Disordered?

I read Lee Ann’s post today about National Eating Disorders Awareness Week and it stuck with me. Not because I’ve experienced diabulimia, but because, even though I’ve not, I can still relate to her comments and experiences.

And, like  Lee Ann, I have often struggled to put into words my complex relationship with food, exercise, and insulin. How do you explain a behavior that is clearly detrimental to your health, but so wrapped up in emotions and memories that you do it anyway?

You see, when you grow up with a constant focus on food, your ideas about it become warped. You learn early to see the two very different sides of food. To treasure it as a sarced gift, and to despise it as an enemy. An ice cream cone can be the reward for a hard-earned 82, the punishment for a foolish 23, or the reason for a disappointing 265.

My mom (also a type 1 diabetic) did her best to allow me to enjoy activities that revolved around food. She learned early on how to use regular insulin to cover an extra treat. But I was still taking shots then, so the treats had to coincide with a regularly scheduled injection or meal.

When we had holiday parties at school, I was allowed to choose three pieces of candy to enjoy with my classmates. The rest was packed carefully in my valentine box or my Easter basket so that I could enjoy it later at home. We tested and corrected for the treats before dinner. At Halloween, I trick-or-treated with the best of them and brought home a large selection of goodies. My cousins and friends would devour most of their loot right there on the spot, but I would have three pieces and save the rest. I was allowed three pieces every night after dinner until the candy was so stale I had no choice but to throw it away.

School lunches were always a struggle and I spent many a lunch with my Cabbage Patch Kids lunchbox, gazing with envy at the trays of my friends and classmates. Oh how I wanted chocolate milk, instant mashed potatoes, and canned corn. The food messages I learned in those early school days are burned in my brain. To this day, I can’t bring myself to eat mashed potatoes with corn, breaded meat on a bun, or canned fruit in syrup.

So even at a young age I was learning about rationing food and choosing my treats carefully. I can remember lining up my skittles by color and forcing myself to eat them one at a time so that the experience would last. I ate them in order from least favorite to most favorite: all of the green ones, then the yellow ones, and so on until I reached the best flavor: grape. This habit stems from a suggestion from my grandma one morning over my oatmeal. After she poured the carefully measured ½ tablespoon of maple syrup onto the center of my oatmeal, she suggested that I eat around the edges, working into the center of the bowl to save the best part for last. I took that one and ran with it. I saved the best for last with everything from breakfast to dinner. When I have a choice, I still eat the foods on my plate one at time, starting with my least favorite and ending with my most favorite. And I still divvy up my skittles, jelly beans, and gummy candies by color if given the chance.

In middle school, I learned that if I wanted to eat something extra, I could exercise to burn it off. So I would ride the exercise bike for an hour, or run up and down the steps until I had “earned” a popsicle.

As a teenager, when I was chunkier and stockier than the other girls in my class, I struggled with body image. My doctors said I was healthy, but I was not tall and lanky like my friends. My mom mentioned to me once that the only way to lose weight is to take less insulin. I never omitted the insulin I needed to cover my food, though. I was too scared of the consequences. Instead, I starved myself: no breakfast, a juice box for lunch, and a light dinner. Of course, I couldn’t survive for long on this kind of a diet, and after months of “success”, I would give in to the cravings and binge on pizza or fast food with my girlfriends.

My exercise obsession continued through high school. I played soccer, swam with the swim team, and generally tried to stay active. During one summer, I worked at a day camp chasing kids all day, practiced with the swim team at noon, and worked out with the soccer team in the evenings. All summer. And I existed, most of the time, on that noontime juice box and a light dinner after soccer practice.

In college, my obsession turned to foods and their values. I embraced carb-counting, but I still also relied on the old exchange program. Always counting and weighing and measuring. A half cup of this. 8 ounces of that. How badly did I want that cookie? It was worth two slices of bread. Or two servings of potato chips. Or a serving of ice cream. Was I willing to give up my afternoon snack? To take an extra shot? To run around the block?

It never crossed my mind that these behaviors might be unnatural, or even dangerous. In fact, I was proud of my accomplishments and my ability to “control” my weight. And no doctor ever asked me about my eating habits or feelings about food. As long as my A1cs where good, I was given a clean bill of health and sent on my way.

Today I like to think that my relationship with food is much more balanced. I do not starve. I eat when I am hungry. But I still struggle with my internal dietician. How bad do I want that order of French fries? Could I settle for the side salad? Just this once? I will pour over a menu in a restaurant, considering all of my options. And if I’m trying out a new place, I might scour the restaurant’s webpage first so that I can compare calories and carbs and fat ahead of time. I am typically the last to order at the table and, at home, deciding what to make for dinner is often an epic dilemma.

And when I finally do decide to have the fries, I blame myself for making a bad decision. If my BG is high afterwards, I tell myself that I deserve it. It’s my fault. I made a bad choice. I should have done better.

I’m on better terms with my body now, too, but it is a daily struggle. I am always trying, but it’s hard. Because this damned disease has done weird things to my metabolism, my appetite, and my body shape. It is hard to keep your weight down when you are always hungry. Add to that the fact that I take exorbitant amounts of insulin to cover the food that I eat, and weight loss and a sense of balance are an uphill battle.

I’ve talked to doctors, dietitians, and therapists about these issues over the years, but none of them really get it. We never really dig into the issue, just skim over the top. There seems to be little interest in helping the diabetic with this ongoing issue. When will the medical community recognize the mental effects of this disease on our ability to maintain a healthy perspective on food and body? And, as patients, what would we ask them to do to help us?

Balance

Life is all about balance. That’s one of the little pearls of wisdom that a therapist managed to imprint on my stubborn brain once. And I try to live by that pearl. But it’s hard, especially when you live with diabetes.

It’s hard enough to balance work with life, fun with responsibility, motherhood with career, alone time with together time. But it’s even harder when you also have to balance food with insulin. And exercise with food. And stress with diet. And, and, and …

It’s like walking a tightrope. On your hands. Any little deviation from the expected, and you lose your balance, tip to one side, legs in the air, waving. If you’re lucky, you’re able to recover. You might over compensate and swing in the opposite direction, but eventually, you find your core again, and settle into that uneasy calm at your center. There is relief, because you’ve found your equilibrium again. And you’re starting to feel better. But there’s tension, too. Because you know that a stiff breeze (or a harder-than-normal workout, or a delayed meal) could (will) upset everything you’ve worked so hard to achieve. Leaving you flailing and reeling from side to side (from high to low) all over again.

And when you fall off the rope completely (because we all do), there is disappointment. Because you’ve worked so hard. Or because you haven’t.

Luckily, we have a safety net of sorts here in the DOC. The descent still takes our breath away, and the collision with the ground still hurts, but the community is here to pick us up, brush us off, and help us climb back onto the tightrope again.

I’ve been unbalanced lately. With all of the changes in my life over the course of the last year, my center of gravity has shifted. No longer sure which way I will sway when I make a choice, I am unsure which direction to go. After a year of carefully avoiding risk — testing, measuring, counting, and testing again — I’ve finally relaxed. And with that relaxation comes a bit of sloppiness. Wobbly food choices and uneven BGs. Increased A1Cs and higher averages.  Perhaps even more interesting, though, my interests are expanding, too. I have long had a passion for technical communication (my career), but I’ve also long had a passion for medicine, especially diabetes. Until I started this blog, though, I had little way to express that passion. Of course, I’ve also developed a surprising passion for motherhood. I always thought I was a “career girl” and I think I still am, but I am struggling to find a way to fit all of my many passions into my life. I guess you could say that I am at a fork in the tightrope. Is there a way to balance my many interests? If not, which way will I go? And how long will it be before I find my uneasy center again?

On becoming a lurker (again)

It’s been nearly four months (!) since I last posted to this blog. And I’ve stopped commenting on the DOC blogs that I read. I’ve even stopped reading as frequently … my reader is woefully stuffed with blog posts that I have failed to read. I’ve given up on cleaning it up.

In fact, I’ve sat at the computer several times with my mouse arrow hovering over the “mark all as read” link. But then I couldn’t do it. What if I missed a valuable nugget? Like the fact that Saffy’s little “D” now loves to dance and is sprouting teeth at an amazing rate (http://www.t1mommy.com/2010/12/17-months.html).  Or that Annie is “rolling” into the home stretch of her pregnancy, feeling the ever-present feet of her little one under her ribs, wiping ultrasound goo from her maternity tops (been there!) and preparing for weekly ultrasounds. Or that Jacquie treats middle-of-the-night lows with gummy candies (color me guilty; there’s always a stash of these on my nightstand and I have, on occasion, found one roaming around in the bed the next morning). Or that a number of great-sounding conferences are just around the corner, including the Diabetes Sisters Weekend for Women Conference and the CWD Friends for Life Conference which will, for the first time, offer a dedicated track for adults with Type 1.

Where did the time go? I miss you guys! What’s a new mom to do?

One of my goals for the new year (I hate the word “resolution”, it makes me break out in a cold sweat) is to figure out what to do with this blog. Lee Ann was right when she pointed out that her friends who have children are “different” after entering parenthood. I am different now, too. But how? I don’t know that I can formulate the words to describe it yet, but there is a difference. My priorities have shifted. My interests are changing. Who am I and what am I becoming?

As I am struggling internally with this identity crisis, I am struggling externally through this blog. No longer the “pregnant type one”, I am not sure what my role in the community is. What do I have to contribute? How are my experiences or insights any different from those of the all of the other writers in the community who communicate our ups and downs so much more eloquently than I do?

Clearly this blog needs an overhaul. From the URL, to the title, to the topics, it needs to go in a different direction … or maybe several different directions. And so do I.

Any suggestions?