Thursday, March 3, 2011

Conceding Crazy

As I drove to the doctor’s office, taking deep breath after deep breath, I thought the good news about being crazy is that I get such satisfaction out of the most mundane tasks.  I made it to my endocrinologist appointment.  Throw a party for me!  Driving is nothing to most people.  Me, I hate it.  Driving on the freeway with heavy wind gusts may be a little less appealing to some people but I only got through it by telling myself, out loud, that I was fine and that I would live.  After several positive affirmations I realized the song that was playing was “The Trick is to Keep Breathing” by Garbage.  Well, at least I was still breathing.  Erratically but still breathing nonetheless. 

Can I just say I hate every single day that I had to be involved in that blasted car accident!  Every day I think about the accident.  I don’t always see it happen over and over in my mind but every day some aspect of that day crosses my mind.  No, I wasn’t hurt physically except for every so often my chest is still tender, but I was definitely changed mentally.  And I was already crazy! 

The drive to the doctor’s office has never been easy for me and this time I was particularly nervous since I can hardly be a passenger on surface streets anymore after the accident, but now I had to face the real test.  Can I still drive on the freeway by myself?  Apparently I can.  Maybe it’s a good thing I’m diabetic because there are so many things I have to do without a choice.  Going to the doctor being one of them. 

I arrived only a few minutes early which didn’t give me much time to calm myself before having my blood pressure taken.  It was 130 something over 70 something and the nurse told me it was fine.  I don’t know how fine that number actually is though.  I’ve had better.  So then I sat there rehearsing what I would say in response to my high blood pressure should it come up.  What happened instead was something I thought I was prepared for but in the end not so much. 

Dr:  How are you today?
Me:  I’m fine how are you?
Dr:  Are you really? 
Me:  Ok, no. 

I knew he was not pleased with my A1C test results and the graphs of my blood sugars would confirm that my control had gone from not great to worse.  The conversation immediately went in the direction of what happened?  My lame attempts at sweeping it under the rug came out as me saying stress happened.  And before I knew it I was saying out loud the words I had said in my mind over and over again as a pretend conversation of the truth.  I never thought I would tell him about the agoraphobia that is now interfering with my daily life, the vomiting for weeks before Disneyland, bad readings because I was on vacation, then the accident and never quite pulling out of stress mode once we got home.  Three months of poor diabetes management equals an A1C of 7.8 (it should be under 7) and finally a conversation I knew I needed to have with someone; I just never expected to tell my endocrinologist. 

To make it that much harder to say out loud I was crying the whole time.  He put a box of tissues in front of me as I sobbed out the whole story.  How I have been this way for as long as I can remember but now I can’t handle it anymore.  He was understandably confused. 

First of all, he was trying to wrap his head around agoraphobia.  I told him it was a fear of going out.  He thought my source of anxiety was that I was afraid something might happen to me.  It was hard to explain because a phobia is an irrational fear and this fear is weird and complicated.  He kept asking what I took for it before.  Nothing.  I’ve never told anyone.  I’ve always just dealt with it.  Does self medicating with Diet Coke and fast food count?  Luckily he picked up on the fact that I am always anxious and he asked if I wanted him to give me something for it. 

My mood brightened, the tears momentarily stopped, I finally looked up at him and asked, “You can help me?  I don’t have to talk to anyone else?” 

“I’m not a psychiatrist but I can give you something that might help.” 

I was floored.  I think he was too in a different way.  He said that the data he had made a lot more sense knowing what I just revealed.  The rest of the appointment was interesting.  I felt like he respected me more and listened to what I had to say regarding how to improve my blood sugar readings.  In the past I have said what I see happening on a daily basis and he would either dismiss what I said or tell me that’s not what the data showed.  Which is one of the biggest reasons why I stopped using the CGM (continuous glucose monitor).  With a 20 minute delay it wasn’t picking up on all my lows and I didn’t think the inferences that I was lying were worth all the hassle and discomfort of wearing it. 

I talked about how evenings are my most unpredictable time of day now.  I said I didn’t think it was my basal rates as much as my insulin to carb ratio.  He agreed.  Then I told him I had a hard time adjusting the insulin to carb ratio because a 1:5 ratio wasn’t enough and a 1:4 was too much.  He said he would talk with the Mini Med representative in this area about getting me a new pump even though the one I have is still under warranty.  Getting a new pump is complicated with the warranties but Heath pointed out that the insurance we have now did not pay for my current pump.  The newer model of the Paradigm 522 allows the Bolus Wizard to program insulin to carb ratios in quarter and half increments. 

Then I asked if I could ever get back to a 1:8 ratio because I hate that I’m so insulin resistant and have the ratios I have.  It makes me feel like I’m in the first trimester of pregnancy all over again.  By the third trimester I would be down to a 1:2 ratio or even a 1:1 ratio.  By the third trimester I just stopped eating carbs because it was depressing and I couldn't keep my blood sugar down afterwards.  He said it was possible but it shouldn’t be my goal.  I’m not a math whiz by any means but I understand the numbers associated with diabetes and I hate mine. 

I told him I’m frustrated that I can get perfect results one day, do the exact same thing the next day and it doesn’t work, then another day the exact same thing works too well and I’m low all day.  I told him I don’t know how to control the unseen variables and it gets frustrating.  He pointed at the prescription he had written for me and said that maybe if we can get the anxiety under control everything else will fall into place.  He’s probably right. 

My eyes leaked the whole way home.  I couldn’t stop crying.  Part of it was embarrassment for not even being able to talk to him about it without crying.  Partly because I couldn’t believe that’s all I had to do – just tell my endo!  Why not?  He had asked me why I never told him before and I said because I didn’t know he could help me.  I honestly thought I had to find a mental health professional and the idea of finding a doctor, scheduling an appointment, driving there, and admitting my faults was too much for me so I would talk myself out of it. 

I was also partly crying because I felt so completely broken.  I spent the rest of the day intensely hating myself for having physical and mental imperfections beyond my control.  It has taken me a long time to recognize the agoraphobia and to stop joking about it long enough to seriously consider doing something to fix it.  For the whole 3.5 years we’ve lived in California I feel like I have been beating my head against the wall trying to regain consistent control of my diabetes and it took enough sabotage from my “mental illness” for anyone, including me, to make the connection.  Which made me spiral even more into depression. 

For as bleak as yesterday felt to me there was a ray of light at the end of a much shorter tunnel.  I dropped off my Zoloft prescription (let’s not even talk about how much I hate taking medication but I knew medication is what it would take to climb out of the crazies.) and Heath picked it up for me on his way home from work.  I believe wholeheartedly in change.  My religion is all about change.  If I can give away favorite sins and have them not even be a temptation anymore then I can stop having the weakness of anxiety rule my life.  God does not intend for me to be a victim to my weaknesses.  I can change.  I don’t have to be this person anymore. 

It’s a little scary since this has been me for so long I don’t even know who the real me is.  But I’ll try to be realistic with my expectations.  Right now all I want is to be able to ride around town in a vehicle without apologizing to Heath and hyperventilating while squeezing the door handle so hard my arm hurts.  That’s where I want to start.  We’ll see what medication will do for me from there. 

2 thoughts:

Dawn said...

Wow! I am so proud of you! It is not easy to admit that you need help even when all the research says there is a huge connection between diabetes and anxiety and depression. Hang in there. The drugs, which we all hate, are not a magic wand, and they take a while to kick in, can be a real life saver. If the first one does not work keep looking. I have just changed antidepressants and my blood sugars have dropped dramatically. I am not trying to say we are suffering from the same thing just that there is help out there and I am so glad to are reaching out. You go girl! I love you!

The Piquant Storyteller said...

Thanks for the love and support Dawn. It means a lot to me.