Life for someone with diabetes can be a roller coaster, and there’s risk. Short term, long term – it’s risk. To get decent A1Cs, you have to be doing something right. To survive Type 1 Diabetes on a daily basis, you also have to be doing things carefully.

So, you’re plodding along in your life and suddenly a steamroller comes along and tries to flatten you. That’s what happened to me last month. I’ve come to the conclusion that sometimes generosity and caring translates to a huge sign on my forehead that says something like: Born yesterday! Want something? Apply here!

That very long story, for the purpose of this piece, is not worth telling. The result is…

So, three weeks ago, I separated from my husband of 4 years, and have evicted my overseas guest who was here for 8 weeks. I don’t actually feel a whole lot better… yet. Sure, I’ve saved my self-respect (or whatever that was supposed to do for me), but in the world of diabetes, living alone in a new location with no new friends yet, doesn’t augur well with me.

If I had time to get out there, it would be easier, but although the work is starting to come in now after eight months of marketing for new clients, I’ve got bills stacked high. My time is spent trying to make ends meet on one income, in a place and a mortgage meant for two, and I have little energy for much more after that.

My daughter lives in this area and I talk to her and see her often, but she works 6 days a week and has a life with a live-in boyfiriend and all their friends. I also have some clients I’m friendly with (but don’t socialise with). In reality, no one else is responsible for me or for how I deal with diabetes.

When I had other people in my house, I could reasonably rely on them to pick me up off the floor, should I have ever ended up there. I never did literally, but I do have trouble when I go low, and there was much security in knowing others were around.

Daytime isn’t a problem. I test often, but sometimes I’m caught up in stuff and can leave it an extra hour or so to test. I’m a bit hypo unaware, often not feeling anything but my eyes going strange starting when I’m well below the threshold. Not so good, but I’ve always caught it, even though by the time I do catch it, I can’t often remember what I’m meant to do. Test? Wait for a migraine? (My beginning symptoms are similar.) Put my glasses on? What IS that with my eyes? What does it mean?

It’s a strange kind of funny that every time this happens, you’d think I’d know what to do, but the thought process goes into a kind of slow motion, sometimes illogical deduction. Lack of glucose to the brain no doubt.

While I have never minded living on my own, it was always in places I knew others, and since 1989, my daughter was at home until she was a late teen, She’s smart, resourceful and has lots of common sense. She knew what to do when something was wrong. Since she was 6, I always had husbands or others living in my house. Not so now. I’m in the kind of place it’s very difficult to rent rooms for various reasons.

My late friend, who died in February 2010, always knew I was heading for a low, well before I realised it. He was a kind of hypo-dog human! I sure miss him. No one else has ever come close to the kind of instincts he had about me and about my blood glucose.

I do have a dog, a very sweet Border Collie, but she’s the furthest thing you can imagine from being a hypo dog you can possibly imagine! She prefers to have glaring contests with the local frill-necked lizards, on the other side of the open fence.

Living alone, sleeping is more of a worry. Not sure how to solve that. I could get one of those medical alert buttons (at a cost for monitoring or one that dials numbers), but what can I do with it while I’m asleep? I sleep like a log, and that’s a worry too.

So, no really late night snacks unless they’re very low carb. Making sure my blood glucose is stable for a couple of hours before bed. Not going to bed at anything under 5.5 (99 mg/dl), in fact sometimes if I do find myself much lower than that before bed, I’ll take a 4 gram glucose tab.

Making sure my basal rates are just right on my pump means regular night basal testing, especially while the seasons are changing (summer is different to winter for me).

I’m not sure there are any more precautions I can take, but there’s still risk. I think everyone who is insulin dependent, worries about the risks. Yes, you can live with a house full of family and still no one could know you’re in trouble when you’re asleep, but those risks multiply when you live alone.

I may not particularly want to face the day sometimes, but these days I tend to be very thankful I’ve woken up in the morning.

It’s that time of year again – the Jewish High Holy Days – Rosh Hashanah, the Jewish New Year (feast), Yom Kippur, the Day of Atonement (fast), and Succot, the Feast of Tabernacles (feast). It’s a plethora of festivals and Holy Days like no other – all at the same time of year. Not that I’m particularly religious – in fact, I’d say I’m not at all religious. Christopher Hitchens is a hero of sorts, so an easy conclusion follows about my beliefs. Nevertheless, I definitely didn’t say I don’t like traditions. I love them! I have no rational explanation yet these High Holy Days are part of my heritage and ones I still like to partake in, in some way, every year.

Tonight was the start of Rosh Hashanah.

The same dilemma faces me every year. Food has special significance in Judaism – traditional food at traditional times of the year. Symbolic food for a sweet year is eaten on Rosh Hashanah. Sweet Challah – a yeast-risen, eggy bread that is usually eaten on Friday nights, and made sweeter for Rosh Hashanah. Apples are also traditional. Both are dipped in honey, and plenty of it!

The nightmare for someone with diabetes continues with, for Europeans, something called gefilte fish. Yup, sweet fish mixture (don’t ask) with chren, horseradish mixed with beetroot. Don’t ask! I love it but I guess it’s like Australian Vegemite – an acquired taste. You either grow up with it and love it, or learn to like it if you’re living in someone else’s tradition, or you turn your nose up at it. The non-European Jewish people – some  from the Middle East, Africa and some Mediterranean countries don’t have gefilte fish in their traditional food and often don’t like it. Thanks… if you’re sitting next to me, I’ll have yours too!

Course number three will have a side of tzimmes, a sweet carrot dish. And there are more dishes – sweet, sweet, sweet. How else can we expect to have a sweet year unless we stuff ourselves with traditional sweet foods? That’s tradition for you!

Every year, I look at the apple, the challah, the honey and all the other dishes, swearing I will only take a tiny bite. But, you know… I want to have a really sweet year.

The problem is the massive carb guestimate that goes along with eating that kind of food.

While you’re in a fascinating conversation with someone else at the table, you are barely aware that you’re reaching for another piece of challah because this year, it’s especially yummy, or that someone has put a plate of freshly cut fruit in front of you and it’s just there, staring at you, saying: eat me, eat me. Fresh rockmelon, honeydew melon and watermelon. One small bite, right? Wrong! Honey cake (yes, honey is THE star of the show) and more fruit. So that’s 4 courses (at least) times sweet.

Um… what was that? Maybe 50 grams of carb… maybe 150… maybe some carb number out of my reach. None of the food comes with a carb count. After years of enjoying the food and madly blousing under the table, you get pretty good at guessing, but you can never be sure. Just 10 grams of carb out – nearly one teaspoon of sugar, which could easily be contained in a single bite of some of what I was eating – can be the difference between ‘in-range’ and oh hell I need more insulin. Believe me when I tell you, it’s seriously good food, firstly because it’s good food, but secondly, it’s food you’ve had at this time of year, every year of your life, so it has a history in a deeply rooted tradition. Maybe like a traditional Christmas lunch, which I’ve never had. The older you get the more past times and places you are reminded of, and the more entrenched that tradition becomes – least it does for me.

Insulin pump, thank you! I could never have managed this without you! (And never did!) I’ve had you now for 2.5 years, and still thanking my lucky stars! Combo bolus for a few hours, and add straight boluses here and there as you realise you’ve nearly lost count of the carbs. Manageable, although I suspect I had an entire week of carbs in one sitting. And I’m well aware that it will do my waistline no good at all! Insulin makes me fat – it loves me that much!

Every year, when I get home and pull out my meter, I make bets with myself – how high am I going to be after all that food I wasn’t going to eat, and how off was my carb guesstimate. In times past, I would also be doing some of the cooking for the crowd, so I would make some lower carb dishes as well. This year I wasn’t in the kitchen for the first time in 12 years. Eat or starve!

All things considered, I was a little high by the time I got home, but a 9 mmol/L (162 mg/dl) wasn’t so bad. Yesterday my endo said he advises people not to correct under 10 (180)… not that I’d follow his advice. That wouldn’t work for me. I’ll correct if I’m in the 7s or 8s (126-180). I feel better if I’m around 5.5-6.2 (99 – 112). I seriously expected to be way higher, so I’m pretty happy I almost nailed it. Just one more little bolus before bed.

Wishing all who celebrate this special time of year: Shanah tova u’metuka - a good sweet year.

How high do you go before you correct? At certain times of the year (e.g. Christmas or some other special occasion), do you have food you don’t usually eat? Clearly I do! And I’m not one tiny bit sorry!

I would dearly love to wring the neck of the person who told me many years ago: You can live a perfectly normal life with Diabetes.

On what planet?

The more ‘normal’ your A1C is, the more you had to do to get it there and keep it there. It’s a 24/7 thing when both the stuff that sustains you and the medication that fixes you, can kill you. Hmmm… a lose-lose situation.

When the stresses of daily life make your blood glucose soar around a number you don’t want… when an unexpected walk though a shopping centre has you rummaging for your meter and some glucose… when a simple social situation where there’s food, turns you into a mathematical genius… when the endless rounds of doctor visits, endos, eye doctors, foot doctors, pharmacy visits and any number of allied health visits and more, has you calculating how much per hour your time is really worth… when you’re tossing up between paying for medical insurance and paying the mortgage… when you wake up every morning, thankful you’ve woken up at all, but have to start managing diabetes all over again…

Just a few points of a very long list of D-life intrusions. How is that normal? Not remotely so. And where is the cure “within five years” I was promised more than 30 years ago? On the horizon? Yeah, right, that horizon keeps being a horizon for now, no matter how fast you run towards it.

Unless you eat the same, do the same, take the same every single day, day in and day out (and even then, there’s unpredictability), and if that’s normal for you (it isn’t for me), it’s still not normal.

After a few relentless years of diabetes, and if you’re interested enough, you end up with a PhD in D-Management. It’s life-long learning as you figure out what works for you, and watching as new things are discovered, new studies done, new technology – none of it perfect, but each step makes a difference.

Food, activity, stress, insulin – a small mix in a much greater mix of how this disease works.

And there’s survivor guilt of sorts too, when you hear about so many people dying or not living well because they can’t afford insulin. Nowhere is this more prevalent than in third world countries.

But this isn’t really a grumble… ok, it is of sorts because ‘normal’ doesn’t factor much into living with diabetes. Normal would be forgetting you have diabetes, eating anything you want, not taking insulin or other medication, not testing a gazillion times a day and generally not having a problem doing that. It’s like having a baby – your awareness is on your baby all the time, no matter what else you are doing. Babies grow up, diabetes doesn’t, although it can get easier to manage over time, the more you learn and the more determined you are.

Factor out life stresses, depression and other things that get in the way, diabetes IS manageable, but living with it is not a normal life.

There are few things you can’t do with diabetes – piloting a commercial plane, for one. Yet there is so much on-the-job discrimination for some… like you wouldn’t believe! No way, in this post, am I going into the other discrimination and misinformation out there that impacts on our lives. If you are determined and you can manage your diabetes, there’s no reason you can’t do almost anything you want. Being spontaneous is a little more difficult sometimes, but still do-able. If you grab your supplies in an always-prepared bag and go, you could almost call that spontaneous!

For me, this is a testament to how well many of us handle diabetes, despite so many obstacles, the huge education curve and the day-to-day vigilance. We do what’s required of us on a 24/7 basis, not only to stay alive from day to day, but to stay as healthy as possible for the long term. This is not only a mostly silent disease, all too silently it can wreak havoc with other medical complications if not well-managed 100% of the time.

And parents of kids with diabetes – I’ve said it before and I’ll say it again – what an amazing job you do! Out of love, you take on this disease as if it was your own, losing sleep, worrying, doing what’s required – trying to manage something even more unpredictable in kids than it is in adults.

Having diabetes is not in any way a ‘normal’ life, but it’s an often invisible disease and one that can be lived as a semblance of normal.