Wednesday, 10 April 2019

Balancing Solo Travel with T1D - Caleb Britton

When I was in London in March, I sat down in King's Cross Station and pulled out my insulin pump to give myself some insulin, and I heard someone utter next to me "We're pump twins!". Sitting next to me was Caleb Britton: Caleb is a sophomore Kinesiology major at Gordon College in Wenham, MA, and is studying to be an Occupational Therapist. He loves music, writing, startup culture, and lucky for me, travel! We both happened to be in London at the same time, and Caleb bumped into me whilst travelling around Europe! I thought his expertise should be shared, I especially love his 10 handy travelling tips. Enjoy! - Alyssa x

I’d wanted to visit Europe since forever. Throughout high school and the beginning of college, I would keep bringing it up with my family – could we, by any chance, do a Europe trip this year? When the answer was still “probably not” last fall, I decided to take matters into my own hands – I was going to Europe all by myself.
              I ran through several versions of an itinerary, before finally settling on an eleven-day mad dash during my college’s Spring Break. In those eleven days, I would be visiting eight cities – London, Oxford, Paris, Barcelona, York, Edinburgh, Dublin, and Reykjavik, in that order – with visits stretching from three days in London to twenty hours in Paris to three hours in York. One frenzy of ticket and hostel booking later, I was on my way to Europe on an overnight Norwegian Airways flight.

Cliché wing shot!

I tried to pack as much as I could into those eleven days. Every morning I would wake up early in my hostel or AirBnB, grab a hearty breakfast at a local restaurant or cafĂ©, and walk or take public transportation into the city. Even though I gave unrealistically small amounts of time to cities like Paris (20 hours) or Barcelona (26 hours), I still managed to visit all sorts of iconic attractions and landmarks – such as Buckingham Palace, Magdalene College, Notre Dame, La Sagrada Familia, the British Railway Museum, Edinburgh’s Royal Mile, and Trinity College. I enjoyed a beautiful night view of Paris from the Eiffel tower where I ran into a man proposing to his girlfriend. I lost myself in Barcelona’s Gothic Quarter, where people crammed themselves into tiny tapas bars to enjoy a drink, some delicious bites, and good company. And when my eleven-day trip turned into twelve and I was (voluntarily) stuck in Iceland due to the now-defunct WOW Air overbooking my flight, I enjoyed the long, northern sunset as I walked down to the beach in Reykjavik.

I now realize this picture is equal parts British and American…

Magdalene College and local Oxford wildlife

Paris by night!

La Sagrada Familia is simply other-worldly.

Carlton Hill, Edinburgh – complete with my despicable attempt at a beard.

Abandoned church-ish thing in Howth, Ireland

Despite these wonderful perks, though, a solo trip like this is a daunting step into the wider world for anyone, and difficulties are bound to present themselves. Traveling solo can sometimes be accompanied by losing your wallet or passport, draining your phone battery, eating something strange that disagrees with you, or getting lost in a city where you know nobody. But once you throw Type 1 Diabetes into the mix, it adds a whole other element of difficulty. As readers of Alyssa’s blog probably know, Type 1 is a constant battle between high and low blood sugars, either of which can kill you or cause serious harm if left unchecked. In a single day at my Massachusetts college, my blood sugar can fluctuate between half of and two times the amount it’s supposed to be. That’s normal – it’s not perfect, but it’s still pretty easy to balance with experience and routine. When you travel at a breakneck pace through five countries in twelve days, though, that balance is a lot harder to maintain.
Here’s the deal: I love trying new foods, and I wanted to try as many as possible during my trip: the proper English fry-up breakfast, French crepes and baguettes, Catalonian tapas and pintxos, and Haggis in Alyssa’s home turf of Scotland (which, contrary to popular American belief, is actually pretty good). Unfortunately, if my blood sugar was high when it came time to eat, my options were pretty limited – unless, of course, I wanted to spike my blood sugar even higher than it already was, which is never a good idea. Furthermore, all of that food had carbs, and I had no idea how many.

The British love their protein…

…while the French seem to prefer carbs.

And if this wasn’t enough mental math, there’s one thing that sets European cities apart from American ones, other than perhaps New York: Everything is incredibly walkable. Walking means exercise, and for T1s like myself, exercise makes short-acting insulin more potent. If I exercise enough with enough insulin, my blood sugar goes low, and then even walking through a city can put me at risk for a worse low or even passing out. In short, I had to give myself enough insulin to safely eat my next exotic meal, but not so much that I wouldn’t be able to walk around.
As an example, my blood sugar was going low while walking around Oxford with my friend, who was studying abroad there. Because of that, when we got Cream Tea in the middle of the afternoon, I deliberately gave myself a smaller-than-normal bolus for the scones and clotted cream we ate. As it turned out, this bolus was much too small – even after another two hours of walking, my blood sugar was at 300 mg/dL (16.7 mmol/L) when it was time for us to have dinner in Lewis and Tolkien’s old haunt, the Eagle and Child. I still got a Cottage Pie anyway, because I needed food, but I was pretty sure this would spike my blood sugar even higher, so I gave a larger than normal bolus. Of course, by the time my train got back into London’s Marylebone Station that evening, my blood sugar was low again, and I ended up buying a banana and a cookie bar in the station before taking the Underground back to my hostel. Sadly, this sort of up-and-down game was typical throughout the whole trip.
Oxford was still totally worth it, though!

Then, of course, if something went horribly wrong, getting sent to the hospital in a foreign (to me) country could result in a bill equal to my entire travel budget. And if my bag full of insulin, pump supplies, backup pump supplies, strips, needles, swabs, glucagon, and glucose tablets got stolen, who knew what could have happened.
Thankfully, the worst didn’t happen. But I did have multiple low blood sugars pretty much every day, and half the time the only carbs I had to me were powdered orange glucose tables from CVS, an American chain convenience store. Other times, a well-timed smoothie or sweet treat from whatever shop or restaurant happened to be nearby me – my favorite pick-me-up was a chocolate chip baguette in Paris. My worse low by far was on the final night, in my hotel in Iceland, when I was at 50 mg/dl (2.8 mmol/L), my glucose tablets were running out, and the vending machine refused to accept the final ten kroner coin I needed to buy Pepsi (thankfully it ended up taking my debit card, which I probably should have tried first in retrospect, but I wasn’t exactly thinking clearly).
Don’t let any of that scare you, though, at least no more than is healthy. Going to Europe or any foreign-to-you country, even with Type 1 Diabetes, is absolutely worth it, so long as you understand the risks and have plans in place to minimize them. The challenges of travelling with a chronic illness are very real, but they are far outweighed by the places you see, the amazing foods you try, and the fascinating and diverse people you encounter. For me, this latter category included the Pumptastic Scot herself, whom I met in King’s Cross Station, right after discovering that, sadly, there is no barrier between platforms 9 and 10. Pity . . .I already bought my Hufflepuff scarf.

And thus my dreams were crushed.

If you, dear reader, are considering traveling abroad with T1D, especially solo, here are some friendly tips to help you on your journey.

1.      Always have backup. Bring twice as many supplies as you think you’ll need.
2.      Carry a wallet card explaining what to do if you have an extreme low blood sugar and can’t communicate.
3.      Upload a copy of your passport to the cloud, so that if it gets stolen you have access to it. This one goes for everyone, but access to an ID could be especially important for a diabetic in distress.
4.      Learn how to say things such as “I have diabetes” or “I have low blood sugar” in the language of the country you’re visiting. My next country is China, so this will be fun…
5.      If you’re staying in a hostel, inevitably you’re going to be digging through your stuff in the dark while other people are trying to sleep. As part of trying to only do this once, make sure you have a juice or soda ready to go next to your bed.
6.      Temp basals are your friend. If you use a pump and you have a target blood sugar, try dropping cutting your basal entirely for half an hour or more while you’re walking from place to place.
7.       Troubleshoot, troubleshoot, troubleshoot. If you’re having consistent lows, drop your meal boluses, then drop them again the next time around. Keep doing this until things even out.
8.      Always be asking yourself, “What if I had a low right now?” Pack lots and lots and lots of energy bars and glucose tablets, even if you think they’re disgusting. As much as possible, buy up sodas, snacks, and juices, so that you’ll have them on you if you do indeed have a low blood sugar. When you budget for your trip, take this into account – I spent over $50 (over £38) on low blood sugar snacks during my trip.
9.      If you’re on a plane, even a low-cost airline like Norwegian, EasyJet, or Ryanair that nickel-and-dimes you for everything, and you have a low blood sugar, don’t be afraid to ask for free snacks and drinks if you have a low. This worked for me on Norwegian, when I had an overnight low on a transatlantic flight from Boston to London, and the flight attendant gave me free juice and cookies.
10.  Speaking of flying, once you get on the plane, gather everything you need to have on you during the flight – including glucose tablets and your meter – and stuff them into the seatback pocket in front of you. This way you won’t have to get up or dig around in a bag to find things should you have a low blood sugar.

Happy travels!

-          Caleb

“The world is a book, and those who do not travel read only a page.” – St. Augustine

Sunday, 3 March 2019

The Problem with Mental Health Campaigning

One day I was working, and I was having a bad mental health day. All I wanted to do was to seclude myself, sit in a corner and cry, but I had to continue on with my day as if nothing was wrong, so I decided to listen to a podcast called “Happy Place” – presented by Fearne Cotton (available on Spotify), because I felt like I needed to listen to some positive, upbeat messages. I stumbled across an episode of this podcast in which Fearne Cotton interviewed Stephen Fry, who is the president of the mental health charity “Mind”. I thought it was such a coincidence that the exact thing I was struggling with was being discussed so openly, when mental health is often something that I try so hard to hide.

As I was listening to the podcast, Stephen Fry made such a good point about mental health awareness campaigning. There are 2 points that need to be made when doing the campaigning, otherwise it can do more harm than good:

  1.  “Mental Health is dangerous, often life-threatening and is a shockingly awful experience for some”, but…
  2. “It is so possible to lead a fulfilled, happy, connected, loving, beloved life in which you are a full proper member of society and you are not owned by your disorder”

This really struck a chord for me. I often talk openly about mental health online, when I have a screen to protect me and allow me to articulate my feelings without getting upset, but in person, seldom do I talk about my struggles with mental health. The main reason for this is the second point, I don’t want anyone to underestimate my abilities, coddle me or constantly question whether I am up to the job.

Stephen Fry, later in the podcast, talks about how someone with a physical illness (e.g. Type 1 Diabetes or Asthma) is more able to admit when they are unwell because people are more likely to understand that it isn’t their fault, and this is so true for me. I find it hard to admit when I feel unwell with Type 1 Diabetes, but when I do admit defeat, I can explain why. When I am struggling with my mental health, and I can’t explain to people a logical reason why, I find it difficult to tell people when I need to step back. I don’t want to be treated differently.

In the podcast, Stephen Fry eluded to the fact that “We live in a country that often think that passion and emotion are an embarrassment”, and I cannot agree to that more. The act of showing and sharing emotion can be so powerful, it shows a vulnerability that I truly believe people respect. I want to be able to open up fully and show people my full emotions, but I end up bottling it up, hiding it and often making it worse, and that may partly be because I *am* embarrassed to show weakness.

I want everyone to understand mental health. I want everyone to know that 1 in 4 people will experience mental health issues at some point in a year, and it can be very dangerous. I also want people to understand that because someone admits weakness, it doesn't mean they should be treated any differently in the future!

I hope that in the future, I can be as open and honest about my mental health as I am about my physical health. I aim to be open, transparent and confident about all aspects of my life, as I am only human after all, but for now I will acknowledge the need to educate about mental health and also know that because someone struggles with mental health, doesn't mean they can't live a full life.

Until Next Time,

Alyssa x - The home of Happy Place podcast - "Mind" mental health charity

Wednesday, 6 February 2019

A New Adventure - Corrymeela!

2019 brings a completely new adventure for me, something I have never done before!

Last semester I managed to gain much better control of my Type 1 Diabetes (but definitely not perfect!), and I felt so much better for that. One of the things I want to do when going away to Northern Ireland (where my University placement is) can help me redefine what living with Type 1 Diabetes means to me. In the past year I have quite a negative outlook on it, it has held me back from doing thing, and although it has given me opportunities, I have resented it. This can be a chance to gain a positive outlook on the strength it has given me and the opportunities. I have already noticed that I use the fact that I live with Type 1 Diabetes as conversation starter, a way to connect with people who have been through similar experiences, and that in itself is a strength which I wouldn't have gained without Type 1 Diabetes.

I'm on a placement at an organisation called "Corrymeela", which is based on the North coast of Northern Ireland. I live, eat and work on site, interact with all the groups that come through, help out wherever I can, but one of the main things I am using this experience for is to figure out how to be myself. I am living in a house with around 20 volunteers from all different cultures (There are volunteers from America, Scotland, England, Northern Ireland, Canada, Germany, South Korea currently!) and this will be a test to see whether I can prioritise living with so many other people and taking care of myself.
In front of the beautiful scenery at Corrymeela
Me on the Giants Causeway

Corrymeela brands themselves as a centre for peace and reconciliation, and it has 4 areas of work, which are Sectarianism, Marginalisation, Legacy of Conflict and Public Theology. The groups that come through include school groups, international groups, people who want to learn about the conflict in Ireland and how it relates to them e.g. South Korea, and many many more. The work that Corrymeela do varies so much, but all groups leave with a legacy. They use the phrase "Corrymeela begins when you leave" because Corrymeela sows the seeds for lifelong learning. After being here for less than a month, I have already learned so much, both from the groups and the people volunteers and staff at Corrymeela. I often feel naive, because I didn't know the extent of the problems that Northern Ireland faced and still face, and so it has reminded me that lifelong learning is so important, and that we should never judge anyone else's lives unless we know all the facts.

Some fellow volunteers in front of a mural in Belfast

That being said, being at Corrymeela has been difficult because all the food is served cafeteria style. I give my insulin dose based on how many carbohydrates I eat, and this usually means I can look at the nutritional information on a food packet, or weigh the food I eat and figure it out. I don't have any of that information here, and so I have to guess how much carbohydrates I'm eating. I have gotten it very wrong so far! This means that often my blood sugar is high, making me tired and not be able to concentrate properly, which in turn means that I am not as productive as I hope to be. I think this will be an ongoing challenge for my remaining time at Corrymeela.

Having a day off in the pub
I want to use Corrymeela as a chance to learn skills of self-care, to help with my ongoing mental health. I think the location itself helps massively, just looking outside the window at the outstanding views is so peaceful. Corrymeela also holds something called "Silence in the Croi" every morning, where volunteers living on site can go and reflect on their day, or read a book, or journal, and I have found this an amazing way to start my day. Just sitting there, not having to think about anything and just being present in that moment is such a good feeling and sets my days up perfectly.

Being here, I have already learnt so much, but the main thing I have learned so far is how to be part of a community. Being able to lean on others and have them lean on you is an incredible feeling, and something which I have never truly felt before. If that is all I gain from being at Corrymeela (and I'm sure it won't be!), my time will have been worth it.

I'm looking forward to seeing what else Corrymeela has in store for me and how much I can learn in the short time I am here. I want to be a tourist and learn the culture that Northern Ireland has. I can already tell it's an experience I will cherish.

Until next time,

Alyssa x

Volunteer dream team

Friday, 30 November 2018

Common Misconceptions about Type 1 Diabetes

As with everything, there are so many misconceptions about type 1 diabetes, mostly made worse by the stigma the media causes. Here are some questions and comments someone living with type 1 diabetes can get:

At least its not cancer
Cancer and Type 1 Diabetes are not comparable at all, and by saying this you are making light of how hard type 1 diabetes can be to live with!

Invisible Disability - Someone living with Type 1 Diabetes
looks the same as everyone else!

Wow, you must have ate too much sugar as a kid!
Type 1 Diabetes is an autoimmune disease, which means the immune system essentially attacks itself, it has nothing to do with eating too much sugar or being overweight.

You can reverse diabetes if you lose weight, can't you?
This is a confusion between type 1 and type 2 diabetes. With type 2 diabetes, it can *sometimes* be put into remission through dieting, but with type 1 diabetes you are insulin dependant for life, as the cells in your pancreas don't work anymore.

I would rather die than inject myself everyday!
This one is quite insulting actually. If I didn't replace the insulin my body doesn't make, it is a death sentence. You get used to it, because you don't have another choice!

Can you catch type 1 diabetes from someone who already has it?
No! Diabetes isn't contagious, it is genetic.

Should you be eating or drinking that because of your diabetes?
People with type 1 diabetes can eat anything, they just have to know how many carbohydrates are in the food, give insulin accordingly and know how each food affects their own body. We are recommended to eat the same healthy diet as everyone else!

Someone living with type 1 diabetes can eat and
drink anything (within reason!)
Basically, Type 1 Diabetes should not hold you back. It is hard to live with, it requires constant control, but you can live life to the full nevertheless. Someone with type 1 diabetes will be dependant on insulin to live for the rest of their lives, it's not something you can grow out of.

Asking questions is a brilliant way to get to know what someone goes through, so please keep them coming, but also be sensitive about it!

Until Next Time,

Alyssa x

Tuesday, 20 November 2018

Natalie Balmain - More Than Just a Type

I asked my friend, 'Natalie Balmain', who is founder of Type 1 Clothing, to write a blog for me talking about her life as a whole, both positive and negative. When living with type 1 diabetes, it is easy to let it take over , and Natalie talks about how living with type 1 diabetes has played a part in hers. Please read it until the end! - Alyssa

"I've been thinking of how to start this blog for a long time. I don't generally find it difficult to write about my opinions or experiences, but I do find it hard to be vulnerable.

You see, I have a lot to be vulnerable about. I've felt every hollow, stinging, shot-to-the-heart pain you can imagine, but because the foundation of my soul lies in loving everyone, (whether they be an old friend or someone I've just met on Facebook), I've never wanted anyone else to feel the pain I've felt. So, I never shared it.

When you watch my vlogs, or see me speak at an event, you'll see that my message is a positive one. My drive is to inspire others and make everyone around me happy. By nature, I'm a people person, and if I only achieve one thing in life it would be to help everyone else know that they can overcome anything, and live happy, fulfilling lives. Especially my type 1 family, because in all honesty, they are the some of the truest friends I've ever had.

So it upset me recently to hear stories from some of the young people I seek to inspire, saying that either friends, family, or they themselves, have used me as an example to demonstrate that 'controlling' type 1 diabetes should be easy, and if I can manage it so well, why can't they? And my heart sank. I've always sought to uplift people with the positives, but in that moment, I realised that the negatives are just as important. So, I decided that I'm going to share mine.

Firstly, I would like to make it very clear that controlling type 1 diabetes is NOT easy. My favourite meme on the subject describes it as "Walking a tightrope. Except you're on fire, the tightrope is on fire, and everything is on fire". Yup, pretty much sums it up. Over my 12 year tenure as a T1D, the most part was spent with an average HbA1C of 12. That's pretty horrific. I've had touches of neuropathy, signs of kidney damage, and a blue-light trip to hospital in 2017 in severe DKA with a blood PH of 7.0 (when I later saw the healthy blood PH range chart, 7.0 was labelled as 'Death').
Its only in the last year and a bit, and only because I've been fortunate enough to have access to technology like my Dexcom CGM and an insulin pump that I've been able to bring my HbA1C down from 12 to 8. And even that brought on haemorrhages in my retinas. It's still not perfect, but I'm getting there. Perhaps I'll even manage to avoid some complications, despite being told at diagnosis that complications were 'inevitable'.

So, maybe some of you reading this are not type 1 diabetics, and maybe you need an explanation as to why I'm still struggling after all these years to 'manage' my condition. (I can't tell you the number of times I've wanted to scream in someone's face when I've told them I'm a type 1 and they have responded with 'but it's manageable isn't it?')

Well the dirty little secret is, none of us are JUST type 1 diabetics. We are human beings with the same real lives and stresses and emotions as any of you, AND we have type 1 diabetes on top of that. Perhaps if none of us worked, or cried, or danced, or ever had a heartbreak or lost a loved one; if we had no lives at all, then maybe we could all have perfect blood glucose levels all the time. But life isn't simple like that.

On top of the fact that everything we eat has a different effect on our levels (even the same food eaten at different times of day requires different doses); exercise, having your period, stress, excitement, heat and so many more things impact your blood glucose, and that's before we even factor in mental health and life.

Mental health is the biggie for me. You see, I suffered with depression even before my type 1 diagnosis. When I was 5 years old, I lost my Mum to cancer. I only found out recently from a cousin that I didn't speak for months after that happened- my brain had blocked all those early childhood years out. 

And maybe it was the fact that I didn't have my Mum around, that I was desperate to be loved. Whatever the reason, being desperate is a sure-fire way to NOT make friends. I remember being at primary school and hearing my child minder ring up other kids’ mum's to invite them round to play. I could only hear one side of the conversation, but it was always "Ahhh.. ok, never mind", as those kids' parents made excuses for their children who didn't want to play with me.

Over the course of my young adult life, I got into trouble a lot. I hung out with bad crowds just to feel part of something. When I got my diagnosis of type 1 diabetes, the guy I had been seeing for just a couple of months couldn’t cope with it (and my severe depression), but I guess he felt too much pity for me to break up with me, and so I stayed in a 7.5 year relationship with someone who cheated on me from the first day to last, hoovering up any shred of self-worth I might have had left. (I'd like to add at this point that I don't actually blame him, we were both young and my diagnosis and depression was too much for either of us to deal with well).

When I eventually found the strength to leave, after a period of living on my friend's sofa because I had no home and no job, I got a place by myself and let strangers party in my flat just, so I wasn't alone. I ended up being assaulted in my own house. Since then, I've kept myself to myself because being alone has seemed preferable by comparison.

Even writing this now, I feel an overwhelming urge to apologise to you all for burdening you with this. But perhaps if I lay all my cards out on the table, it might make it easier for you to understand why managing type 1 diabetes isn't just about finger pricking and injections.

You could probably understand why people who have gone through things like that might have mental health issues, or even feel suicidal. But let's put that into perspective: what if someone with those struggles ALSO had type 1 diabetes, and was responsible for keeping themselves alive every minute of every day? Could you understand why that person just might not always feel like it's worth the effort? Why do we try so hard to stay alive when life itself can be so tough?

Now I'm not suggesting for a minute that everyone has been through things as extreme as I have (although many may have dealt with worse), but every one of us has struggled at some point. We've all lost loved ones, dealt with heartbreak, been fired from jobs or fallen out with friends. We all have good days and bad ones too. And those struggles impact us emotionally, and in turn, affect our strength and our motivation to look after ourselves. How many of you have gotten drunk to cope with things? You know it's bad for you, but you still do it. Well, type 1 diabetics know that not being on top of our control is bad for us, but we are only as human as you are.

So perhaps next time you judge a type 1 for not having good control, remember that berating us is only adding to the problem. Child or adult, all anyone in this world really needs is love, and support.

Love Natalie"

Wednesday, 14 November 2018

First dates with Type 1 Diabetes!

When you live with a physical disability that is visible to the people around you, it is hard to control how you are viewed because of previous stigma. Having an invisible disability means that you can control how people view you, and it means you have to decide how and when you let people in on what you deal with. On a normal day, I am very open to talking about living with Type 1 Diabetes, however when you go on a first date, it is very different!

Going on any first date is really nerve racking to begin with, knowing how to conduct yourself and how to act. You have to try and impress without being over the top, try and get to know the person your dating, and health issues aren't always on the top of the conversation agenda, however often they are really important to bring up. When I try to impress someone, I personally don't feel it is very 'inviting' to tell someone that I wear a cannula and an insulin pump 24/7, that I can get very easily get unwell and I might need someone to look after me. I always get afraid that they may feel it is more trouble than it's worth.

When I first started dating, I never brought it up until the second date, as I honestly didn't know how to handle things in that situation. Even testing my blood sugar and taking insulin, I would go to the toilet and take it to hide it more, but I feel now that it wasn't the best tactic to take.

I then tried to be honest about it, and mentioned it in the first date, but I was nervous about doing this and I made too big a deal of it, made it a big drama and went into the details. Living with Type 1 is a big part of my life, but it is only a small part of me and my personality. By doing this I made it seem like it was the only major part of my life.

I now tend to wear a small part of diabetes show, to try and give the impression that I have nothing to hide (which I don't!). For example, I will have my insulin pump visible by clipping it to my skirt/trousers, or I'll have my cannula from my insulin pump showing on my belly. I don't even mention it until my date asks, and I just get on with things, check my blood sugar and take my insulin as normal. Even though I'm not often confident about opening up fully, confidence is key because it isn't a topic I can or should avoid at the end of the day.

I have very limited experience on this topic, and this only really counts if you go on a date with someone you've never met before, but it has been a bit of a nerve-racking experience for me in general. First dates are difficult in the first place, but I added extra pressure onto myself that I really didn't even need to!

Until next time,

Alyssa x

Thursday, 27 September 2018

Pregnancy and Type 1 Diabetes

I normally write this blog about my personal experience with Type 1 Diabetes, however I am very aware that my experience can be very different from someone else. A big topic that I haven't had any experience with is "Pregnancy when living with Type 1 Diabetes", so I asked my friend Lindsay to write about her experience of pregnancy!  - Alyssa

I was diagnosed with Type 1 Diabetes age 6 and I remember being told several times as a “grown up” in clinic “you really must tell us when you decide to start a family”,  “ diabetics can have problems in pregnancy”,  “ diabetics are prone to big babies and complications during pregnancy"! My thoughts: "Gee thanks guys really make it sound like good fun, and yeah I am now petrified"! 

My husband and I spoke about kids and we knew we wanted a least one (coming from a big family I wanted more but one was a good start). 

I am fortunate to have an amazing consultant, who supported me pre-pregnancy, which was a lot of work. When I was told I would have to keep bloods between 3.9-5.2 and no higher than 7.8 two hours after food, I did think, "is this really for me"! My diabetes has never been textbook and never will be I am sure! I have struggled a lot with DKA (Diabetic Ketoacidosis) in the past and I was not the strictest of person when it came to my diabetes. The thought of this really did scare me but my consultant had given me a script for folic acid (ideally we have 5mgs of folic acid 3 months before trying to conceive) so she must have been happy for me to try. Diabetes has never stopped me doing anything else in my life and why should it stop me doing the most important “job” I want in my life!! 

So I came off the pill and fell pregnant straight away!  Oh my word, I have never been so nervous, scared and anxious but also happy and excited about seeing 2 wee blue lines. My Husband knew first, but very quickly afterwards my consultant and dsn (Diabetes Specialist Nurse) phoned to warn them they were not going on holiday for the next 9 months!! 

Because we found out very early we had a bit of an agonising wait until our first scan (you generally get an early scan at between 6-8 weeks to check viability and everything is in the right place). This can be abdominal and/or internal scan due to size of sac. I had to have both at this time. I was told there was a sac there but that it was very early days and too early to see anything else (slight disappointment) but I was also told I must have got my dates mixed up. I knew that I hadn’t though! This is where my job as a nurse started to become a hindrance, because I knew potentially what this could mean but no one was saying anything to me. So I went back after a few weeks for another scan and blood tests, and there was still no growth within the sac. I had unfortunately had a miscarriage. I was completely devastated, and yeah, I automatically thought it was my diabetes fault. I hit rock bottom with my mood, and depression set in, I did not care about diabetes as in my head it had caused all this hurt and grief I was suffering, and I hated it!  It was horrible. I was told officially by doctors that my diabetes was probably not to blame, and that 1 in 3 pregnancies end in miscarriage, which is a scary scary statistic! 

After a while, my husband and I decided to try again so in January 2014 I peed on that stick again, and there were 2 blue lines: “oh f***”! I was so so nervous, but was I ready for it! My diabetes team were again amazing, I was seen every two weeks in clinic right from the start, and we were working on getting tighter control etc. When it came time for that early scan, I was completely and utterly petrified! I jump onto the bed, wriggle my trousers  done a bit, have freezing cold Jelly on my stomach, and I couldn't even look at the screen. Then those magic words were said“do you see that flicking white dot, that is your babies heart beat and it all looks perfect”. I have never felt joy like that before. There was so many happy tears, I just had to get to next milestone at 12 weeks! 

Those early days seem to drag but I worked on keeping my diabetes in control as much as possible. I would beat myself up if my blood sugar was not in “target”. And oh my word it was tough at times, who knew bread could spike your blood sugar so much after eating it! My appointments with my consultant, dsn and dietitian continued every 2 weeks and I got a monthly hba1c (average blood sugar). Things were improving, however, due to outcome of previous pregnancy I was continually on edge! It was horrible, I wanted to get my hopes up, however I was scared too! So it felt like I was just going through the motions!

The dreaded scan day came again, so many tears that morning before we got to the hospital. I was prettified. I got there, jumped up on the table... jelly applied to my stomach and then we heard the most amazing sound ever! We heard a heartbeat, yep you guessed it, more tears. But happy ones. My baby looked the right size, actually measuring 13 weeks and a day. Heart beat was nice and strong. was amazing feeling being handed our scan pictures.  Everyone was telling me, “ now you can relax a bit”! Were they being serious, I was type 1 diabetic and pregnant, relaxing was not on the cards!

The bi-weekly appointments continued, my hba1c was being done every month. I dreaded this result more than ever because if it was high, I didn't know what damage I could be causing my little one. I would regularly be really upset if my bloods went high thinking of the damage I could be causing! Emotions and pregnancy are not a good mix at the best of times BUT add in the guilt of all of this as well, it was not good and I was often in tears due to this. My 20 week scan came and everything was perfect, our little boy was cooking nicely and measuring right on target. My consultant keep saying to me that I was doing a fab job, but did I believe her?! Nope, I was not hitting the “targets” all the time and I was striving to be better. My hba1c was 6.2% (44mmol/mol, right on target) which is the best it has ever been, but it still was not good enough in my head. 

At 24 weeks we had another scan, but this time it was checking the babies heart. This was so strange,  different from an ultrasound scan as we did not see our wee boy, we just seen all his wee heart chambers pumping blood around. All was fine no problems at all, another hurdle overcome! Could I dare to dream? My dream of being a mum was actually coming true. 

At the other scans at 28 weeks and 32 weeks, everything was still spot on, apart from my little monkey deciding be good fun to turn into breech position. If I was to have my dream of a natural delivery he needed to turn round. At 36 weeks he was still breech, so we were given a date for a planned c-section, with the option of a scan that morning to check if he had moved, and if he had moved I could be induced and have a natural labour. The date I was given was 11th September... no big deal, you might think, but it was my birthday that day too. This would be the best birthday present ever. I would be at 38 weeks and 2 days at time of delivery. I was so proud of myself for getting that far in a pregnancy with no complaints, no mega problems. Of course, I had hypo, I had to change my basal and insulin to carb ratio on my pump a lot during pregnancy as insulin requirements change SO much. But I honestly had the best control ever during my pregnancy, and I was determined from the start that I was not having a big baby. I was not going to be another “ diabetic mums have big babies statistic”. Yeah, my diet changed a bit during pregnancy too more low GI (glycemic index) foods to avoid the blood sugar spikes after meals but, you know what, it was not as bad as people make it out to be. Diabetes and pregnancy takes planning and is very time consuming for the 38-39 weeks but it can be done!! 

Anyway, on 11th September at 8am I went to the hospital, having fasted for theatre. They had wanted me to stay in the night before because I was “high risk”, however I stressed to them that I had been a “high risk pregnancy” right from day one and because it was my birthday the next day, I would be going home, going out for my dinner and be in the morning! Yeah I can be stubborn at the best of times!

I went to theatre for my c-section, peanut, as we called him, had not moved from the breech position! The whole experience was very calm and relaxed in theatre, my husband was in with me too, I had my insulin pump on still, no sliding scale and I knew what to do with basal rates etc as soon as baby was born!

At 10.17am our gorgeous LITTLE baby boy (7lbs 6oz) Logan James Milligan entered the world and he was perfect!! I've never been happier in my life! And he was tiny! My husband got the first cuddle and then me, and it was the best feeling in the world!

His blood sugars were “borderline low” all day but the midwifes were happy for him to stay with me and just try to encourage feeding. Come 10pm I was not happy and I wanted a doctor review, as he had borderline low blood sugar all day and he was a very drowsy baby! The decision was made to take him to neonatal department overnight and tube feed him to try and help his blood sugars (yeah I felt mega gutted but I knew this was the best outcome). The next day his blood sugar was fine and I had my wee boy back where he belonged beside me. 

He has been perfect since, and now I have a wee whirlwind of a 4 year old that I would not change for the world. He has no medical issues at all, yeah he has a slightly increased chance of having diabetes but we would cross that bridge if we came to it. 

So yeah diabetes pregnancy can be tough, stressful, frustrating and lonely at times BUT it is doable. I had the best control ever during my pregnancy, and it was not as bad as I thought. Would I go back for another go... possibly just need to wait and see.  

Thanks for reading! If you have any question etc I am happy for to answer, or if it is of a personal nature send me a wee personal message: