Here I am, a little after midnight, wide a-fucking-wake.
And evidently, I'm fighting with Dawna.
Well, not really. We're not fighting, exactly. But I upset her, and now she's downstairs watching TV while I'm upstairs doing what I tend to do when my brain won't shut the fuck up. I'm writing. And I suppose this is part of building a relationship, too. Learning how to disagree, how to handle the moments when one of us says something stupid, and how to navigate the fact that two people can love each other completely and still occasionally piss each other off.
But the disagreement itself has very little to do with what's cracking my pipes right now. That has everything to do with my absolutely shitty relationship with sleep, my decades-long battle with type 1 diabetes, and the fact that medical devices apparently believe their primary responsibility is to make sure I never get a decent fucking night's rest.
To be clear, I'm not an irresponsible diabetic, per se. I just suck at counting carbohydrates. For those of you fortunate enough not to understand what that means, type 1 diabetics have to administer insulin to manage the glucose that enters their bloodstream, particularly after eating carbohydrates. If I'm going to eat a piece of bread, for example, I need to tell my insulin pump approximately how many grams of carbohydrates I'm about to consume so it can deliver enough insulin to cover them. Sounds simple enough, right? Count the carbs, push a few buttons, and let modern medical technology do its thing.
Except it isn't that fucking simple.
Because everything affects blood glucose. Exercise can drop it. Too much insulin can drop it. Carbohydrates raise it. Fatty meals can drag the whole process out for hours. Illness can make insulin less effective. Scar tissue can interfere with absorption. The time of day matters. Stress matters. Your state of mind fucking matters. Sometimes you can eat exactly the same meal, take exactly the same amount of insulin, and get two completely different results because your body apparently decided to change the rules without bothering to send you a memo.
And after living with this disease for a couple of decades, I've learned a thing or two about how my body behaves. I've developed habits, routines, and ways of dealing with the constant fluctuations. Are they always perfect? Hell no. But they're mine, and they're built on years of experience living with a condition that never takes a fucking day off.
Which brings me to insulin pumps.
These things are technological marvels, and I genuinely appreciate what they do for me. But holy fucking shit, do they love to make noise. They alarm for everything. High glucose. Low glucose. Predicted high glucose. Predicted low glucose. Low reservoir. Expired infusion set. Something needs attention. Something might need attention. Something might possibly become a problem three hours from now, so naturally we should wake this motherfucker up immediately and make sure she knows about it.
I actually wrote another blog about this very thing a few months ago, because apparently my relationship with medical technology is an ongoing source of literary inspiration.
The problem is that these alarms don't give a flying fuck whether you're sleeping. And sleep, for me, has become something of a precious commodity. I absolutely hate being dragged out of a perfectly good sleep because some medical device has decided that a number on a screen requires my immediate attention. Sometimes it does. Sometimes it doesn't. But after years of being woken up by these things, I've developed a healthy resentment toward the engineers who design them and then presumably go home and sleep peacefully through the fucking night.
I've been as low as 30 mg/dL and still been standing, although that doesn't mean a reading that low isn't dangerous. And I've experienced plenty of high glucose readings that eventually came back down without turning into a medical emergency. I know what diabetic ketoacidosis feels like, too, and I've learned to recognize some of the warning signs in my own body. None of that makes me immune to a serious problem, particularly if my pump stops delivering insulin, but it does mean I don't react to every abnormal reading with the same level of alarm.
And quite frankly, sometimes I just want to fucking sleep.
Now, add to all of this the incredibly shitty sleep schedule I've developed lately. Most evenings, I'm exhausted by seven or eight o'clock. I go to bed, fall asleep, and then wake up somewhere around midnight, wide awake and ready to contemplate the mysteries of the universe, solve problems nobody asked me to solve, or write a few thousand words about whatever happens to be pissing me off. Eventually, somewhere around four in the morning, I fall asleep again, only to get up at five and get ready for work.
It's a ridiculous way to live, and I'm trying to change it.
Part of the reason is Dawna. I leave for work early, come home late, and then promptly turn into a pumpkin before the evening has even gotten started. During the workweek, we might get an hour together before I'm ready to crawl into bed. And that's not enough. I want to spend time with my fiancée. I want to sit with her, watch television, talk about our days, laugh about stupid shit, and generally enjoy the fact that I get to share my life with this incredible woman. So I've decided to start pushing my bedtime later, hoping that eventually my body will get the message and stop treating eight o'clock like some kind of mandatory shutdown procedure.
Tonight was one of my first serious attempts.
I was tired at my usual time, but I pushed through it. I stayed up until eight, came upstairs to lie down, and probably fell asleep somewhere between eight-thirty and nine. Not exactly a dramatic victory over my internal clock, but hey, progress is progress.
Unfortunately, my blood sugar had other plans.
We'd had Jersey Mike's earlier in the evening, and my glucose climbed to around 350 mg/dL and decided to hang out there. For those unfamiliar with diabetes, that's high. Really fucking high. And it wasn't coming down the way it should have. The sandwich had plenty of processed meat and cheese, and meals with a lot of fat can delay digestion and make glucose management a pain in the ass for hours afterward. Combine that with my less-than-stellar carbohydrate counting, and it's not particularly unusual for me to find myself chasing a stubborn high after a meal like that.
So I went to sleep, figuring my pump would eventually catch up. And if it didn't, I'd deal with whatever needed dealing with when I woke up. That's been my habit for years. If something can reasonably wait until morning, I prefer to let it wait. I know there are situations where waiting is a terrible idea, especially when insulin delivery might be interrupted, but I was tired, frustrated, and desperately hoping to get through one fucking night without having to troubleshoot my diabetes.
Dawna, however, was worried.
And I get it. A glucose reading of 350 that stays there for hours isn't something to shrug off. She knows that, and she cares about me. So she came upstairs to check on me. More than once, apparently. At some point, I woke up to find her looking at the app on my phone, trying to figure out why my glucose wasn't coming down.
Now, Dawna has an engineering brain. She sees a problem, and she wants to solve it. It's one of the things I love about her. She doesn't just sit around wringing her hands and hoping something gets better. She starts looking for the cause, examining the variables, and figuring out what needs to change.
And she noticed that my infusion set had expired.
For those of you who don't live with an insulin pump attached to your body, a quick explanation. The reservoir is the container that holds the insulin, and the infusion set is the tubing and little device that delivers that insulin beneath the skin. My current pump allows me to replace those components separately, which is different from the pumps I used previously. Those older systems had me accustomed to changing everything together, so that's generally how I still approach it.
The infusion sets for this pump are designed for up to seven days of use. My reservoirs typically last somewhere between three and five days, depending on how much insulin I'm using. And because I hate wasting supplies and don't particularly enjoy sticking new things into my body any more often than necessary, I've gotten into the habit of leaving an infusion set in place until the reservoir is empty, even if the set has reached its recommended replacement date.
Is that what the manufacturer recommends? No. Is there a reason those replacement intervals exist? Absolutely. Infusion sites can become less reliable, and leaving them in longer can increase the risk of problems. But I've gotten away with stretching them before, and as happens with so many things in life, getting away with something repeatedly has a way of convincing you that your particular method works just fine.
Until, perhaps, it doesn't.
So Dawna is looking at my phone, sees that the infusion set is expired, and points it out.
And I'm lying there, freshly dragged out of sleep, slowly realizing that I might have to get up and start fucking around with my insulin pump. Which means getting supplies, changing the infusion set, checking everything, and making sure insulin is actually getting where it's supposed to go. And once I'm awake enough to start doing all that, there's a pretty good chance I'm not going back to sleep anytime soon.
To make matters worse, I have to be up at four-thirty tomorrow morning because I'm hosting a large meeting with my team at work, and I want everything to go smoothly. I've been trying to fix my sleep schedule, I finally managed to stay up a little later, and now I'm staring down the possibility of another night spent awake while the rest of the world gets to enjoy the wonderful fucking invention known as sleep.
So I was grumpy.
Actually, grumpy probably doesn't quite cover it.
And Dawna, being Dawna, was trying to help. She'd identified something that might explain the problem and was pointing it out because she was concerned about me. But my half-asleep brain wasn't particularly interested in troubleshooting, and I couldn't seem to assemble the mouthwords necessary to explain why I was so frustrated. Instead of telling her that I understood what she was saying, that I appreciated her concern, and that I was just exhausted and dreading the interruption, I barked at her.
And she went back downstairs to watch television.
Now, look. She didn't deserve that.
She wasn't doing anything wrong. She wasn't trying to annoy me, criticize how I manage my diabetes, or make my night more difficult. She was worried about the woman she loves, and she was trying to help. From her perspective, she saw a potentially serious problem, tried to point out a possible solution, and got snapped at for her trouble.
From my perspective, I was watching another desperately needed night of sleep go straight down the fucking toilet.
Both of those things can be true at the same time.
And that's something I'm learning about relationships. Sometimes the disagreement isn't really about the thing you're disagreeing over. Sometimes it's about exhaustion, frustration, worry, or whatever else happens to be rattling around in your head when somebody says something perfectly reasonable at precisely the wrong moment. Dawna couldn't see the thoughts running through my head. She couldn't know that I was already mentally calculating how many hours of sleep I had left before my alarm went off, or that I was quietly mourning the loss of another night when I might have actually slept like a normal fucking human being.
All she knew was that she was trying to help, and I got mad at her.
And I can't blame her for being upset.
So here I sit, a little after midnight, wide a-fucking-awake, writing about the whole thing while my fiancée is downstairs watching television. The irony isn't lost on me. I was so worried about losing sleep that I managed to get myself worked up enough to guarantee I wouldn't be sleeping anyway. And somewhere in the middle of all this, I hurt the feelings of the person who was only trying to make sure I was okay.
That's a pretty shitty outcome for something that started with a sandwich.
I know we'll figure it out. This isn't some earth-shattering disagreement that's going to redefine our relationship. It's two people learning how to live together, how to understand each other's habits, and how to handle the occasional moment when one of us is being a complete pain in the ass. I'm sure there will be plenty more disagreements in our future, because we're human beings, and human beings have an extraordinary talent for getting on each other's nerves, even when they love each other.
What matters is what we do afterward.
I can't promise I'll never get grumpy when somebody wakes me up. Hell, I can't even promise I'll be particularly pleasant the next time my insulin pump decides to throw a midnight tantrum. But I can try to remember that Dawna isn't the enemy, that her concern comes from love, and that the frustration I'm feeling about my diabetes doesn't belong on her shoulders.
And I can try to do better at explaining what's going on inside my head instead of expecting her to somehow figure it out. Which is a little embarrassing, considering I'm a writer. You'd think somebody who spends so much time putting words together would be reasonably good at producing them when they actually matter. But apparently there's a significant difference between having a keyboard in front of me and being woken up in the middle of the fucking night.
We're still figuring each other out. Our relationship is young, and we're learning where the rough edges are, which buttons not to push, and how to give each other a little grace when life gets frustrating. I don't expect either of us to be perfect. I just want us to keep choosing each other, even on the nights when one of us is tired, worried, or being an asshole.
Because at the end of the day, I know her smile will still melt my heart, and her hand will still calm me when the noise starts creeping in around the edges.
And that's worth figuring out how to get through a few shitty nights.
