The Luxury of Forgetting

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From Beta Cell, this is The 3s, the show where we try to find out what it's like for all the people in our lives who don't have type one, but are affected by it somehow. Dave met Rachel after she was diagnosed with type one, so he's had to play catch up with both learning about what the disease is, and how he fits into her life with it. He's constantly trying to find the balance between letting her manage the disease herself, and knowing when she needs his help.

They discussed the day-to-day challenges, like low blood sugars and his fear of needles, but also the larger issues of insurance, starting a family, and growing old together. Their conversation is an interesting look into just how diabetes sneaks its way into every facet of our lives that, as people living with it, we're so used to that we don't notice anymore. Throughout, you can tell that they truly are partners, not just in diabetes, but in their lives together. Let's hear their story.

Rachel: Hi, my name is Rachel Arteaga. And this is my husband -

Dave: I'm Dave Abrams.

Rachel: We currently live in New York City, but we will be moving to New Jersey soon. I am a former teacher.

Dave: And I'm an engineer.

Rachel: And I'm 37 now, and I've had diabetes since I was 13. And my daily life is - I have a Medtronic MiniMed 670G, and I use Auto Mode, and so when I am connected to my sensor, and it's giving me that information, I'm just constantly looking at my pump. First thing I do in the morning, last thing I do before I go to bed, and basically I feel like I'm running an experiment every single day with every meal that I eat. So that can be a little bit stressful, especially at work, or I've been struggling with exercise lately. But yeah, that's what daily life looks like for me. And yeah, so I'm going to ask my husband, Dave, if you remember the first time that you found out that I was type one diabetic?

Dave: I think it was at your apartment, one of the first dates that we had, we were at your place. And I think I remember seeing it; I was like, "Oh, what's that?" And you were like "Oh, this is my diabetes sensor," or something like that. And I didn't know what it was. And you explained everything to me. Kind of like you explain it to everybody.

Rachel: And did you have any sort of feelings when you found out that I was type one diabetic?

Dave: I thought the technology was cool. I didn't know anything about diabetes. I don't think I've ever met a diabetic person before you. And I didn't really feel an emotion or anything. I don't know, I just thought was "Oh, okay."

Rachel: And you're an engineer, so that's probably why you thought the technology was cool.

Dave: Yeah. [laughs]

Rachel: [laughs] So in what ways does my type one diabetes affect you in your life?

Dave: It makes us plan a little more, because if we want to go and do something, we have to plan food, and we have to plan.... I know that, especially for me, you know, I'm a guy. So, you know, part of being a man in a relationship is traditionally that you're supposed to take care of the woman, make sure she's safe and protect her and all that. So for me, for a long time, part of that was making sure that you had snacks, making sure that your, you know, level was reasonable. But then, after, you know, it didn't take long for me to realize that you actually have all that totally under control, and I'm usually just getting in the way. So yeah, I guess it doesn't really affect me because you've got it all under control. But we do allow some extra time to plan, and we have to make sure we have access to food. And that's about it.

Rachel: It doesn't affect your sleep?

Dave: No, I usually sleep through it. You tell me, "Oh, I woke up once or twice a night." I usually sleep right through the whole thing.

Rachel: So lucky.

Dave: I know.

Rachel: So what type of things you help me with?

Dave: Oh, yeah, so you've got that, uh, that sensor. What do you call it - your clam?

Rachel: I - we call it a clam because it looks like a clam, the transmitter.

Dave: Yeah. And so that, sometimes if you put it on a position that's hard to reach, I'll help you with the glue stuff, and I'll try not to mess it up. And sometimes if we go for a run, I'll carry the dates. But that's about it, I guess.

Rachel: And just like Dave was saying, there are some things that I don't want help with. I think maybe in the beginning, like you said, you'd try to make sure that I had the things I needed, or I don't know, maybe even in the beginning, you were like, "Oh, are you supposed to eat that?" or whatever. And that would make me really upset. So um, so yeah. Dave doesn't really helped me with that stuff anymore, and I'm glad.

Dave: I'm glad, too.

Rachel: So you say you sleep through the beeps and everything like that. What about...? Have I ever... I must have woken you up if I've been low, or like drinking juice or something like that?

Dave: Yeah, totally. That's happened to me - that, that doesn't happen so often. But yeah, when it does, when you have, like, a middle of the night, you know, low or high or something, and like, you're kind of a little bit in panic mode, and you have to, like, go into the kitchen and break out the juice boxes and the dates and everything. Once in a while I'll wake up, but you - it completely, you're completely independent with your own diabetes care. So I'm not too worried about it usually. I'm trying to think - I feel like there was one time we were on a trip somewhere, and you didn't have any sugar, and you were having a low and we had to walk to get to a store. And it was -

Rachel: I think, I think, wasn't that when we were trying to get - We were on our way to get Indian food. Which is already so carby, my sugar was about to be high. But before that, I had the low. [laughs]

Dave: Right.

Rachel: Yeah, I think that's probably one of the most severe lows I've had.

Dave: Yeah, that's right. And I remember thinking because you were low, you kept giving me these weird, like, these weird answers. I was like, "Do you need something to, like, drink? I can run into the store and just grab, like, a mango lassi or something? Tell them I need anything. And you're like, "No, it's fine. I'm just gonna sit here." I was like, "Wait, that doesn't make any sense, but alright, you're the - you're the boss." But I think as it turns out, you had a low. And it's harder for you to like, think of things clearly when you have a low. And so anytime, yeah, anytime you have a low, I get kind of worried, because even though you're totally in control of everything, and independent, it's like having the low makes it harder for you like, like, plan or think or something like that. And it's like scary, because do I trust you being independent? Or do I, you know, overstep my bounds in the interest of your safety knowing that you have a low and your life can be at risk. And yeah, that's a I have a conflict, I guess when I think about it, when you have a low. You know, sometimes I want to be like, "No, listen to me, have this juice box, you're not thinking straight." But...

Rachel: Well, if I'm slurring my speech, then you probably have more wits about you than I do.

Dave: Yeah, I think this was one of those times.

Rachel: Yeah.

Dave: Yeah, I didn't know what to do.

Rachel: Then we got to the restaurant, and I got a soda. Fine. And I probably had a gigantic spike after that.

Dave: Yeah.

Rachel: I know there was another time where we were all hiking. And I also felt, like, really, really low and I had to sit for quite a long time.

Dave: That will usually happen. We're going on like a long hike, that you'll need to take, at some point, you'll have to take like, a snack break, or a chill break. Which is like, what's the rush, really? You know? We're on a hike, take a break. It's probably good for me.

Rachel: I'd rather not - I'd rather not go alone in the first place on hike.

Dave: Yeah.

Rachel: I remember the last time we went on hike, you were like "Eat something before we go," and I got mad at you.

Dave: Right? I remember that. [laughs]

Rachel: [laughs] How has your relationship with my type one diabetes changed over time?

Dave: Yeah, I'd say... It's not the relationship with the diabetes directly, but relationship with everything that goes around it, like healthcare providers, being on the phone with insurance companies all the time. And you know, having to basically battle insurance companies on the phone all the time to make sure they give you the supplies you need. So in the beginning, I didn't - I didn't see that as much. So I didn't really feel any way about diabetes, but after having seen what you have to go through all the time, constantly fighting the bureaucracy and the, you know, the barriers to just getting the service that you need. It's like - it's just so draining. So I think for any relationship, you know, to have to see the one person constantly struggling all the time, that's probably what, you know, affects me more than actually having diabetes, you know, for me, so I guess the - my relationship with diabetes hasn't directly changed. But my relationship to, I guess our healthcare system right now, has changed, seeing that you seem to be going through like, a lot of pain in that, that I maybe didn't see myself going through.

Rachel: Yeah, and I often say that probably the worst part of the diabetes is not the diabetes itself, but it's the constant worrying of, will I get supplies? What if I don't have a job? How will I get supplies? How can I get the things I need if I'm ever not insured? And then when I am insured, like you said, sometimes the insurance company gives you trouble. And it's just, that's probably, for me, the worst part of the whole thing, so. How do you feel about the future? Like, are you hopeful? Are you scared?

Dave: I'm hopeful, I'm not scared.

Rachel: What are you hopeful, like, for? What do you think will happen?

Dave: Yeah, I think the management will get better, you know, the devices, I gotta give them credit, like, those things are pretty rugged, like, you use the same thing for years and years, and years, and years, and years and this thing's like rock solid, like, they fall, they're like, attached to you at all times. Like, think of how durable a cell phone has to be. And this is like, 100 times more durable, it's crazy. But I think the software inside could probably - I think that part will get better. You know, people with diabetes, will probably see a lot of technology that will help them, probably in the next, like, 15 years?

Rachel: Well, I think that's probably true, but I worry about who get access to that technology, and how affordable it will be, and especially with just the most basic component, the insulin, is unaffordable. And that's like the basis of all the technology, whether you have an insulin pump or syringe, you need the insulin itself. And there's so many people who can't even afford that, because it's ridiculously overpriced. So. So yeah, I think that they'll, they'll definitely develop new things, but I just hope that the people that need it can take advantage of that.

Dave: I see what you mean, though, like even the guy on the corner over here, how's he gonna keep getting insulin? You know?

Rachel: The guy on the corner is a vet who is diabetic. And he -

Dave: Yeah, what happens if he stops getting insulin? And he doesn't - let's say he doesn't have another way of having health insurance, I don't know. There's like a lot of people, there's tons of people. And not everybody has health insurance, I'm - God, I can't even imagine what it would be like to not even be covered.

Rachel: Right?

Dave: It's like, what do you do?

Rachel: I remember when I wasn't covered for a little bit, and that was so scary. I probably wasn't covered for like, six months. And luckily, I had leftover supplies, but that was really, really scary. I don't know how people - like, it's crazy that families experience that for obviously, much, much longer. And people die because they're not covered, or they can't afford insulin. But I'm glad you have hope.

Dave: I have hope. [laughs]

Rachel: [laughs] Um, so Dave and I are thinking of adopting. And one reason was, because, even though I know that there's plenty of people with diabetes, with type one diabetes, that give birth to healthy babies, I was just kind of scared and hesitant to go through that experience, knowing that it would be a high risk pregnancy and knowing that I would need to be under the utmost control, even a year before conception and then like seeing the doctor like multiple times a week, even during the pregnancy, and that just sounded very overwhelming. But, Dave, do you have any concerns about me having type one diabetes and being a mom?

Dave: I never thought about that.

Rachel: It is something that when we talk to the adoption agency, she said she'd had to like, make sure that was okay.

Dave: I don't think that I can think of a problem with that, really. No, I don't think I would have any concerns. I don't think I have any concerns with that. Like I said, to think about it.

Rachel: Yeah, I mean, I think there's plenty of parents who have type one diabetes, and they do a wonderful job. When I was teaching, sometimes I would have lows while teaching and I'd be by myself, and that would be kind of scary, because I would have to make sure I stop and eat a snack. But then I have all these kids there, and I'm on my own. And so sometimes I think about that in terms of being with, you know, a child, like our child, if I'm alone, and I have a low, this kid, you know, doesn't understand or, or something. But, I mean, the - so far when I'm on auto mode, which is most of the time, that's prevented me from having any severe lows, so hopefully, that won't really be an issue.

Dave: Yeah, let's hope it's not an issue. [laughs]

Rachel: And so what do you think old age and retirement will be like?

Dave: It's gonna be great. [laughs] We're gonna get old, gonna have a garden, and get a dog, think we'll get a dog from the shelter. It'll be old too; we'll all be old together.

Rachel: Why are we gonna wait until we're old to get the dog?

Dave: No, we can get other dogs but, y'know.

Rachel: Oh, yeah, that was the other thing we were thinking, was getting a dog and training it to be a diabetes dog.

Dave: Yeah, the dog will be old, and we'll be old, and everyone would be old.

Rachel: But that would be good for when I'm like, if I'm alone, and I'm, you know? With kids? The diabetes dog will -

Dave: See that? There's always a way. Yeah, I think being old this gonna be great. We're gonna do our hobbies. You're gonna do? I don't know, stand up comedy. Drawing comic book characters.

Rachel: Yeah. And they're all gonna have type one diabetes. [laughs] And how do you feel when you watch me manage my diabetes when I'm like, doing pump things, or sensor things, or checking my sugar and stuff like that?

Dave: I think when you're putting your site - when you're using that injection thing, I hate that thing with the needle. I just can't. I hate that thing. They gotta find a better way to do that. I hate that stupid thing. Like half the time, it's like, it hurts. That thing's like torture device.

Rachel: So how do you feel when I use it?

Dave: Like when you when you - when you use the thing? When you, like -

Rachel: The inserter?

Dave: Yeah, I hate that part. That's the worst.

Rachel: What, are you, like, disgusted? Are you like -

Dave: No, I just hate needles. I hate, like, getting blood taken and getting vaccines or whatever. I'm pro vaccine. [laughs] That came out wrong. I just hate getting the shot. So when I see you give it to yourself, it's just one of those makes-your-skin-crawl kind of things for me. But like when you have to adjust your level on your pump, or when you have to take the thing off to go swimming and you put the buffer thing on top of it, I don't know what you call that. Yeah, I don't know. I don't really feel any way about any of that stuff. It's just, like, it's an inconvenience, but for you. It's like, unfortunate that you have to do it all the time and maintain it all the time, but I guess I'm just so used to it that I don't even think about it at all.

Rachel: So I'm thinking about how, as someone without type one diabetes, how do you think that has changed your life, if any way?

Dave: I want to say that like, it makes me grateful that I have pretty good health. Because we live, we both live great lives, you know? And even with type one, you're still living a great life, so it's like, it's not like it's, you know. I don't know how that changed my life. I think probably it really hasn't changed my life that much. I think, just, probably being with you has changed my life the most. Diabetes just is like, something there. I don't know. I don't really know if it has.

Rachel: Okay. Is there anything else you'd like to share? [laughs]

Dave: Yeah, sometimes I I have the luxury of like, forgetting that you're diabetic. Sometimes you come home, and like, I greet you at the door, and then you like, take out your pump to adjust something or check something. And then in the back of my mind I'm like, "Oh, yeah, that's the diabetes again." But you don't get that luxury. So that's unfortunate, I guess, that you always have to have that in the back of your mind. Even the pump sounds like really quiet, when it beeps at night, like it's like, it's like, what does it sound like? [sings] Doo doo doo doo doo? [laughs] And it's pretty quiet, right? So you have to be able to like, hear that in the deepest REM sleep?

Rachel: Well, sometimes I don't, and it just starts vibrating.

Dave: Oh, yeah?

Rachel: It's like, "Wake up."

Dave: Yeah.

Rachel: If I don't hear it right away.

Dave: Still, though, I feel like that means you must. You must be sleeping later. Or something like -

Rachel: I don't sleep well. I feel like I used to, but like, back back back back back in the day. But I sleep better when I'm not attached to my sensor. Which sucks because the sensor makes sure that I don't go low at night. But if there's no sensor, then the pump's not receiving any information, so as I'm going to bother me.

Dave: Right.

Rachel: And so sometimes I go to, if I don't have a sensor on, I'll go to sleep with like a slightly higher blood sugar, so that I don't wake up with a low and I get to sleep through the night. And those are like the most solid sleeps.

Dave: Yeah.

Rachel: But those, but then my doctor doesn't like that.

Dave: See it's that kind of thing that like, that makes, that just like, really gets under my skin. It's like, it's the management of it. I don't know, I feel like most people even, even people who are in the profession don't realize how, how tough it is to manage it. It's so tough. It's like impossible. It's like you, like, have one eye closed, and you're trying to shoot a moving target through like, I don't know, I don't have a good analogy. It's really hard, though.

Rachel: Do you ever get tired of me complaining about it?

Dave: Oh, yeah, sometimes, but then I realize, you know, then I just try and put myself in your position. I remember it's such a pain in the neck. Like to deal with and, and I don't know anything about what it's like, I don't know what a high is like, I've never had a high in my life. I don't know what a low is like either. So it's like, I should just shut up and listen.

Rachel: Thank you for shutting up and listening. Well, thank you for having this conversation with me as a type three. I do want to say that I think you have been really supportive and also have given me my space. So I do appreciate that, but you, you have been supportive and, and sometimes I've been.... Like there's times where I've been embarrassed or annoyed that I've had like, I had a low or had to do something diabetes related and you're always really understanding, and you set the tone for, like, if we're with friends, then they're understanding because you're understanding. But I think that you've been a great partner. So thank you for that.

Dave: It's my, it's my absolute pleasure, my love.

Rachel: And on that, see you next time.

Dave: See you next time.

This episode of the 3s is brought to you by Companion Medical, the makers of the InPen smart insulin pen. I haven't used the InPen myself, so I called up my friend Ella to get her opinion.

Ella: I love how InPen keeps track of my insulin doses. It logs what time I take my insulin, how many units I take, and then also keeps track of how much insulin I have left on board. It's really made my diabetes management so much easier.

For more info, visit companionmedical.com.

The 3s is a production of Beta Cell. A very special thanks to Rachel and Dave for sharing their story. If you haven't yet, subscribe to Beta Cell wherever you listen to podcasts to get all of our shows downloaded onto your listening device automatically. While you're there, leave us a review. It really helps other people find the show. If you love The 3s or any of the Beta Cell shows, you can join our fan club. There, you'll instantly get access to every episode of Out of Range After Dark, as well as bonus clips and extra content from all the Beta Cell shows. Visit patreon.com forward slash Beta Cell to join today. I'm Craig, and this is The 3s.