary mixers that I tend to avoid and I don't like "diet" beverages so I don't do cocktails with diet mixers as some choose to. I typically opt for a glass or wine with holiday meals, usually it's best to have alcohol with food and obviously not over do it. Because the liver processes alcohol, the moment you start drinking it, your liver stops producing glucose in favor of processing the alcohol, which means a person with diabetes needs to be aware of the possibility of experiencing hypoglycemia, or low blood sugar.
How do you handle people who push food at you that you can’t or shouldn’t eat?
Having diabetes has actually given me a new freedom when people try to feed me things. I used to feel obligated to try a little bit of anything someone offered me out of politeness. No one, diabetes or not, should ever feel obligated to eat food they don't want to or shouldn't out of politeness. A simple "no thank you" is a polite way to turn something down, other variations are, "that looks good, I might have some later" (if it's true) or "thank you, but I can't". That also means I'm only eating food that I like.
At one of my in-laws family gatherings that my husband's great grandmother hosted, she baked a sweet potato just for me because she had made a sweet potato dish that contained a lot of sugar.
You are slender with diabetes. Does this cause problems or confusion with people?
When people find out that I have diabetes I get questions like, Did you used to be fat? Did you eat a ton of sugar as a kid? Or How can you have diabetes, do you take care of yourself? This stems from ignorance about diabetes of all types and furthers the stigma that people with diabetes have to deal with. November is diabetes awareness month, which means it's a good time to learn about diabetes and make a conscious decision to stop supporting negative stereotypes.One of the symptoms of diabetes (both type 1 and type 2) is actually unexplained weight loss, I lost 25% of my body weight during the time between when my body stopped producing insulin and my diagnosis.
Is there a particular memory you’d like to share over the time you’ve had diabetes?
I don't really have a particular memory to share. I've been proud to be able to help show the face of diabetes through articles with my local paper, Mashable, my blog ProbablyRachel.com and even diabetes-focused magazines. I've been able to help others with diabetes figure what questions they need to ask to find better treatment and educate strangers. I think one of the hardest things for anyone living with a chronic illness is feeling isolated. Often we don't have people in our offline lives who have the same problems we do, support groups and online communities can help break that isolation, and if I can help someone feel less alone by talking about diabetes, it's a good thing.
You can follow Rachel at www.probablyrachel.com.She is also on Twitter and Pinterest.
Many blessings to you!
For information, go to www.diabetes.org.