Monday, September 9, 2019 - 11:36

A Journey in training to be a doctor with Insulin Pump therapy by my side

Written by- Dr Apoorva Gomber MBBS,MD drapooorvagomber@gmail.com

There is no way around it: medical school is a challenge. A series of balancing acts, juggling lectures, clinical rounds, make sure you follow up on patients irrespective of how terribly sick you feel and then the never-ending exams. You are the doctor in training and there is no running away from reality!
I was trying every day to fit myself in the best possible puzzle balancing my own diabetes at one end and the incessant amount of learning in medical school. This was hard... very hard and now when I look back I sometimes wonder how did I balance all of that out. 

Studying medicine is very much like a marathon, not a sprint. And I knew it will be painful but as rightly quoted “The race always hurts, expect it to hurt. You don’t train so it doesn’t hurt. You train so you can tolerate it.” And that’s how life is living with type one diabetes. 

I had my own phases of diabetes burnout with bouts of motivation to keep walking on this journey. There were days I forgot my insulin injections at home and had to miss a meal because I was too scared to tell my friends I have diabetes. There were days when I had to run away from my examination hall to get a fruit juice from my bag lying outside because a low blood sugar just blacked me out. I couldn’t remember a thing after all the efforts I had put in for that exam. There were days of mental exhaustion and days of feeling I am not worth it. There were also days I had bouts of positivity that I’m going to make it to the end. 

Seven years after my diagnosis, I was still not ready to make peace with it . I was injecting myself 4-5 times a day- a single shot of long acting insulin at night and 3-4 meal time short acting insulin trying to achieve numbers which my endocrinologist strictly aimed for. The constant chasing of numbers with fluctuating blood sugars, the tough battle of medical school stress, constant monitoring by finger prick testing my blood sugar using a blood glucose meter was such a hassle that I had mental breakdowns. Those who are reading this living with type one diabetes can exactly relate to what this feeling is.

Frequent visits to my endocrinologist we decided to introduce an insulin pump therapy into my life to achieve those targetable HbA1c numbers. Initially I was reluctant to accept an insulin pump which will be attached to my body 24X7. I had the fear of the society and answering to questions from people oh what is that? The worry of how to dress up with an insulin pump and petty thoughts of where to hide when I wear dresses.
However, I was confident I could do this all by myself. I had to give more time to understand my own body and I had faith I will make peace with my own pancreas by making my own mistakes.  
So the journey in medical school continued this time with a pocket size pager called insulin pump and it was blue little pancreas I had to clip on my waist belt. I was able to balance out night duties, long hours of studying, coaching classes for my postgraduation and then too many experiments with food to find out what works best for my body. From injecting 4-5 times a day with the constant fear of hypoglycemia in the middle of anywhere to now when I could just press a button and take my insulin dose. Initial few days were trying to get adjusted to this little stranger who stayed with me all throughout the day. Every night I used to feel what if I get trapped in the insulin pump tubing when I toss & turn on the bed. Every day was a new day with newer challenges and new ways of basal adjustments. I experimented with bolus wizard – a special feature on the insulin pump which really helped me master the mathematics of carbohydrate counting. The best part of the insulin pump for me was I could finally overcome the fear of unpredictable hypoglycemia. I did not have to run outside the same examination hall to grab that juice box but all I had to do was suspend the insulin delivery. I felt more confidant and responsible about my own diabetes management. I researched a lot about diets, carbohydrates, low carb trials and advancements in the diabetes technology. And each day taught me so much more I couldn’t imagine.

By the time, I was in my 2nd year pursuing my MD degree from one of the busiest hospitals in New Delhi with hospital work, staying up to date in the department and preparing yourself for a list of seminars, thesis and conferences. Somedays were exhausting and I felt like giving it all up with the stress that comes along. I decided to upgrade to new generation pump; the pump was a life saver all this while because there were times I could stop my insulin delivery in the middle of my seminars without taking a break and missing out. I didn’t want diabetes to come as a limitation and doubt my capabilities of being a doctor. 

MD exams were harder than what we imagine with series of written tests, practical’s and the uncontrolled levels of stress always made me go high on blood sugars. Dehydrated, sick, nauseated or swelled up there was no way running out of the field now. I had to give the best shot in my exams and I kept trying to give it all.

This feeling still brings goosebumps when I think about how Insulin pump helped me balance my diabetes just a little better. I had experimented with lots of food choices and understanding each day about my carbohydrate factors, about my continuous glucose monitoring graphs and alarms of suspending insulin when I was getting into a low blood sugar. 
There is no doubt, insulin pump therapy made me much more confident about managing my own diabetes, achieving desired HbA1c targets, experimenting with various cuisines, travelling to different places, speaking at conferences and trying to fit into the near normal life. 

I had my own ways of beating stress with my type one community at “Diabetes India Youth in Action”(DIYA), a non profit organization me and my type one friends co-founded in New Delhi. It isn’t just a support group but a platform where there is exchange of experiences, ideas , hacks and just everything beyond diabetes. We have been organizing DIYA day camps where we take charge of our own diabetes and never let it define us. We explore, play, share, learn and laugh because we’re all in this together. 

At one end was adventure and the other end was managing my medical training. I was juggling and running around to fit in. This did take a toll on my blood sugars every now & then. Just like there were good days, there were some bad days too where my pump did malfunction or my infusion set was ripped off because of the humid weather in delhi or the stress hormones just messed it up. There are sometimes zillion factors that determine our blood sugar – some we know and some we still don’t know. 

It’s neither a miracle device nor a cure to diabetes. I never say getting an insulin pump will make your life simple. But with the right knowledge of understanding the working of an insulin pump and coordinating with your own body’s individualized approach gives you peace to be near normal – a little space in your mind to accomplish what you desire.

This would not have been possible without the support of my Mom & dad who made sure I don’t step out of my house unprepared; my close friends and my support group.

And for all the type one’s out there reading this and parents to kids living with type one diabetes I understand diabetes is very hard but it shouldn’t limit anyone from dreaming, from running, from achieving all what you desire and to follow your passion. 
This is my short journey with a stranger- a stranger I never thought will help me believe that I too can win over diabetes. 

For now the score board reads- Diabetes = 0, Apoorva =1! 

Disclaimer :  “Any and all the information provided in the blog are independent views of the author, for general overview and education purposes only. Recipients of this information taking any decisions and acting or omitting to act on the basis of the information contained in the blog shall be doing it purely at their risk and discretion and they are advised to seek professional advice.”

Meeting kids in the hospital diagnosed with T1D

Let’s call it a wrap! Last day of my MD exams. Phewwwww.