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  • Writer's pictureApril Blackwell

How T1D is like mission control: Toughness

This morning I rolled out of bed in a groggy haze - my alarm clock and the baby had gone off at the same time. As I reached for the monitor I heard (and felt) a muffled, "rip." The insulin pump site that had been hanging on by a thread had just ripped clean off my skin, and of course, there were 60 units left in the reservoir. Not to be outdone, just a second later the symphony of morning sounds continued - my insulin pump and phone app were alerting me of a low blood sugar. Par for the course, the wiener dog showed no mercy for my precarious situation - she chimed in with her own whiny chorus.


To many that description of my morning may seem extraordinary, but I'm here to tell you, diabetes doesn't take days off or give you a pass. Somehow it seeks out those moments when you are already weak from life in general and slaps you on the bum with it's two cents.


You see? Those alien worlds of T1D and human spaceflight really aren't all that different. Toughness is one of the "Foundations of Flight Operations" - a set of qualities that we practice on and off console - a guidebook established by the first Flight Directors and their Flight Control Teams in mission control. And as much as everyone tells you to "keep work at work" and "keep home at home" I can' help but notice the parallels between my life as a Flight Controller and my life as a Type 1 Diabetic.

"Taking a stand when we must..." Boy must we. All day, every day. As Flight Controllers we are the system experts. If an ISS emergency hits in the middle of the night as I'm sitting on console in mission control - it's just me. I'm the only person in that room (and probably the only person awake in the world) who knows how to control the attitude and propellant and gyroscopes and orientation of the ISS. My brain is the resource that the six people onboard are counting on to keep them safe. Sometimes that means standing up, pushing information and using all of the skills I'm equipped with to keep the crew and vehicle safe.

Diabetes is no different. We are the system experts. Sure the system is different, but the fundamentals are the same. In the middle of the night its often "just us" dealing with a low blood sugar or insulin delivery problem. Our brains are the resource to keep ourselves alive, sometimes in difficult or high-stress situations. We have to count on ourselves and our training - falling back on the muscle memory of testing our blood sugar, administering insulin shots or eating to recover from a low blood sugar. To avoid stunted dreams, we have to use this experience and expertise to take a stand - pushing information and data to the right organizations and supporting each other - our synergy can overcome seemingly insurmountable barriers.


" try again and AGAIN, even if it means following a more difficult path." Yes. This here. Flight Controllers are trained to devise "work-arounds" and options and risk trades for every potential scenario we can think up. And when something happens we immediately formulate our calls into a "Failure, Impact, Workaround" format. After the initial troubleshooting or safing we think about the "Next Worse Failure" and devise more work-arounds and options and risk trades. Often these work-arounds are not simple or straight forward or easy or documented, but if it means doing the right thing - keeping the crew safe - then its the correct path, no matter its difficulty.

As people with diabetes we try again And often, if our goal is tighter control, it means following a more difficult path. The manifestations can range anywhere from minute-by-minute timelines from eating until workout, strategic placement of insulin pump sites or CGMs, avoiding specific foods in proximity to certain activities, carrying around five pounds of extra/backup supplies, or considering diabetes-next-worse-failures and planning appropriately. And in conjunction with "taking a stand" - this version of toughness - trying again and AGAIN, resonates so clearly with how T1Ds are too often unnecessarily restrained.


Toughness is a welcome side effect from this unwelcome disease.

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