Wednesday, February 23, 2011

Your Accepted! Just Sign Here

This is the time in our diabetic lives when we decide to officially accept Mr D into our world. It's like saying, "Okay, you're here to stay, and I accept that, now just sign here..."

It's something we all have to come to terms with; as a parent of a Type 1, or an individual with Type 1 Diabetes. 

The journey towards accepting diabetes is different for everyone. It is like anything in life we are forced, not asked, to deal with.  Job losses, relationships, deaths, or even a friend moving away.  We are emotional creatures, and we all deal with things differently.

Since I am male, I have found the following "Stages of Grief" useful to me.
You see (most) men have "slow dial up connections to their feelings" Woman are (more) likely to have a high speed, 4G connection to their emotional centre. Let's just say, I needed much help in the emotions department. Moving along....

The stages of grief are likely familiar to some readers so just skim them.  They were written by Elizabeth Kubler-Ross in the sixties, but are still useful today.

To quote her directly:

The progression of states is:
  1. Denial—"I feel fine."; "This can't be happening, not to me."
    Denial is usually only a temporary defense for the individual. This feeling is generally replaced with heightened awareness of positions and individuals that will be left behind after death.
  2. Anger—"Why me? It's not fair!"; "How can this happen to me?"; "Who is to blame?"
    Once in the second stage, the individual recognizes that denial cannot continue. Because of anger, the person is very difficult to care for due to misplaced feelings of rage and envy. Any individual that symbolizes life or energy is subject to projected resentment and jealousy.
  3. Bargaining—"Just let me live to see my children graduate."; "I'll do anything for a few more years."; "I will give my life savings if..."
    The third stage involves the hope that the individual can somehow postpone or delay death. Usually, the negotiation for an extended life is made with a higher power in exchange for a reformed lifestyle. Psychologically, the individual is saying, "I understand I will die, but if I could just have more time..."
  4. Depression—"I'm so sad, why bother with anything?"; "I'm going to die... What's the point?"; "I miss my loved one, why go on?"
    During the fourth stage, the dying person begins to understand the certainty of death. Because of this, the individual may become silent, refuse visitors and spend much of the time crying and grieving. This process allows the dying person to disconnect from things of love and affection. It is not recommended to attempt to cheer up an individual who is in this stage. It is an important time for grieving that must be processed.
  5. Acceptance—"It's going to be okay."; "I can't fight it, I may as well prepare for it."  In this last stage, the individual begins to come to terms with his mortality or that of his loved one.
I want to point out a few things:

First; the author focused on death, but the principals are universal for any loss. For a PWD it is the loss of many things(routine, freedom etc) Too many to list.

Second; even though it says progressive, it was not that way for me, or us(my wife & I) as Parents of a couple of Type 1 kids.

Here is a brief recollection of how I experienced the stages:

When I was nine and introduced to Mr D, I just went with it. What choice did I have.  I guess a little denial. More Shock.

When I realized it wasn't going away, or that their wasn't a cure to be coming soon, the first thing I felt was sadness, kind of skipped a few steps. Which would place me in the depressive stage.

I would ask, "Why me?" but went with it. Sounds like I was bargaining, perhaps with our creator.

When the hormone flux came (adolescence) the denial hit, I'll be fine, I can do what I want, just sort of went on my Merry way pretending diabetes didn't exist. Oh, with intermittent episodes of anger, directed at my parents, friends. Let's say Anger, and Denial.

Fast forward a few years.  College. I decided to pursue Nursing (in steps) So first I took a 1 year nursing assistant course when I was 19. Didn't know what I wanted to do.  Get this! I actually failed, no kidding failed, my diabetes portion of our biology course. The teachers were concerned.  I was still in denial.  I remember saying to the prof, "I know how to manage my diabetes, don't worry" She did not look the least bit convinced.

Then I met my wife.  She was great. Didn't make me feel like a "Diabetic" Like that's really a bad thing, well it is when you you're in denial.

At this point I was in denial but aware that I didn't know as much as I thought I did about this diabetes thing. I retook the exam and passed. Learned some stuff too. Then graduated.

I then transitioned into the anger stage as for now I knew I had to do something about the big D, and that pissed me off. But I would flip-flop between denial and anger for another 2 years. My wife, would gently say "You should adjust your insulin, and test" I wish I listened.

I decided to pursue my RN education. I was presented with an opportunity to spend time in the diabetes clinic as part of a placement. I accepted. I met other people dealing with diabetes. Wow, you mean I am not alone! It felt awesome to share, and instantly connect with others. This was when I started to accept Mr Diabetes.

That was my moment when Mr D was accepted into my world.



The Kübler-Ross model, commonly known as the five stages of grief, was first introduced by Elisabeth Kübler-Ross in her 1969 book, On Death and Dying.[


Valerie said...

It wasn't so straightforward for me started with sadness because I didn't really know what it meant to have diabetes, but then I buckled down and did what I had to do. I was never really angry about it until this last year...but I also haven't been bringing my A game, so it's been harder to manage = frustration. It's strange...I think with any kind of loss, it's not so straightforward. I think you can reach acceptance but easily go back to denial or anger. Very interesting to think about though--good post!

Meri said...

I love your dial up/4G analogy!

We all have our own paths to acceptance...and they are all so different. I was all over that stages map...I think I zig zagged it for a good 4 years. :)

Reyna said...

Great post...and I definitely zigged and zagged all over it too...and it took me a few months to really "GET" that "D" was here to stay for good, my son's life.

As always, great post and educational Trev!

Wendy said...

Great post!

It took a few years here as well. I think I finally "accepted" things about 18 months ago. I have no idea what the road ahead will be for my daughter.

She was dx 3 weeks after her 2nd birthday. She doesn't know life any other way...but I don't think that's going to make it any easier for her to come to terms with reality once she figures out the truth that lays hidden under our family's sense of normalcy. She young enough to be protected from knowing the heavy stuff -- complications, etc...but she won't be this young forever...

Michael Hoskins said...

Trev: Thanks so much for your post! I've just stumbled across your online spot here for the first time, courtesy of several other D-blogs... so, here's a long-belated welcome to the ever-expanding Diabetes Online Community! Awesome way to know we're not alone, and so many of us have signed the contracts in different ways. For me, at 5, it played out in many of the same ways you mentioned - with the nuance that my own mom has been Type 1 since she was 5. So, my teen rebellion years were clouded with some unfortunate "blame" and choice words I instantly regretted. Anyhow, at least we have some say in how we interpret and let that contract play out. See you around!