Type One Warrior Feature: Sarah

I am hopeful that this will become a regular feature on our Type One Warrior page. A warrior feature that proves, above all else, that type one diabetes does not discriminate. It affects all races, all ages, all genders and all socio-economic backgrounds. The more stories we read the more we learn about the disease and how different every single person’s journey is.

Sarah Munro is a 27-year old mom. She was one of the first friends who came to our side when Harrison was diagnosed over a year ago. Sarah has been fighting Type 1 Diabetes along with a few subsequent ailments for 17 years.

Photograph: CT Photography

Last A1C score: 6.8
Lived with T1D for: 17 years

My diagnosis story

I was really sick. The previous year I had been diagnosed with bronchitis and from there I had started losing a lot of weight. I was 10 years old and looked like a rake. I remember going to see a friend of mine's gran in hospital one day and the lady lying next to her had diabetes. I didn't know anything about diabetes at the time but my friend told me that she was dying. Around the same time, my mom got really worried about my weight loss and took me to the doctor. He sent me off for blood tests and we went home.

I'll never forget that phone call at home: I answered the phone and it was the doctor. He asked to speak to my mom. We had another phone in my parents bedroom and she went there to talk to him. She started crying, and when she got off the phone she came and told me that I had diabetes and I needed to get to hospital.

I remember thinking about that elderly lady lying in hospital and I just started crying saying 'I don't want to die'. My blood glucose level was at 39, a non diabetic's ideal blood glucose level ranges from 4-6mmol/L.

I have a huge needle phobia so learning to inject myself and check my own sugars was a huge battle for me.

Dealing with Type 1 Diabetes in public as a child and teen

I have never necessarily been ashamed of being a Type 1 Diabetic, I’ve just never advertised it. When I was diagnosed the teacher at my school educated the class about diabetes. The friends I had were really supportive and most of these friends ended up attending the same high school as me so that adjustment was easy.

I met a friend on one of the diabetic camps and he would openly inject himself at the dinner table even through his jeans. I preferred to go away from people (usually the bathroom) to inject myself, but that was more because I was so afraid of people bumping me while I was injecting.

The most difficult thing to overcome being diagnosed a Type 1 Diabetic

Shew! I have found each phase of life has had such a different battle. Initially learning how to inject was tough. In hospital they taught me with a needle and an orange. Going back to school was also tough as I had missed a lot and trying to catch up was very stressful.

The pre-teen years were tough as we were still in the learning phase and adjusting medication. During my time of facing how to inject myself despite my fear, I went through what is known as the "honeymoon period'. This is when your pancreas kicks in a little and gives its last couple of squirts of insulin. Because my body was producing small amounts of insulin, the amount of insulin needed via injection was greatly reduced. I was starting to have hypos (episode of hypoglycaemia where your body has too little glucose going to the brain) but the doctor encouraged my mom to continue trying to get me used to injecting even if it was half a unit, or none at all.

My teen years were terrible. Hormones caused many issues for my sugars, often ending me up in DKA in hospital, and twice in a coma. With the added stress of exams and what to study or where to study - it was all just such a mess. Varsity was another challenge: the extra independence came with extra responsibility. Going out for drinks with friends wasn't as simple as just choosing what drink to have or whose house to have pre-drinks at. Clubbing, cocktails, shooters lead to late night/early morning burgers or feasts at the local clubs hotdog stand.

The next challenge was when I was pregnant. I had a terrible pregnancy. I was diagnosed with pre-eclampsia at 12 weeks and soon after I was diagnosed with hyper-emesis gravadium. My kidneys very quickly started showing signs of deterioration and I was battling terribly with my eyesight. My HbA1c was the best it has ever been in a long time when I was pregnant because of how disciplined I was - I had a strong motivation to be healthy. My baby was born at 26 weeks and this is the only time I have ever been grateful for my Diabetes. Diabetic women are known to have larger babies due to the excess sugar which in turn, makes the baby secrete extra insulin which then increases the fat deposits in the baby. My baby boy was only 300gms over the usual weight of a 26 week gestation baby, but any NICU mom will tell you that 300gms is a LOT!

To date, the most difficult thing I am facing and have not yet overcome, is that I will not be able to carry another child. Diabetes is an auto-immune disease, thus resulting in patients being prone to more auto-immune diseases. My blood results are showing that I may have Lupus and this together with the Diabetes makes it far too great a risk to be pregnant.

Using a pump and how it’s changed my life, for better and for worse

I switched over to a Roche Accu-Chek Spirit Combo in 2013. I was originally on a different pump but I found the features and customer support for the Roche pump far outweighed the other brand. Having a pump is great! I was on 5 injections a day, so for someone who is needle phobic this is just awesome! The trickiest part is planning where on my body to wear the pump when I want to wear something without pockets, or for a day at the beach.

How I control my Diabetes

I must admit that I go through phases of control. I get demotivated really easily when it comes to strict control over my blood sugar levels. Life also gets crazy busy with a child, and so often the first thing that goes out the window is self-care, but he is also my biggest motivator for keeping and staying healthy.

My symptoms of hyperglycaemic or hypoglycaemic episodes

When my sugar goes too high I'll often get a headache along with increased thirst, fatigue, blurred vision and I find it difficult to concentrate.

When my blood sugar goes too low, I start sweating and get shaky and weak. My vision gets blurry as well and I also get a headache along with dizziness. I feel like my heart is racing and I get a feeling of anxiety and nervousness. This is also when I get grumpy and very moody or irritable. My hubby knows to just give me fruit juice and a snack.

My treatment for lows: usually a small box of fruit juice and then some pro vitas with cheese on works well for me.

Some of the other implications with Type 1 Diabetes

While I was pregnant, the blood vessels at the back of my eyes burst. I couldn't tell the difference between green and blue or pink and orange. If I lay down and suddenly got up I could see the blood floating around in my eyes and once it had settled there would be tiny black patches where I just couldn't see.

Other autoimmune diseases

I have tested positive on an ANA test. An ANA test detects antinuclear antibodies in your blood. Antibodies help you fight infection, but antinuclear antibodies attack your body's own tissues. Your body basically starts attacking itself. My main symptoms are that I am frequently tired, and my muscles and joints are sore.

Positive message for other Type One Warriors

I have to quote AA Milne here: 'Promise me you'll always remember: You're braver than you believe, stronger than you seem, and smarter than you think'.

There will always be challenges and obstacles that you need to face - but how you approach them and overcome them is what will define you and set you apart from others. Cands refers to those that are diagnosed with Type1 Diabetes as 'Type One Warriors', and I believe that that is because warriors don't get to rest - it's a 24 hour daily challenge. But with proper training (knowledge) and proper weapons (our team of doctors, dietitians, etc), and the correct armour (our medication) warriors come out victorious!

Photograph: Julia Reese

My treatment regime

I have a Dexcom that continuously monitors my blood sugar. So every morning I wake up and look at my phone to see where my blood sugar is sitting. I then bolus according to what it is and what I'm going to be eating for breakfast. Lunch time is pretty much the same - check sugar, attempt to carbcount, bolus for the meal and eat. Throughout the day I check my phone to see what my blood sugar is doing. If my levels go out of range, my phone will alert me and I adjust accordingly.

The toughest part is the evenings for me. Having a little toddler to entertain, cook for, feed, bath and get into bed often sees my blood sugars taking a little dip. Paired with low blood sugar symptoms of irritability, anxiety, weakness and shakiness - it's just not fun. It's then supper time for us if we haven't eaten with our boy, and same routine as during the day. Then before I go to bed I give a little injection of some medication that helps prevent the extreme swing of lows and highs. If I wake up during the night I will often check my phone to see what my blood sugars are doing.

I use both insulin pens and an insulin pump. I originally was only using insulin pens and to get the closest to a 'functioning' pancreas, I found I needed to give 5 injections a day. This consisted of 1 long acting insulin in the morning (this covers me for 12 hours) as well as a quick acting insulin which will cover breakfast. Lunchtime is another quick acting insulin shot. Supper time is also a quick acting shot to cover the meal and then before bed it's one last long acting shot to see me through the night.

Not every day is the same as before - you can eat the exact same food one day as the next and do the exact same activity, but your body will throw in a surprise for you somewhere and you'll find yourself either having to give another shot or trying to correct a low blood sugar reading. I found the pump relieved a lot of this stress for me. 

It’s annoying when people say things like “should you be eating that if you’re a Diabetic?”...

Oh my goodness, go and educate yourself please!!! I wish people would spend a little time learning about our disease and stop making silly statements like "should you be eating that?" or "You shouldn't be having that if you're a Diabetic".

Exercise

I don’t exercise. Should I exercise? Absolutely. I went through a phase where I was going to gym 3/4 times a week. Spinning class twice a week. Played tennis twice a week and danced (ballet) twice a week. I was exhausted every night, but my sugars were really well controlled and I got the most amazing sleep. Time is sadly not on my side these days.

Hardest part about being a Type 1 Diabetic

Lack of knowledge and education and lack of willingness to learn about this disease from others. I'm tired of explaining what I'm doing and why or what I'm eating and why. People don't always understand when you get tired - and I mean really tired (diabetic tired). Sometimes, because of the fatigue, I have to postpone get-togethers or change plans at the last minute.

Also, airport security is such a pain. So is trying to keep medication cool.

Best part about being a Type One Diabetic

I’m laughing out loud for this one - the best part for me was probably at school when I was having a low... I got to eat in class! But honestly, I really think the best part has been learning so much more about my body. Learning about this disease and helping others has been rewarding in itself. I've met so many amazing people because of this journey that I'm on.

One thing I’d love non-diabetics to know

The difference between Type 1 Diabetes and Type 2 Diabetes I guess. I always joke and say “my diabetes is nothing like your grandma’s diabetes”.

One thing I’d say to a newly diagnosed warrior

Set yourself goals. One goal can be to learn how to inject yourself, another can be learning to carbcount, another can be inserting a new infusion set for your pump etc. Having goals similar to these really helped me when I was diagnosed. It 'broke down' the trauma of being diagnosed, and each goal I accomplished felt like I was 'beating' it. 

My support

​My husband, Craig, is amazing. He knows what to do when I'm having a low or high, he knows how to help me correct it as well as what support and encouragement I need. My family is also wonderful. I think my diagnosis hit my parents hard and my mom has especially taken so much time to learn and do her best for me when I was growing up. I remember my mom and dad waking me up at 2am some mornings to see what my sugars were doing. I always woke up so grumpy, but even more so when my sugars were low. They would get me something to eat and while I was eating to get my sugars up my mom would rub my feet for me - instant good mood!