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The Tipping Point

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27 January 2006

The Tipping Point

Whether you have had diabetes for a year or 30 – we all experience the same peaks and valleys of managing our illness.

I will now use a novel approach to describe how and why a “low” period begins… a low period can last for a day or a year (depending on the linear amount of time you have been living with diabetes).

It is called the Tipping Point. (There is a book, called The Tipping Point, and I have borrowed the term…) This is the definition:
In epidemiology, the concept that small changes will have little or no effect on a system until a critical mass is reached. Then a further small change "tips" the system and a large effect is observed.
I believe that for many people there is a moment when you are stripped down to your barest and most raw feeling about confidence in managing diabetes, and in feeling secure about the decisions you have made – both daily and long term. It is when all those “little things” about diabetes finally become, as said above – a critical mass.

What made me think about this exactly? Well, obviously my own experiences but mostly from an email that I read on the “UK Pumpers” support group. Someone who has had diabetes for 46 years (and pumping for 5 years) wrote to everybody saying that he had had enough. BG’s were bad, A1c was terrible and he was overwrought in having to deal with another unpredictable day. Nothing was working.

Man! (I don’t often use that expression) I am undeniably familiar with this emotional precipice! One of my greatest tipping points was at a time when I was in University. Things were not easily manageable, and I couldn’t come up for air. My A1c was abysmal, and I felt terrible. I didn’t want anything or anybody. I cried a lot of tears before I finally woke up. That was my tipping point.

The result of the tipping point is then making the decision that something radical must replace the current situation. Sometimes we make this decision wittingly – other times, sub-consciously.

Once the tipping point has past, whatever decisions come next – (and I find this the most draining!) is the shed-load of self-coaching and reassurance that can only come from within. It is this unbelievable and magnificent will of a person who just won’t let diabetes beat him. As for the e-mailer…I hope he resists any radical moves while in a “low period.”

Have you had a tipping point?

7 Comments:

Blogger Sandra Miller said...

Elizabeth, today, while waiting for test results for my son-- after months of riding a rollercoaster in which we're all over this for a week or two, only to have it all go to hell, resulting in weeks of uncontrollable highs -- I'm right there.

But I'm not the one with diabetes.

It's my son. So today, while he's at school, I'm a wreck. Totally spent.

But tonight, I'll look at his logs, figure out (yet again) where and when we need to test basals, and (hopefully) celebrate the fact that he has diabetes alone. Nothing more.

7:41 PM  
Anonymous Kevin said...

This certainly rings a bell. I've recently had my own "wake-up" call regarding my diabetes care (or lack there-of). Signs of numbness in my feet has been one of the scariest, most depressing, though ultimately empowering things to have happened to me and the level of my diabetes care. I can only hope that it's not too late to slow down/halt/reverse this and/or any other complication associated with this damnable disease.

I'm actually reading "Blink" now, which is by the same author. Kind of interesting stuff. Perhaps I'll read "The Tipping Point" next.

8:50 PM  
Blogger Keith said...

This comment has been removed by a blog administrator.

5:05 AM  
Blogger Keith said...

Elizabeth--
I have, I guess you could say, a minor tipping point about this same time every year. My diabetes control is directly related to my exercise patterns. After coming through the Christmas holidays and now January with poor exercise patterns, it really starts catching up with me. My clothes get snug, my insulin requirements go up and my bG's just become much more unpredictable. That signals me it's time to get on the treadmill and bike trainer. And yes... it's time!!!

I've got The Tipping Point on my desk beside me and haven't had a chance to read it because of the stack of computer books I'm trying to get through!

(I deleted my previous post... I'm such a keyboard person that I inadvertently hit enter and blogger posts before I'm ready!)

5:28 AM  
Anonymous Elizabeth Zabell said...

Elizabeth-
Yes, that sounds very familiar to me. I think that I was there a few weeks ago. It seemed like I couldn't do ANYTHING to make it better. On top of that, I think that the reality of having to do this forever set in. I mean really set in.

It didn't seem that bad at first. I felt sort of empowered. Now, it just feels like a hassle.

I can't say I'm thrilled to have diabetes. Not at all. But after getting my latest A1c, I feel a little better. More under control. Maybe its starting to tip the other way for me.

6:45 PM  
Blogger mytime79 said...

"It is when all those “little things” about diabetes finally become, as said above – a critical mass."

I didn't known that there was a name for this - "tipping point." I'm there, i'm totally there.

For me, I had not faced the reality of having diabetes for so long that I didn't feel the effects of having the disease. About a year and half ago, it all started to unravel and it keeps unravelling.

You say that the strength and reassurance eventually has to come from within... I can't see it, I don't feel that I'll ever be strong enough to give myself that and everything else that I need.

I want to feel strong and feel that I can be okay, but I'm just not sure how to do it.

3:20 AM  
Anonymous Thea said...

I am glad to have stumbled across this site, and especially happy to see that I am not the only person out there who has felt their powerlessness and frustration build to a crescendo... a "tipping point." I am teetering on my own right now and often feel at a loss for what I can do. I've had diabetes for 18 years, yet I don't seem capable of caring for myself as well as I did when I was 8 or 10 years old. I have been a "bad diabetic" since I was about 12 -- sweets are my major faiblesse, and since I'm brittle, my insulin regimen has been nigh impossible to balance, so I've gained more weight and become more insulin resistant.
I made a good turning point when I went to study abroad in France last year -- I was walking a lot, hiking and dancing and generally moving a lot, finally taking modern insulin (no more N and R, but NovoRapid and Levemir!), and eating much more sensibly. I lost a lot of weight, but sensibly, and my blood glucose levels were great.
Then I had an accident -- a fall that herniated a disc in my back, which sent me back home to the States earlier than planned, and then necessitated surgery. I felt more pain than I had known was possible; I was weak and immobilized for months, barely able to walk and sit, and simply felt like my life was over. I went back to this compulsive eating, and my blood sugars were wretched... I stopped caring, and I stopped taking responsibility for my diabetes care, since I felt so powerless about most all other aspects of my health.
Eventually I struggled through enough physical therapy to go back to university. I grew physically stronger, which helped me regain my will -- not only to live, but to devote myself to having a good and fulfilling life. Now that I'm moving almost completely normally again (still no heavy lifting), I've decided that if I want to live a normal life and go off to grad school next year, I have to act like an adult and take responsibility for all aspects of my life, with my health and diabetes care foremost. My sudden gust of resolve has come just in time, it seems -- my blood pressure is still much too high, I have edema in my legs (at 27!), I have gained 70 lbs. since my surgery, and have a positive microalbumin. I am terrified that my will won't be strong enough to help me get my body and health back into shape. But it seems that many of you are at a similar point; eventually one must realize that others are in the same situation, discard their feelings of powerlessness, ignore their qualms and doubts, and get to work on taking care of themselves, daunting though it may be!
I wish all of you good luck on keeping strong and brave. I hope that everyone at or just after this tipping point will continue to pursue their goals and retake the reins, as it were, of diabetes control -- I hope that I can do it, too!

3:34 PM  

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