November 28, 2013
Written by Steven Liechty

Dear Theo,

I'm 31 years old, a college graduate, and for the most part I'm OK with the things I've done, the things that have happened in my life, even the bad things, and I'm more or less OK with my life in general.

Two things that haven't come together in general:  I can't seem to find a job I can tolerate and/or an actual career, and I can't seem to get my diabetes under control enough to start thinking about having kids with my soon-to-be husband.  I've been praying, not just for me, but for the right employer and my soon-to-be husband to all mesh at the time that would be good for all of us.

It's pretty discouraging to keep praying about this and seemingly getting not much of an answer to anything.  I've been applying for jobs and rewriting my resume.  I've been trying to eat as well as I can to keep my blood sugars stable and in range, recording my blood sugar results, my insulin injections, etc.

I just don't know what to do anymore.  I know things won't happen exactly when I want, the way I want them to, but something's got to give.



Dear Lost,

I have a few tiny bits to offer, but mostly I want to lean on the wisdom of someone I love. She is in her early 30s, a longtime diabetic, a formerly vocationally confused person, a Christian (on her good days), and a first-time mother (35 weeks pregnant and counting!). She has been where you are, and isn't there anymore. Maybe what she's learned, can help.

The things I want to suggest to you, about how to find work that is good enough, and maybe great:

Lutheran pastor Fred Buechner said, "The place God calls you to is the place where your deep gladness meets the world's deep need."

Sufi poet Rumi said, "Let yourself be drawn by the stronger pull of what you really love."

All this presumes you have some deep gladness, and something you really love—which I don't necessarily hear in your voice. I ask you a question, one that sounds simple but might actually be a little terrifying: if you are having trouble feeling deep gladness, what might be masking it? Can you explore that question when things are quiet, and you're really willing to hear the answer, no matter what changes the answer might imply?

And finally, Ecclesiastes says, "I know that...it is God's gift that all should eat and drink and take pleasure in all their toil." But he also said, just a few verses before that, "what do mortals get from all the toil and strain with which they toil under the sun? For all their days are full of pain, and their work is a vexation; even at night their minds do not rest. This also is vanity." So, if you can't find work you love right away, maybe there's a way to minimize the impact of your job so that it doesn't consume you night and day, but it feels like your Real Life is spent in doing other things and work is just a means to an end.

Now I'll get out of the way and let you two talk,



Dear Lost,

First: I've totally been there. I've TOTALLY been there. For many years. And while I was there, it didn't seem like there was a way for me to figure it out. I knew what I SHOULD be doing, I knew the steps I technically needed to take to get there, and I could even do it for a little while—but the thing was, I knew I had to do it for longer than a little while, and I just. couldn't. do it. I didn't know why.

Ultimately, and surprisingly for me, I ended up turning things around by doing two things:

1. Learning (slowly) to be more honest about what it means to have diabetes, what I have to do to take care of myself and being honest with people around me about needing to check my blood sugar, needing to eat a certain way, etc., regardless of if they thought it was weird or gross or whatever.

I found that most people just didn't know, and once I told them, it was basically OK. Kind of like when a kid asks you a question and you realize that you don't have to go into all the details, you just have to tell them enough to satisfy the basic question at hand. I realized that I was neglecting my health often, because I wouldn't want to say something as simple as "could you wait just a minute while I check my blood sugar?" or "would it be all right if we went somewhere other than a pizza place, so I can find something that will be easier for me to eat?"

Once people become more aware, it takes some of the burden off of you to always be the only one who's looking out for your health. Since you are soon to be married, I'd suggest - if you haven't already—reflecting on how comfortable you are sharing your health journey with your fiancé—and encouraging you to talk to him about it even if it's awkward or uncomfortable (it took me SO LONG to really be able to be honest with my husband about all of this! I still struggle with it! I have to give myself pep talks sometimes and remind myself that he won't be angry/upset/freaked out, and if he is, it's better to know and work through it).

2. The second thing I did - and I'm not kidding when I say that this is the reason I'm healthy today and this is the reason I had the confidence to get pregnant (although I didn't feel confident at the time! but a more underlying confidence...), and this is the reason I'm still healthy: I decided to take medication.

I was mildly depressed for a while during and after college, and really didn't take care of myself at all, which led to a self-perpetuating cycle of poor blood sugar management bordering on an eating disorder. Actually no, it was an eating disorder, I just never saw it as such or asked for help specifically for that. But I did, eventually, get over my opposition to pharmaceuticals and ask to be put on a mild antidepressant (Wellbutrin) which I didn't know at the time, but later learned, is used in the treatment of addictive behaviors and eating disorders.

As soon as I started taking it, I felt as if I had been released from the uncontrollable cycle of eat, eat, eat, high blood sugars, high blood sugars, high blood sugars, eat, eat, eat...etc...it was AMAZING. Suddenly I could follow through on the diabetes goals I had for myself because I wasn't being held hostage by this awful cycle of disordered eating and insulin dosing. I have no medical proof for this other than general research indicating that I'm right, but I'm pretty sure my poor control during college contributed to my eventual need for a low dose of medication to set things right again, and once I had that roadblock removed, I could focus on making progress and having my efforts pay off.

When I first started taking Wellbutrin, my a1c was in the low 9s. From there it steadily declined and for the first time in my adult life I was able to maintain an a1c between 6 and 7. I only wish I'd decided to accept that help sooner.

So I guess what I would say is: Get help. If you can't do it by yourself, that's OK! Get help! From somewhere. It's OK to take medicine. Or to go to therapy, if that works instead. But if what you're doing so far hasn't worked and hasn't been sustainable, take a chance and try something else. You can always ALWAYS stop. I only took Wellbutrin for about a year. I don't need it anymore. Medication may not be the solution that works for you—it might be something else, and that's fine. But something will work.

I offered a testimony at my church a few years back. The gist was that Jesus asks us to love our enemies, and that teaching became easier for me to understand when I thought of the enemy as my own body. Treating my body with love was the only way to move forward, the only thing that wasn't counterproductive. That didn't help me to actually do it, immediately. But it helped me to think about it differently. Which is maybe, eventually, what allowed me to do it.

On the vocation front: are you limited in thinking about what types of careers or vocations you will consider due to some lingering fears about diabetes and what it will make possible/impossible, or what it means for insurance coverage, or other considerations?

Again, I speak from my own experience here: as soon as I stopped trying to find the perfect job, I became a lot happier with the work I was doing and with the jobs I've had. This sounds cliché, but it's called work for a reason. I still feel conflicted about this, so I'm not sure if it's such good advice: but at some point I decided to stop putting so much energy toward trying to find the perfect sort of work because I realized I needed/wanted to spend energy on the other things in my life (church, husband, family, music, staying healthy, having a baby...).

I will keep you in my prayers - it's hard! Sometimes, to see if you can do something, you have to just go ahead and try to do it, and suddenly you find yourself pregnant and then lo and behold, you CAN do it - if you can set up the right support systems for yourself.   You don't have to be the perfect diabetic pregnant person to have a healthy baby. It feels really risky and in some sense it is, but honestly, I've had some sky high blood sugars during my pregnancy so far and, perhaps I've just gotten lucky, but everything looks fine. And that is true for most women with diabetes who have kids that I know.

The fear is worse than the reality. Once you're in it, you just sort of get through it! Praying and meditating can help, but even I haven't relied on that as much as I've relied on friends and acquaintances and my doctors to get me through, which are, in a way, an answer to prayer.

I guess the one last thing to say is: Practice not being embarrassed. By anything. Not by any questions, or uncertainties, or fears, or worries, or triumphs, or ANYTHING having to do with staying healthy while you're pregnant (and probably after) with diabetes - a little awkwardness and embarrassment is NOTHING compared to getting honest answers to your real questions.

There are some great blogs you can read, and books too:

Cheryl Alkon wrote a great book about being pregnant with type 1 diabetes.

Kerri Sparling has the best blog about this ever: www.sixuntilme.com (look up the tags about pregnancy)

God be with you!


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