I spent much of yesterday ruminating. As I alluded on Monday, there are some inherent risks to putting stuff of a personal nature online. This has been a concern to me as long as I’ve been blogging, but now that I’m in the process of organizing art therapy groups for children, marketing the groups, and thus facing the likelihood of people who don’t know me looking for me online, it’s become a more prominent worry.

I’ve pondered the terribly vexing dilemma of how to balance writing a diabetes blog about my life with diabetes that’s an honest, genuine, and accurate reflection of who I am and what I’ve experienced, with the ever present obligatory expectation that I keep my personal stuff to myself since I’m a therapist. I think it goes without saying that I’ve failed at achieving that balance because one side of that scale is going to come at the expense of the other side.

The striking irony is I don’t believe I’d be in a position to dole out mental health services to other diabetics if it hadn’t been for social networking. The blog has been the most recent phase in my journey through the tubz which began with diabetes message boards and online communities years ago. I like to think that today I’m about as accepting of this disease and well-adjusted to it as it gets, much thanks to having people with whom I could share my own personal experience, and not just the standard diabetes crap, but the worst of it – the anger, grief, denial, eating disorder, fear, depression, resentment, sadness and tears. Before the internet, try as I might – and believe me, I tried – I couldn’t find a support network to unload all that. It was an ugly, painful mess to cart around for all but a few of these almost 31 years with diabetes.

Now it’s not the burden that it once was, but since all my personal diabetes business is now online, one of my concerns is that people will see that I have a history of receiving mental health services, and they’ll inaccurately think I’m incompetent. I do make remarks about being crazy or insane or whatever you want to label it, but (a) I loves me some self-deprecating humor because if you can’t laugh at yourself and any miseries life brings your way, you’ll be, well, pretty miserable, and (b) I unapologetically think everyone is nuts. Everyone. I don’t think there’s anything wrong with it as long as you have enough self-awareness and insight to know it’s part of you, and as long as you do what you can to make sure it doesn’t interfere with your life or relationships or being semi-happy. People get depressed. People get overwhelmed. People get neurotic. People get angry. People get paranoid. Some of us need extra help when those kinds of things happen, and there’s nothing saner than seeking help under those circumstances. So, yes, I’m looney-tunes, but truth be told, so is the rest of the world.

Unfortunately there’s a stigma about that. I know the stigma keeps people who need treatment from pursuing it, and I know it keeps people from being honest with others, and sometimes even with themselves, about who they are. So, picking up on Monday’s theme, in most circumstances, I try to be open about my experience with mental illness because I want other people to see they can lead relatively normal, successful lives despite blips on the psychiatric radar.

Also unfortunate is the reality that there are people who will think less of me, in one way or another, for having disclosed some of my more personal diabetes-related experiences, many of which have to do with my mental health. There are people who will think I should be lying on the couch instead of sitting in the therapist’s chair, figuratively and literally. There are people who will think I’m a poor role model for having managed my diabetes as I once did, disregarding the fact that I could be a poster child for diligent, balanced diabetes care now. There might be people who don’t hold it against me that my life has taken the path it has, but they’ll think less of me for divulging it so openly.

A growing source of anxiety is my concern that other therapists and health care professionals will think I’m unprofessional and have questionable boundaries. I already know that navigating this line between personal and professional is a precarious endeavor. It’s possible I might make some mistakes. However, if anything, I think I’ve been hyper-vigilant. I regularly discuss with my art therapy supervisor the unusual dynamic between what’s happened to me personally and how that’s been the driving force behind what I want to professionally accomplish. I’m constantly questioning the step I just took, the spot in which I landed, and the next step I’m going to take. Part of that questioning is considering if I need to change directions, and as I consider the next step, I’m looking back wondering if I need to cover my tracks in some way.

I’ve been considering a variety of options some of which were suggested to me by others in discussions I’ve had about this. It’s a little late to throw a pseudonym into the mix it seems, but I’ve considered going back and editing my name out of everything. This doesn’t really feel like a good or especially practical solution to me though. Even if my name were removed from my blog, I’ve guest blogged, I’ve left countless comments on other blogs, I have countless comments on diabetes websites, so it’s not hard to find stuff about my life with diabetes.

Along similar lines, there’s the possibility of creating a second blog under a pseudonym, one with more personal or possibly controversial subject matter, and one with my name that would be the less personal, more professional blog. That of course doesn’t eliminate what my blog is or has on it so far though. And honestly, the thought of having two blogs isn’t even marginally appealing.

I could make my blog private so I would have to approve anyone before they can access it, but that doesn’t feel like the answer either. I don’t know how other people respond when they find themselves at a blog that requires permission, but when I come across one of them, I just move along. I can’t see what the blog is about since I can’t see the blog, and I just assume it’s private because no one wants anyone but whoever they select to see it. Furthermore, one of the things I like about the intertubz is finding cool sites serendipitously, not because I went in search of them specifically. I also know that many people who read my blog essentially stumbled upon it in one way or another, and I really hate to eliminate the possibility of getting readers that way.

A less drastic option would be to be more selective and conservative about what I post. This goes back to the aforementioned balance between authentically writing about my experience, and self-censoring because I want to be a proper therapist. The two sides of that coin feel very mutually exclusive to me, so if I opt for one, the trade-off will be the other. Of course, not having tried the less personal side of the coin, all I have is conjecture, but there have been lots of times when I’ve poured my heart into a post, tears streaming down my face, because I need to express whatever is troubling me. I need to express it on my blog because that’s one of the reasons I created it, because I know the people who will have the most understanding and empathy are people with diabetes, and for all practical purposes, everyone I know with type 1 diabetes is online. I can’t start editing myself to the point that I’m keeping all the messy diabetes feelings locked in a void within myself, but I can’t shake the sense that being the kind of un-self-disclosing therapist I’m supposed to be would mean hiding all the ugliness that diabetes can bring. That’s a no-win situation if ever there was one.

And so, do I leave everything as it is? Do I keep blogging just as I have? Will I be forever justifying and explaining myself? I don’t think there’s a right answer. I’m not sure that there’s even a best answer. Am I over-thinking it? I certainly over-think lots of things, so this is likely no different. Maybe I just need to have more faith that things will work out. Maybe I need to trust the process the same way I want people who might want to work with me to trust that I’m competent despite my admitted flaws. My map doesn’t show where I’m going, and I’d never pretend that it did, but I think I’ve traveled far enough that people should have faith in my ability to help them take their own next step.

Yesterday afternoon, after having dozed on the sofa, I had the sudden realization that it was my 4th anniversary for being eating disorder-free. It’s kind of an odd day to acknowledge I guess. Not a sad occasion, but I’m not sure that I’d call it a happy one either since it’s one I wish I had no reason to have in the first place. Similar to a D-anniversary, for me it’s a cause to reflect on where I’ve been, where I might be headed, and how to steer clear of pitfalls that might appear in my path. It reminds me of things I’d rather not consider, but it also reminds me that my life has changed for the better.

I considered whether or not I wanted to post about it. To write about something or not, it’s a question I ask myself many days. Often it’s because I can’t decide if I can make some run-of-the-mill diabetes issue or occurrence sound entertaining or thought-provoking. Sometimes the topic in question is one I’ve written about before, so it’s a matter of figuring out if I have anything new to say about it, which has a certain irony since diabetes itself is as repetitive, routine and rote as it gets. How many times does anyone want to read about me being high or being low or running out of test strips or…. well, you get the idea. There are occasions when I wrestle with whether or not writing something will offend someone or someones. Regarding some topics, I’m opinionated as all get out, but I’m not looking to make people mad or offend anyone or make an enemy where there wouldn’t have been one otherwise. Then there are times when I hesitate to write about something particular to someone else because I don’t like to assume everyone else wants to be the subject of my musings and ponderings.

Milestone

Certainly, I give some thought to whether or not I want to post things of a more personal nature. What happens if that hiring manager with my resume on their desk googles my name? Will they see someone worth hiring, or will they see a formerly really crazy person who’s still got a good deal of crazy going on, and can’t guarantee the super crazy won’t reemerge? When I do start spilling more personal stuff, I either cross my fingers having all this here on the WWW won’t come back and bite me in the behind, or I just pretend that possibility doesn’t exist. At the end of those days when I’ve tiptoed into TMI territory, I hope that someone somewhere got something from reading whatever I might have shared, and if there is a price to be paid in the form of a lost opportunity or criticism or doubts about me, well, so be it as long as one good thing came of it.

So the lingering question once I realized the significance of the day was whether or not I wanted to say anything about it here. There was a time before I blogged when talking about it was terrifying. Then it became strangely liberating, which actually isn’t so strange if one considers that I wore myself thin, no pun intended, to keep it a secret for the 18 years it was a perpetual black cloud over my head. Days of recovery became weeks became months which have now become years though, and there’s a part of me that wants to sweep it under the rug. It’s as much a part of my current existence as I want to make it, and I think it’s no surprise that there’s a strong inclination to leave it in the past since it’s hardly something to be proud of.

In the midst of deliberating if I had anything worth saying about it, it was way past most normal people’s dinnertime, and we had yet to eat, so I decided we should go out for dinner. We didn’t go anywhere fancy, just someplace we often go to grab a quick dinner. The hostess seated us, we discussed our menu options, and waited for the server to take our order. Ironically enough, our waitress was a girl with whom I was in treatment 4 years ago. A couple of years ago, Jason and I went to grab lunch after a movie, and I heard someone say my name. She was there in her uniform, greeting me with a big smile. She asked how I was, but it seemed to me that the unspoken question was how is your recovery going. I told her I was great, that things were going really well. I then asked her the same, and her eyes gazed through the floor to the left of her, as she unenthusiastically and reluctantly said she was OK. It’s worth mentioning that I hadn’t even recognized her at first because she was significantly skinnier than when she had been in treatment. She gave me a hug before she scurried back to work. Before we left, I scribbled my phone number on a scrap of paper from my purse, and gave it to her, telling her to call me if she needed to talk. I never heard from her.

Since then, I’ve seen her there many times, but we’ve never interacted, nor has she been our server. Until last night. I was fiddling with my phone when I recognized her voice, so I looked up. I was wearing my Eagles baseball cap so maybe she hadn’t realized it was me with my nose in my phone. We made eye contact, but she didn’t say anything to me though, and I didn’t say anything to her. It’s standard operating procedure to not “out” people with whom one has been in group mental health treatment, which is especially true if said person is at their place of employment. Although she had seemed happy to see me that day two years ago, I couldn’t assume she felt the same way last night. So it was weird trying to pretend like I didn’t know her, taking her lead. It made me sad because she’s still very thin, and my gut says she’s still struggling. Maybe I’m wrong, but I hate thinking that I might be right.

In that nonfrontation (you know, like confrontation, but not), I found my answer to whether or not to post. I obviously can’t help anyone who doesn’t say anything, ask or come looking for help, but if I put it out there that there is help, that it is possible to overcome an eating disorder, that life is so much better once it’s a thing of the past, then maybe someone will come searching and find the blog or this post or another post I’ve written on the subject.

I hope it helps someone who’s considered taking a so-called short-cut to weight management see that the cost of an eating disorder isn’t worth whatever benefits are perceived. I hope someone who’s suffering with their own eating disorder can see a glimmer of hope that recovery is possible, as impossible as it might feel. I hope a parent is reminded to have an honest discussion with their diabetic kid about body image and dangerous weight management practices. I hope a parent is reminded to not be so quick to completely hand over the reins of diabetes care just because their kid seems mature enough because once you hand those reins over, good luck reclaiming them if your kid starts to flounder. Remember, the day will come when all that responsibility will fall squarely in their lap, like it or not, so there’s some benefit to all involved if a parent maintains at least some degree of active participation.

It’s hard to live with myself knowing all I did to not take care of myself and how that took a toll on all aspects of my life. I do think things happen for a reason though, and so I keep hanging on to the hope that someone else will learn or get inspired or otherwise benefit from my screw-ups. And that’s why I decided to post.

So the posts have been sparser than usual this week. I don’t have any good excuses. I’ve been a little distracted, a little busy, a little in a bad frame of mind, a little sleepy, and a little unmotivated – depending on what day it was and the moment in question. The writing stars just weren’t aligned for me this week.

One of the sources of my distraction is a good thing though. As I told you last Thursday, I finally decided to just do it, and I’m working to get an art therapy group for type 1 kids started. Last Thursday evening, I went to check out the second of two office spaces I was considering, and once I saw the space, which was much bigger than I had remembered having only glanced in that office on one or two occasions, and after I talked to the therapist who is subletting it, I gave her my deposit, and I left with keys in hand.

I can officially start using the office on October 6th, but in order to get kids, I have to start marketing. Now, I’ve joked for years that I couldn’t sell water in the desert if I tried, so this hoop presents something of a challenge for me. I have some ideas, but tackling them in a strategic fashion is a tad overwhelming. My wonderful friend, Allison, who is in marketing and hopefully doesn’t mind that I’m mentioning her by name, offered to help me. Asking people for help is not one of my strengths, but Jason very logically pointed out that if she offered, I should take her up on it since I don’t really know what the heck I’m doing. So I did.

She and I went to dinner a couple of nights ago, and she had me scribbling notes, making lists, and starring items of particular importance I can do to make something of this. After sharing a meal, my neuroses, and my endless stream of self-deprecating humor (Allison is a good friend for laughing at all my jokes), I left with a long to-do list that included finishing a brochure on which I’d been obsessively working since I got it in my head that I was really going to do this. She gave me lots of feedback about what to keep and what to change, and this is what I’ve been laboring over for the last 36 hours.

Once printed, it’s my plan to send a letter with a brochure to area doctors’ offices, and then follow up with a visit so I can drop off a stack that the offices will very hopefully distribute to patients’ families. I’m having a hard time hitting the button to complete my order though, so after a nudge from EJ and CALPumper on Twitter, I’m posting images here (click to see them bigger), hoping to get some opinions about whether or not these seem OK. When Allison and I talked about it the other night, we leaned toward omitting the fee, but I’m still on the fence about that. I can’t decide if including it excluding it is more of a disincentive to contact me. Should I rearrange, add, reword, or omit anything? If you’re a parent with a D kid, would you be interested in this? Did I convey that the group is for any kid with T1, not just kids who are having problems? Any and all objective feedback would be appreciated regarding these issues or whatever else jumps out at you. Thanks, and hopefully, the writing stars will be less out of whack for me next week.

The diabetes community has been increasingly abuzz with discussions about World Diabetes Day which is November 14th. Now, I know it’s almost two months away. Perhaps you’re saying, why worry about it now? Heaven knows, I’m the queen of doing things at the last minute, but now is the time to start making plans. When I say make plans, I don’t necessarily mean you can sign up for something that’s already planned and organized by your local diabetes organization because unfortunately, chances are fairly good, nothing is planned. When I say make plans, I mean you very well might need to take it upon yourself to organize something and make it happen. I know it’s a daunting prospect. I’m hardly a schmoozer who knocks down doors either. I’m happy to join and participate, but I’m not connected to anyone or anything of any influence, most definitely not in my own community. So, yes, I have reasons, excuses, justifications and rationalizations that are as good as any.

The problem is that the level of involvement for WDD in the US compared to most other nations is embarrassing. Is it a lack of organizational support? Mayhaps it’s a lack of government support on the national, state, and local levels? I’m sure it’s a combination of reasons, but what’s stopping us from changing that when nations around the globe are putting us to shame with their dedication to making WDD live up to its moniker? Egypt lit up The Sphinx, Brazil lit up 159 landmarks and buildings, France had 46, Italy had 72, including Il Colosseo, which you might know better as The Coliseum. The US had 41 last year, which is comparable to some European nations, but I’d like to point out that we’re way bigger geographically speaking, so we just aren’t living up to our potential. My stomping grounds, The City of Brotherly Love was showing diabetes some love with 11 buildings and landmarks lit in blue last November, but that doesn’t mean we should sit back and be content here in Philadelphia anymore than it means you should sit back and be content to let someone else make WDD a big deal in your neck of the woods.

So what the heck am I going to do? Well, I’ve been thinking about that. I’m obviously blogging about it, so I think that counts for a little something. Last year, I participated in the Philadelphia WDD event by initiating and facilitating a community art project. That was super cool, so I’m hoping to do something similar this year as well. I’m also interested in having artwork made my diabetics on display somewhere, but I don’t know where, and I don’t know where the art is going to come from. As I said in Monday’s vlog, things tend to look spectacular in my head, but they lose something in translation to actuality if they even make it that far. Speaking of Monday’s vlog, I also had the idea of wearing my sparkly pancreas in November. I wouldn’t wear it to work because it’s really not appropriate, but otherwise, I could pin it to whatever shirt I’m wearing. Surely, it’s an instant conversation starter, and I would have the opportunity to enlighten a person or two.

WDD at The Coliseum

I think most of us bemoan the gross misconceptions about this disease. The list of ridiculous things people say or we hear is, well, ridiculous. If I had a dollar for every time I had to explain to someone that I didn’t used to be fat, or I can eat whatever I darn well please, or that I might be checking my BG or taking insulin in public because that’s what I have to do to live, but diabetes doesn’t make me deaf so stop commenting about my self-care tasks like I’m not there. November is American Diabetes Month, so hopefully, we can all do a little something to raise awareness throughout November, but if you’re only going to do one thing, make it November 14th. I think it would be awesome if we could increase the buildings and landmarks lit up in blue, but if you want to start small, it’s really as simple as wearing blue and telling your friends and family to do the same. We can make WDD bigger and better, and for our own sake, we need to do it, and we need to start NOW.

What can you do to get started? Visit the World Diabetes Day website. Visit the new World Diabetes Day in the USA website. Follow @WDD. Follow @WDDUSA. Become a fan of WDD on Facebook. If you have a blog or website, post about it, add links, add a virtual candle. Check out the Flickr group for pictures of WDD past to get ideas and inspiration. Please help make it fabulous, and please share what you’re doing with the DOC and everyone in your life. It matters. You can make a difference. It is important, and whatever you do to help is important.

I know my blog posts are usually too long, and apparently that tendency is carrying over to the vlogs. I know I don’t vlog very often, but I’ll really try to work on that. In the meantime, I hope you can hang in until the end. I’m pretty sure you might possibly think it’s more or less worth it.

For more from my muses, check out Chris and Christal.