Is predictable possible?

A friend of mine Molly Schreiber writes a wonderful blog about her life with RA and diabetes. On May 2, 2015 she wrote a terrific item titled ‘Unpredictable’. In this blog she remark’s about how unpredictable life is with RA. She will get no complaint from me on that.

Her words started me thinking about the world of disease management and how unpredictable we who have RA and or Diabetes have it. Yesterday morning I woke up with a raging blood sugar, I was 238, I felt crazy bad and I had this terrific headache. When I took the morning medications it just got worse. I wanted to eat, yet I didn’t (it was too early), I wanted to throw up but couldn’t, and I should have laid back down but could not bear it. Instead I waited it out. This nonsense of feeling ill in the morning is not a new thing. It has been happening a lot and I cannot figure out how to overcome it. Usually around 3-5 AM my blood sugar has been rising and I cannot get it under control. I have taken more insulin and less, ate less, I even rode the exercise bike two mornings at around 5 AM. It doesn’t matter what I do or how hard I try it seems my blood sugar is operating with its own agenda, and I am paying the price.

But it does not happen every day. It is most days, but not every day. Of course I know why it is happening. I know it is the infamous morning liver release of glucose. I know I am close to having an infusion so being uncomfortable is normal. I know all these things but I still want to manage disease perfectly.

Perfect?

I do have days when things are just right. My blood sugar is perfect, my RA is under control and I feel good. Other days (more than not) I feel bad. So what keeps me going? Is it the feeling good, or is it a desire be more precise in how I hit my numbers? Is it a desire to please my doctor, or an internal mechanism that insists I do better today than I did yesterday?

I know the simple explanation is that I need to feel better, but it I also think it is more than that. I am constantly competing with myself in a game I cannot win and on a game field that is ill defined. If we have diabetes, we cannot fully understand the game we are playing, let alone the board we are playing on. How many of our friends, or family members define diabetes as a simple in and out transaction. Eat more, take more insulin, eat less take less insulin, hit the number and achieve bliss. Like a stable calculation is all we need to learn in order to feel good.

Then how about RA? Well that seems simple enough, I mean biologic treatments take care of that, right? Do them on a schedule and that is fixed until the next one. Yet if we live with RA we know that it is far more complex than a simple schedule. Spend time as a person with RA and you find that the flares have no pattern and the general aches and pains have no explanation.

With all this randomness, how then are we to make sense of it? One way is that we assign numbers, report percentages and follow trends. We mark fluctuations in numbers as if those are the object of our effort.

I try to hit a blood glucose number at 9 AM and treat if I don’t, I want no visible swelling and get concerned if I have it. I want my fingers to be straight and my blood sugars to be in range. I report it, count it, and classify all the changes big and small. I compare results to yesterday and push for better results today.

Beating Yesterday

I strive to beat yesterday’s numbers because I think today will be better if I do. I make big and little challenges in my life in order to get through my day. Part of that adjustment is to boundaries of the field I am playing on. What will my body allow or tolerate today? My mission it seems is to find the edge of what I can endure and work backwards. Why do I do this? Is it because I dislike limits so much? Maybe I do not think limits apply to me? Or maybe I just seem more intelligent if I know what the field looks like.

With RA and Diabetes I have to redefine those boundaries every single day. If I have learned one thing about living with chronic disease it is how much I dislike any boundary Diabetes or RA set for me. So be forewarned Diabetes and RA, if you tell me I cannot do something that is all I can think about. Tell me maybe and I will think of it less, tell me yes and I likely will not care much. This week, I am doing what I always do. I am pressing the boundaries to define the field so if I get it right I can feel like I beat RA and Diabetes. All in the knowledge that if I get it just right, it will not matter one little bit, because tomorrow I will get up and do it again. That is the way the RA and Diabetes game is played. It never ends, and I seldom get it just right, but I will never stop trying.

 

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(Cover image courtesy of Stuart Miles at Free Digital Photos.net)