Commitment Issues (also known as, My Big 2014 Commitment to Change)

I have dubbed 2014 to be the “Year of Commitment to Change.” Because, really, I’ve always had some sort of commitment issues. Not with my relationship with my husband or my friends or family, but with myself.

Years ago, I (albeit grudgingly, because I was diagnosed at 21, which should have be the height of “fun” time for me in college) made a commitment to myself to take care of my diabetes. When I was diagnosed, my doctor basically said there are 2 types of people with diabetes: those who live with it, and those who die from it.
I chose to be part of the former, and have taken numerous steps and changed my lifestyle dramatically over the past 19 years to make sure I was going to live, and live healthy, for as long as I possibly could. I’ve worked diligently to learn how to count carbs, take the right amounts of insulin, discover settings on my pump that help me avoid post-prandial spikes, acquired a CGM – the list goes on and on.

I go to my regular 3 month endocrinologist appointments like clockwork. I get my labwork reports. Everything looks pretty darn good, like it has for many years. My HbA1c is 6.1, and has been hanging out in the 6’s ever since I went on the pump in 2003. When I was pregnant, it even dipped into the 5’s.

At my last appointment, my endo and I had one of the most serious conversations we’ve had in years (the last one being in 2008, which was the “I’m trying to get pregnant” one, and I was reduced to tears because I felt it was never going to happen. But it did.) Our new-and-serious conversation revolved around my weight, which has steadily gone up since I was diagnosed with Type 1. I was a healthy weight back then at 21, I was an avid hiker, and loved to exercise. Fast forward almost 20 years…..a sedentary job, maturing into my 30s (and now, 40s), a bout of depression,  the roller coaster of hormones when trying to get pregnant, and then the pregnancy itself have helped me put on so much weight, I am now categorized as “morbidly obese.” Just saying that makes me cry.  I have explored the gamut of diets, exercise, changed how I eat, and definitely lost some weight along the way, but never enough to get down to a weight where my feet don’t constantly hurt, where I can sleep well at night, where I have enough energy to play with my daughter for hours, or where I can take up an exercise regimen without hurting myself in some way and losing track. I’ve been stuck in a rut of metabolic syndrome that has made gaining weight, despite my best diet-and-exercise efforts, far easier than losing weight. It’s discouraging, and my body is so very tired of constantly fighting some kind of pain from carrying around all this extra weight.

The me I want to be, again

A New Year’s picture of me, when I was at a healthy, manageable weight – before type 1 diabetes and metabolic syndrome had set in.
I want to be this again.

My endo says, “You are healthy, except for your weight. The medical issues, pains, etc that you have all revolve around your weight. Have you ever thought of having bariatric surgery? I wouldn’t recommend it for most of my type 1 patients. But you….I think you can do it. And I think you’ll see that as a tool, it will help you get to a place where you can manage your weight once again, and not get sucked back into the metabolic syndrome.”  For some background…my endo is a Type 2 himself. He had gastric sleeve surgery 1 year ago. I’ve seen the change in him – he looks, and tells me most importantly, he *feels* AMAZING now. He told me that he would refer me to his surgeon, he would go to the pre-op and post-op support meetings with me, and we could even do group personal training sessions with his personal trainer. He is on board to help and support me, which helps calm *some* of my fears about having an elective weight loss surgery as a Type 1 diabetic.

So….here comes the commitment part. If I want to do this, it’s going to require a LOT of commitment to changing, well, just about everything. I have to commit to a LOT more doctor visits over the next year. I have to commit to going to support group meetings. I have to commit to learning about how nutrition and digestion will change with the surgery. I have to commit to a non-impact exercise routine (to save me from injuries and so much foot pain) and know I will deal with blood sugar fluctuations as a result.  I have to commit to overhauling my diet and changing the way I consume food and drink. My diabetes management, that I’ve spent so much time perfecting, will drastically change – both before, and certainly after the surgery.

I have already tried to track down other Type 1’s who have had gastric sleeve surgery to ask them how they have managed, and if they have had any major complications or issues.  I have yet to find any. I feel like I’m navigating un-chartered territory here, and it’s scary. But, I’m even more scared of what my life will look like (or, if I will even be alive/healthy) in 20+ years if I can’t get rid of this extra, exhausting-and-debilitating weight. I’m sure there will be people in the DOC who are going to frown upon this choice I’m making…who think I *should* be able to lose 125+ pounds just by diet and exercise alone. Unless you have been THIS weight that I am, and struggled with all my injuries and aches, you have no idea how daunting it is, or how excruciatingly  painful. I need a dramatic change, I need it soon, and this is what I am going to do.

My first steps:

1. I am owning up to this commitment I am making – to take a risk that will change my life and my health for the better.

2. I am sending out feelers everywhere I know to find other Type 1s who have had gastric sleeve surgery. I’ve posted to a few bariatric surgery pages already, and found plenty of Type 2’s who have done it, but not a single Type 1. I’m hoping the DOC can reach out it’s arms and find someone within it’s ranks who has done this as a Type 1 and is willing to chat with me about it.

3. I’ve had my 1st consultation with the surgeon, and have scheduled nutrition counseling and a sleep study. Still to come: psychological evaluations, support group meetings, and various other tests and examinations to make sure my body is a good candidate for gastric sleeve surgery.

Even if I end up on this journey not knowing or being in contact with anyone else who’s done it that’s “like me,” I can at least document what’s going on through my blog, and I hope it will help someone else in the future. Wish me luck & strength, folks, and here’s to a Happy New Year for all of us!!

35 thoughts on “Commitment Issues (also known as, My Big 2014 Commitment to Change)

  1. Good luck…I think you’re very strong and brave for making a decision to better both your life and health! It’s always scary to do something out of the/your norm. Much luck and well wishes your way 🙂

  2. You sound like a strong committed person who is willing to do some tough stuff in order to stay healthy, and you should be so proud of yourself for that!! And you should be proud that you are documenting it so others don’t feel alone. And I hope you know I’m proud of you too!!

  3. Thank you….trust me, I need all the support and encouragement I can get! I’ve been pondering this for a while, running through so many pros and cons. I don’t want to chicken out, because you all know, surgery is scary and definitely risky. But if I stick to it and have this done, then I have no choice but to continue the work to make it a successful weight loss tool. I HAVE to do this- first of all, for myself, so that I can wake up in the mornings and have the energy to truly live again, and second, because I so desperately want to be alive and around and able to enjoy life with my daughter, my husband, my family and friends. I don’t want to be miserable and unable to walk in my 60s, which is where I feel I’m headed if I can’t get my feet and joints under control. Weighing much, much less is most certainly a step (pun intended) in the right direction!

    • Thanks, Stephen! I read that article when doing some research, and I just can’t wrap my head around the “changing how everything is connected” part of the RnY surgery and how it would change my management of type 1. It seems so drastic and scary. Gastric sleeve surgery to me seems a little more conservative, and while the initial weight loss is less and it requires more “work” ongoing, it’s the one I am lobbying for, and think I can handle best with regards to diabetes. We will see!!!

  4. This is exciting, terrifying, and I want to be supportive! Metabolic syndrome sounds like a beast.

  5. I’m with Katy. This sounds like an incredibly complex situation to deal with, both in the decision-making and then following through with it. Good for you for facing the issue rather than putting it off, and also for discussing it — so the next T1 looking into this won’t come up empty when they try to find someone to relate to.

    • Scott – just knowing you guys are all out there gives me a sense of hope and determination like I’ve never had before. It’s going to be an interesting trail to blaze for me, to say the least! I would not want to do it without having your help as sounding boards. And if I can’t find someone who’s done it before me and can “mentor” me, well, then I will just have to be even more diligent in documenting how all this happens, and how it’s hopefully successful!

  6. I am here for you girl in whatever way I can to support you! You are a strong, amazing person and I wish you much success in your commitment to change! Hugs! Karen

    Sent from my iPad

  7. I don’t have any advice; just a “Go Rhonda! Go!” nudge of encouragement.

  8. My friends and I like to say “you do you”

    As in, who cares what “other” people say, you are in charge of this decision and we will support you how you need it.

    I don’t know of another T1 who has had it, but I can put it out there on Twitter.

  9. Having T1D and metabolic syndrome maybe is like having celiac and T1D? In that you gotta do these extra things most PWT1D don’t do/have the need to know about. Maybe from the outside, people think, “That’s kind of crazy that Katy bought a new toaster. I wouldn’t change toasters.” But once you know about it, it’s like: OF COURSE I CHANGED TOASTERS.

    I’d think [Met. Synd. + T1D] is *at least* as common as [celiac disease + T1D], which is 1 in 10 <—super common! They'll all start popping out of the woodwork soon!

    I can't wait to read more.

  10. Brave steps Rhonda! The toughest commitments are the ones we need to keep with ourselves. For some reason, “we” think it’s acceptable to let ourselves down while making sure not to do the same to those around us. It’s a vicious cycle.

    I’m proud of you for beginning this journey and prioritizing you. I can’t think of a better pioneer to pave the way for type 1’s in your situation.

  11. I had gastric bypass and I have T1. Feel free to email if you would like to chat.

  12. Oh Rhonda, I’m so proud of you for pushing toward good health for yourself. I don’t have experience with the surgery but it sounds like you are in good hands. I truly hope you find the support and answers you need to put your mind at ease. I wish you the best in your journey and am always hear to listen if you need to spill some feelings 🙂

  13. I am looking for type 1 who have had the sleeve done. Where did you find them and can you help me to connect with them?

  14. Hi, thank you for sharing your story. I’ve been type 1 for 20 years and am also considering the gastric sleeve. I haven’t found any info on type 1’s and this surgery or any bariatric surgery for the matter. It’s very discouraging and makes the process that muh harder and scarier 😦

    • Kathy – glad it’s just not me having a hard time finding someone who has done it before us. I have chatted with a couple of type 1s who had RNY, but as you and I both know, that is a dramatically different surgery from gastric sleeve, and I’m sure the diabetes-related challenges with it are also very different. If you find someone, let me know, and I’ll obviously do the same here 🙂 I have asked my surgeon’s office to look through their records and files and see if they can hook me up with a mentor who is Type 1 and had the sleeve surgery done, but so far, no luck there either.

  15. Reblogged this on cdbamerson's Blog and commented:
    I feel as though I’m in the same boat! The surgeon I’ve been referred to is “scared” to operate on my because he’s never performed the procedure on a Type 1. He said T1s aren’t overweight. Hello!!!!! Do you see me?!?! He made me feel so isolated and alone. I’ve started this blog to hopefully locate other overweight Type 1 Diabetics needing help with bariatric issues. You are not alone!

  16. Finally, I run across someone with Type 1 diabetes and had sleeve surgery .. I have look the internet over trying to find someone!! I hope you still have this blog open so maybe I can get some answers. I am having surgery on Sept 10, 2014 and I will start my 7 day per diet on Wednesday. Can you Please let me know how you are doing, I really need to hear the good ~ bad ~ and the ugly. I know this is the surgery for me but I am still crazy out of my mind with worry about what is going to happen.

    • Julie! I’m just getting back from vacation, but would love to chat with you more. I’ll send you a private email 🙂 I am doing GREAT and have lost about 40 lbs so far, less than 3 months since surgery. Dealing with the T1D part of it has definitely been challenging, but it’s do-able!

      • I am so glad you will be able to help me through this process with some answers. I am getting really nervous as time comes quickly, just worried about the lows that I’m sure I am going to have! My 7 day pre op starts tomorrow. I have my mind set and ready for the change!!

      • The lows had me freaking out as well, but to hopefully help calm your fears, here’s one thing I think should be a constant among us: Once you’ve had the surgery, and your stomach is 20-25% of the size it used to be, digestion works WAY differently. You do have to reduce your basals/ how much insulin you take, because you will be eating FAR fewer carbs than ever before. On top of that, IF you do start to go low, drink a few sips of juice. You know how usually it takes some time to sink in and take effect? Not so after surgery… sip it, it hits your stomach, it immediately starts getting absorbed. I have been juggling some lows at weird times here lately, BUT, never fear – getting up to normal-ish blood sugars is easier because stuff does hit your system way faster.

  17. Oh thanks for that information, that helped me a lot. Glad to know that just a couple of sips of juice will do it. If there is anything you will be able to tell me that would be helpful, I would appreciate it.

  18. Hi, I just started to read your blog and I am very interested because I am considering the gastric sleeve but like you know , it’s very difficult to find types 1
    I been type 1 diabetic for 26 years and now with pcos , hypothyroidism and a BMI of 31 , I just went my doc and I ask her about the surgery and she left me in blank , she told me that there’s no evidence for t1 improvements and for my weight i do not qualify , she just said it is your decision .
    So do you had the surgery???
    I would like to know about your experience
    Thank you in advance !!
    And happy New Years !!

    • Sorry, I’ve been terrible at blogging recently, and the holidays were soooo busy I don’t think I’ve even caught up yet! I try to post things here and there at: – with a BMI of 31, it’s true – I don’t think many doctors/insurance would qualify you for the surgery. My T1 has “improved” only because I am forced to eat fewer calories and fewer carbs, therefore, I take less insulin overall. The surgery (and weight loss) truly helped reduce the type 2 symptoms I was having, which was some terrible insulin resistance. I still have 50-60 more pounds to lose, but already, the type 2 aspects have been greatly reduced. It’s a HUGE lifestyle change, though, and not an easy one when you add on Type 1 diabetes. For your PCOS, have they considered giving you Metformin? Good luck in your search for more information!! I will try to blog more soon…

  19. Please check out our Facebook group “Type 1 Diabetes and The Gastric Sleeve”. There are a bunch of us on there who have had the surgery and communicate with one another. : )

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