I’ve known Val Borbone for a very long time, we worked together a gazillion years ago and she’s one of the hardest workers and most loyal people I know (this is a women who waited years for her boyfriend/fiance to complete his duties in Iraq in a long distance relationship before he moved here from the UK to be her soul mate and husband forever). Val also wrote a diary every day of her life for years before facebook came on the scene, she has some fascinating stories to share. She’s brave and strong and is also an incredibly successful business women and co-owner in her own agency, Zuni. Val’s a working Mum of two beautiful children but her life is vastly different now. I asked Val to share with us the extremities and reality of living with Diabetes. I had gestational diabetes with one pregnancy and I only had it for 9 weeks, it’s life changing and a disease that we don’t give enough time to. Here Val shares the real story of living with diabetes.
In 2008 I was diagnosed with gestational diabetes at week 26 of my pregnancy, discovered at the typical glucose testing period that most pregnant women will experience. I understood that it was common in pregnancy and whilst I was an unlucky one, it would soon go away after the birth of my child. With a reluctant skip in my step, I went to meet a Dietician and Endocrinologist to learn how to manage this temporary condition.
My understanding soon turned to shock when I was put onto insulin immediately. “What you’ll need to do is get yourself a glucose testing kit and start injecting insulin from tonight” said Dr C. “Ah sorry, a what and do what?” After a 30 minute introduction to diet control and an epi-pen device, I was sent on my way with prescriptions to fulfill. Let me make this all a bit clearer for you.
A glucose testing kit is the gear you’ve seen on the TV ads with the tradie – a small finger prick to draw some blood, into the testing machine on a testing strip and voila you have a sugar reading. The normal blood sugar level (BSL) range for non-diabetics is 4-7. My readings were hitting 11-12. I had to conduct 4 tests a day, 2 hours after each meal. The insulin injections were more intimidating. I loaded the insulin vile, screw on a disposable needle, turned the knob to the required dosage, jab the needle into my waist-line and inject the insulin. Simple they said. What a heap of bullshit that was. Have you ever put a needle into your own self? I hadn’t and for the first 15 mins of preparation I baulked at every attempt. I would have been a hopeless junky. I burst into tears just trying to do it before every needle for about a fortnight. I was having 4 needles a day, 1 immediately before each meal and again before I went to sleep. A total of 8 needles a day, I felt like a pin cushion in distress. It also meant I put on weight.
The diet part of my treatment came in the form of counting glucose intake. Most people think that’s pure sugar – sweets, soft drinks, sugar in your coffee etc, but carbohydrate breaks down into glucose, and I was relegated to 2 or 3 “units” of carbohydrate for each meal, depending on the time of day. Think about your usual food consumption and then try putting this into perspective:
1 unit of carbs = 15 grams (find more here)
15 grams of carb =
- 1 slice of bread (17gms) or 1 small bread roll or ½ a muffin
- 1/3 cup of cooked rice/pasta (about 2 tablespoons)
- 10 grapes / nuts / sultanas
- 1 small apple / small banana / ½ an orange / 2 Apricots / 4 strawberries
- 1 teaspoon of sugar / margarine / butter
- 1 portion of red meat @ 150gm
- A glass of milk or small glass of soft drink
Green leafy vegetables were a free food – could consume as much as I wanted. All root vegetables & pulses were all units of carbs. Now think about going to your friends place for dinner, or your Christmas shebang, birthday cake, café meal or just your usual breakfast. Hard much?
I wasn’t allowed to skip meals and I had to have a 1 unit snack in between meals and before bed. I felt like I was constantly eating even when I wasn’t hungry and it bothered me to no end to find something to eat before bed – so I would end up eating a Paddle Pop.
I struggled with the food control at first, but thinking that your unborn child could be born with Diabetes if you didn’t manage it, suddenly provided the strength you needed to main a high level of control. I became obsessed with counting units – I was allowed 3 units for dinner, my favourite meal, which meant sacrifices. Did I forgo any type of carb in my drink (ie flavour) so I could eat more than 2 tablespoons of rice? Definitely skip the bread and focus on the linguini with cream (entrée sized), but no entrée or dessert or coffee or cheese or anything else, I just get the pasta and maybe some seafood in there. Breakfast is definitely the most difficult meal to sustain. Fruit sends you over the edge too quickly and you’re hungry too soon, 2 slices of toast is too high in sugars to breakdown in 2 hours, cereal and muesli are just a joke when you can only have 1/3 cup and a tiny splash of milk to make sure it’s wet.
Going out to dinner felt ridiculous. I’m not a “I’ll have the salad” type of girl. Being Greek, I was all too aware that certain cultures are more prone to Diabetes because of their natural diet – Mediterranean, Middle Eastern, Asian, Indian, South Pacific / Islander – all of us prone to the risk. No more (or any at all) of anything really, my savory tooth unfulfilled and any desire to have chocolate or a jube lolly was crushed. Oh and just to spoil your romantic meal, you have to inject the insulin immediately before the meal remember – off to the bathroom I went as my meal arrives at the table, slowly going cold. You see, you have to wait for your meal to ensure what you ordered arrives, and with the right carbs on the plate. Otherwise you could inject and have to wait for a re-order which will screw with the dosage. That’s how “immediate” the insulin needs to be with your food. Can’t have a Milky-Way as a treat, that’s half my dinner allowance.
To be perfectly honest, Diabetes Australia were useless. Outside of giving me a registration card so I can access needles and testing strips on the PBS, I’ve not heard a single word from them – not by mail, phone, email or mobile, other than asking me to become a financial member. What exactly would I have been supporting if they don’t speak to their actual sufferers and patients? I wasn’t directed to any resources, recipe guides or support networks. Admittedly, their updated website has redeemed itself.
3 weeks later my OB looked me square in the face without any expression and said “oh gosh, with these levels you’ll be on insulin for life, I’ve never seen levels like this return to normal”. He carried on like that was totally normal. Sobbing my heart out with my head down in my hands in his lonely chair, I said stuttering through the tears “sorry, I’m a 32 year old woman and you’ve told me I have to do this for the rest of my life, I just need a minute”. He patted me on the shoulder and said “you’ll get used to it”.
I delivered Angelique naturally without complications, a normal sized baby, 2 weeks early. Managed poorly and Angelique could have been over 8 pounds. She was 6 pounds 13 ounces.
Bullshit number 2 came in the form of the Diabetes not going away after birth. After the 6 week check up I came to the conclusion that my abrupt OB was right, I had Diabetes for life.
The time between pregnancies saw me go onto tablets rather than insulin and it was common knowledge that once on medication, most sufferers will never reduce their dosage and will certainly never be free of it. I hated tablets. They were massive, I mean the size of a medium cockroach, that’s what they looked like, bloody horrible to even push out of their blister pack. Dr C wanted me to pop 4 of them and “come back in 6 months”. I was determined to beat it, so I went on a massive health kick and diet-mania so I could avoid the tablets, but then I fell pregnant again, and back on insulin I was to manage my average 14/15 BSL readings.
I was a lot more relaxed the 2nd time around. I knew much more this time, no more surprises to deal with. But without feeling symptoms, it was difficult to care about the needles. I don’t feel any different taking or not taking the insulin, so skipping it when I fell asleep on the lounge just didn’t seem to worry me. William was born 5 weeks early by emergency C-Section, he was tired from my labour preparation and the BSL was making him lethargic so I didn’t risk forcing him through labour and they cut me open instead. Great. My worst nightmare come true. William was a nugget, 3.765kg and 5 weeks early – if I went full term he would have cracked 7kg. Thank you Diabetes.
Without a baby to worry about in the womb anymore, I didn’t take any insulin for 3 months following William’s birth (he’s 9 months old now). My GP has scared the pants off me with the cold hard truth to encourage me to prioritise myself – I never seemed to have time to eat, let alone every meal, or to inject on time. Bath or bed for the kids, or dinner for my husband, cleaning the house, putting the washing on / sorting it, feeding the dogs or just going to sleep – all of these things were my priority. Without symptoms, what could possibly remind me that I needed to do this?
“Well when you have kidney failure, think of your children driving you to dialysis every week. Dialysis is where your blood is removed from your body, put through a filter and then pumped back into your body. 5 hours per session. Nice. Your eyes can suffer retinopathy, the retina at the back of your eye being damaged. Nerve disease can cause lower-limb amputation. Higher risks of heart disease, blood pressure and cholesterol. Less than 10 years. Is that enough to make you a priority? Don’t put your kids through watching you do this to yourself.” Just the kick up the ass I needed.
My boss said to me, “it won’t be until you stop fighting it and accept it that you will come to terms with it, don’t be its enemy, become friends with it”. Right at that moment I became friends with the needle and just got on with the job and stopped thinking about it so much. That bended ear let me turn a big corner. A life changing corner.
You can beat it
Today I received my HBA1C reading, your average BSL over the last 3 months. In August 2011 before my GP shock, it was 8.9. As the sole income earner in my family (my husband is a brilliant stay at home dad and I work full time in my own business), I can’t secure Income Protection Insurance with a reading >7. Today’s reading was 6.9. I got in the car and cried with a smile. I had done it. I had finally found some type of optimum level to manage this shitty disease, the motivation of my children, the control to count carbs, the discipline to maintain the needles with accuracy, the persistence to remain positive in light of so many life changing instances. My life was changing forever and some days I hate it, but there’s never a day I don’t think about it. It took nearly 4 years, but I hope that I’m now on a clearer path to do this for the rest of my life without begrudging it. I still have 4-8 needles a day but I can see the progress I’m making.
I know I don’t have cancer or a hundred other horrible diseases that so many people suffer from, but next time someone says they have diabetes, give them 5 minutes to grieve their condition, it might just be the corner they are trying to turn.
Diabetes is preventable and in some cases, curable. You can beat this. But you have to work bloody hard to get there:
- Cut yourself a break and dedicate some real time to researching what works for you.
- Try different combinations of food to achieve different results
- memorise carb units of your favourite foods to make it easier to manage – you don’t have to completely miss out, but you do have to sacrifice one for another and the quicker you can make the decision the sooner you’ll accept what you have to do.
- Food prep can also alter carb units – for example, a baked potato is different to a boiled / roast /mashed one.
- Exercise at some point each day, even if that’s housework, do something to burn some of the fuel you put in your body – which can lead to lower insulin intake.
- Think of those long term affects that you truly don’t want to suffer through
- discuss how you’re feeling with your partner and how they can help you
- Be diligent with your medication
- Don’t be afraid to see a Dr that you connect with to provide the support you need