Growing Up w/ Diabetes

today we have CC Karski with us CC is just completing her Dietetic education program and in a few months will be a registered dietitian she's also a diabetic and so she's agreed to talk with us today about the what she sees as the important role of a dietician in working with someone who has a chronic disease CC how old were you when you were diagnosed as having diabetes I was 10 years old so I've been diabetic for thirteen years I had the classic symptoms of diabetes you're needing a lot drinking a lot being tired all the time I remember particularly looking up a flight of stairs and thinking that it was just kind of like a mountain to get up there I was I was I lost control of my emotions you know I just cry with it you know no problem at all my parents and my teachers kind of noticed that I was losing an awful lot of weight at the same time so that's when I was hauled off to the doctor and he picked up some large blood sugar value and so I was diagnosed do you remember what was it like when you came back to school then after after being away for a few days it was I was I was out ten days and I was it wasn't too big of a deal I didn't I didn't you mean the the other children didn't yes I think a lot of questions now they just wanted to know why I was gone and I just told him I was diabetic and I had to change my eating eating style a little bit and take shots and stuff like that it was kind of a novel idea it wasn't I didn't think about the long-term implications that much at that point taking shots was that was that trouble no the the shots weren't a problem I took one in the morning and one at night actually just one in the morning at that time the snacks in the afternoon gave me a little bit of trouble I didn't like to pull out my snack and say I'm diabetic I have to eat this now and so that kind of made me a little bit inhibited around other kids so you're saying that right at the very beginning it wasn't too traumatic right um looking back now what would you say was your toughest time adolescence was definitely the worst when I when I was in junior high I started you know just I started wanting my independence a little bit more I wanted to eat what my friends were eating and I definitely had and still have a sweet tooth and I used to I used to start well back then in about seventh grade I started eating a lot of cookies and sweets and so on and I started I started kind of faking my urine tests I would start you know I needed to be testing negative tres one plus two plus and I was starting to test real high because of all those sweets I was eating so I started just making up the test I wrote down what I knew I was supposed to write down and I just when I had to go to the doctor I exercise a little bit more or just not eat that day or something like that so that to the doctor it looked as if you were in fairly good control yeah that's the perfect diabetic that's coming through the door yes so when when was the first time then that you began to realize that maybe something was the things were not going as well as she wanted to have yourself believe well you know I knew that what I was doing was not a good thing I was I was drinking a lot of water to push all that sugar through and things definitely got worse from junior high the worst was probably when I was about 16 years old I was eating just a good 3,000 4,000 calories a day and not covering it with insulin like I knew I should have been because I had that basic adolescent girl fear of gaining weight so I would just drink a lot of water to push it all through I also when I was about 14 got a complication on my leg of vascular complication and it started as a little small red spot and it just over the years started growing and I knew and the medical community obviously knew that this was because of the poor control and those feelings started you know coming at the same time as my feelings of this is a serious thing and you know I started thinking about the long-term implications of the disease you know so you thought about it and you had some realization as to how serious it was but did this make any change and in the number of cookies you ain't know no one really knew I guess I was kind of a closet eater and the dietitians who wrote up diets for me gave me things like two breads and two vegetables and one fruit you know I looked at it and just kind of laughed inside thinking well I don't like vegetables so I'm not gonna eat those and I'm gonna eat more like five breads or seven breads and they're not gonna be the kind of breads they wanted me to eat so I the diets were just not helpful at all at that point you know I didn't feel like the dietitians or really the doctors knew what I was all about so did this kind of gameplay go on then all through high school or the worst was that at about 16 and then I changed schools and that helped I still had an awful lot of bad eating habits to work on not to mention the exercise discipline so things were still bad well around this time is when the the glycosylated hemoglobin tests came out and I also changed doctors at this point and that's when things kind of came out of the closet and my doctor and my parents realized that I was doing all the cheating on the urine tests you know that I was just way higher than all those negatives and traces that I was writing down give me an example of what your glycosylated hemoglobin oh it was like my first one that they ever took was 16 5 and the normal for for non diabetics was 8 and what what the medical community wanted for a diabetic was 8 to 10 so I was just you know way way out of sight and I felt like I did in the pre-diabetic days no tired all the time and kind of bitchy and drinking water all the time so how did how did you respond then to this being found out tighter no it was it was the scariest time of my life I think I did you know I wanted people to find out and I wanted help but at the same time I didn't want them to find out because I kind of felt like a failure well I did feel like a failure and like I had no control my doctor was supportive but he wasn't very he didn't understand what it's like for a for an adolescent girl not to be able to eat the way she wants to eat and do the things she wants to do so you know things didn't really move along I started kind of taking a little bit more responsibility myself you know being a little better about what I was eating my paper route helped with the exercise but I still had a lot of things to work on what was your insulin regimen at this time were you taking more than than one dose a day yeah after a couple of after the first couple of years I changed to a two shot a day regimen and you know as you know that that requires real moderate eating and and timed eating and that just wasn't working for me and now had you started the blood glucose monitoring at that point yeah that came about my senior year in high school or freshman year in college and that was a that was a new novelty to it did give me a little better control but I still needed to take the control myself so that gave me the the into taking more control but I don't think I utilized it like I should okay so we're through high school now yeah and you're off to college how did how did that work well my first year of college I had had some independence type experiences before that so it wasn't totally going overboard but it was hard to go through the CAF at the foodservice lines and the residence halls and exercise some self-control and you're eating when all that food was sitting there in front of you so that part was real hard and even worse than that were the the ten o'clock study breaks where your whole floor goes out and has a big birthday cake or treats or whatever because I definitely want to be part of that and the drinking was also a problem the parties no one had ever told me how I could safely drink beer they just really evaded that whole question and you know so I had to go out and learn it myself you know probably took some stupid chances to not eating when I was drinking and things like that so I think now that you think things are are turned around so how did how did that happen how did that change begin to take place no that was that was most of it well most of it came from within myself but then there were dietitians who facilitated it and and doctors too if you could tell us a little bit about them yeah towards the end of my freshman year I went to the University of Iowa and changed my insulin regimen to multiple injections and that really works for me you know it allowed they told me kind of indirectly or whatever that it would allow me to do a little bit more cheating it would just allow me a lot more flexibility in my eating and that really appealed to me and so that helped in the control I would just take larger shots and start covering the food I was eating and it allowed me to eat those ten o'clock dormie binges and all that I started well the the dietician there really catered towards my lifestyle she you know I had two different meal patterns that I really was following depending on my class schedule and my work schedule and she was really willing to to set up a meal pattern that was geared towards those two separate routines and you know I on the one hand I didn't want anyone to find out the way I was eating but on the other hand I had a great deal of respect for the woman because she was here she kind of had my number she she knew that I was trying to kind of evade the whole diet pattern routine and you know having someone come in and tell me what to eat when to eat it and she really was willing to work with that you know to accommodate my lifestyle not what her idea of a good diet for a diabetic was okay did did having this information in this knowledge did that do the trick did that make you change or did it take something more than that well it you know I would say most of it came from within me and and those people acted as facilitators or whatever you know helped me along I just took took small steps you know I guess it just goes with growing up and the first thing to change was that was the blood sugar monitoring I just over a week's time in some time in my junior year I just started taking a lot more responsibility for that I started testing even though a lot of those tests were in the two and three hundreds you know it didn't you know I knew that they always had been in in the two and three hundreds but now I was starting to do something about it you know take a shot if it was real high to try to bring it down by morning or whatever and then my senior year when I moved off off campus that helped as far as the food because I didn't have all those wide open choices so I started following a lot better of a diet and at the same time you know now I can go back into food service and choose what's right for me but that just helped kind of getting away from that atmosphere although I wouldn't change those years and then the exercise discipline came last you know I'm I never was really good at I was never at let eclis incline but I was never real good at being of being structured with my exercise doing it every day and that came about third and you you are able to do that now yeah I wouldn't trade it for anything because you feel better oh yeah it just it makes all the difference in the world you know it just gives you more energy and more alertness okay was there any concern you've you mentioned as a teenager having the the one complication the place on your leg that didn't heal any other complications then yeah it's some time maybe my freshman year in college I they found some background retinopathy which is real common after the ten about ten years of the disease which is about what I was a statistic and that in addition to the spot on my leg kind of was a little bit of a scare tactic it made me think I'll geez you know it's only going to get worse if I don't really muster up some self discipline and yeah that it did make me take more responsibility for the disease what I'm hearing all through this then is that you you needed the health professionals to to give you the basic information but it has to be geared very much to to your lifestyle and that you don't really make the changes until until you're ready and so that that your helpers have to be constantly listening for those cues that you give them in their to to help you when when you're ready and they need to be real open to those food Jags or really obsessive times and excessive times when the when the kid is growing up you know adolescence is a tough time for everyone diabetes just kind of adds to the problem so they need to be real open to what see see it's been good to talk with you today we really appreciate you sharing these things with us and I think it'll be valuable to many people this has been a conversation with cz Karski dietitian in diabetic