“The thing about hiking the Pacific Crest Trail, the thing that was so profound to me that summer—and yet also, like most things, so very simple—was how few choices I had and how often I had to do the thing I least wanted to do. How there was no escape or denial. No numbing it down with a martini or covering it up with a roll in the hay. As I clung to the chaparral that day, attempting to patch up my bleeding finger, terrified by every sound that the bull was coming back, I considered my options. There were only two and they were essentially the same. I could go back in the direction I had come from, or I could go forward in the direction I intended to go.” – Cheryl Strayed, Wild
When I wake up this morning, the last thing I want to do is prick my finger.
That is also the first thing I do.
A drop of blood blooms from my flesh, is sucked up by the test strip like a hummingbird’s nectar. Several heartbeats pass, pulsing at the tip of my index finger, while the meter numerates me. 212 ml/dl– too high. I swing my arm over the side of the bed and dig through my purse to find my insulin pen. A few flicks of the vial to unsettle the air bubbles, a 1-unit air spray to make sure the needle is clear. Insulin smells like melted band-aids, and now so do my sheets. I dial 2 units, inject into the tender fat tissue several inches left of my belly button.
New needles glide through the skin so delicately, so precisely. I should be kinder to myself, re-use needles less often. Maybe I would bleed less; maybe my stomach wouldn’t be speckled with jewel-toned bruises.
Already two needles today, and my feet have yet to touch the ground.
I grab my laptop and flip it open, still cocooned in blankets. The sky is too dark, the air too cold and still. It’s a morning for lingering.
My Facebook feed is a winding river of people I haven’t seen in 7 years, posting about their babies and nursing school and what a wild time they had last night at Big Woody’s. When I stumble upon an article by NPR: Tight Control of Type 1 Diabetes Saves Lives, But It’s Tough, I almost don’t read it.
I’ve read a million articles about the importance of tight blood sugar control in correlation to long-term health effects. They make me feel like shit. They stress me out. If you just maintain a steady stream of blood glucose levels between 80 and 130, they coo, then you will be more likely to avoid complications. Click here for a list of 974 complications that diabetics are 8 times more likely to have. But if you just keep your blood sugar in control, they say -quietly wrapping me in a heavy blanket of accountability, guilt, and pressure- you can prevent- or slow the progress- of some of these.
It is the title of this particular article that intrigues me to click on it. But it’s tough. This is the first paragraph:
Here’s more evidence that for people with Type 1 diabetes, strict blood sugar control matters – in this case, it actually reduces the risk of early death. But another study reveals the grim reality: Those with the condition still die about a decade sooner than those without.
I’m dizzy with words I don’t like.
What I find tough is hearing that regardless of how often I try to fill the bowl of my autoimmune disease, 10 years ‘will’ be pulled out from under me like a rug. Perhaps another title for this article would be Tight Control of Type 1 Diabetes Saves Lives, But It’s Not Enough.
What can I do?
God damnit, what can any of us do? What choices do we have?
It is so profound and yet so very simple.
No escape or denial; we have to go forward in the direction we intended to go.
In the face of fear, of complications, of years hanging in the balance, I have to keep going. I have to keep doing the things I least want to do, because the things I most want to do depend on it. Like living, for instance. That’s something I like to do, and something I wish to continue to do.
Good health is so essential, which seems so obvious, and yet sometimes I still forget. Sometimes I just try to glide by, not bolusing for my meal before I eat, or even right after, or rationally knowing my blood sugar is too high to eat the doughnut, and eating it anyways. It feels damn good to put the middle finger to diabetes sometimes. It feels damn good to not do the things you hate doing.
But then, my blood sugar is so low that my bones quiver, or so high that my chest feels full of hot lava, and guilt and fear are seeping through my pores and I am once again confronted with the ways I least want to feel.
The ways I least want to feel are worse than the things I least want to do.
After I finish reading that article, I close my laptop and pick up the recycled glass jam jar that sits on my dresser. It holds my daily routine items: makeup brushes, mascara, strawberry lip balm, and Lantus, the long-lasting insulin I take once daily, at roughly the same time every morning. I dial 24 units, pull the right side of my pajama pants down, and inject into the pinched flesh of my right hip. Countdown from 10 and release.
3 needles before breakfast. A decade of my life threatened before I’ve had my coffee.
But. Yet. Still. What can I do?
It seems there is only one option, really.
To do the things I least want to do, to choose to thrive anyway.