Entry #9 • October 21st, 2025

I’ve spent the past two hours doing admin work for the store—emails, reports, more emails, and, well…more emails. While working through this seemingly endless “busy work,” I found myself thinking about what I wanted to write for this week’s Just Me entry. I think about these entries sometimes days in advance, even a week ahead, depending on what’s going on.

This one could’ve gone in a few different directions. But as I continued sifting through my inbox, one email caught my eye—the one that’s been staring me down for weeks now, patiently waiting on my to-do list while I’ve kept finding reasons to put it off.

If you’ve been reading these entries since they started a couple of months ago, you know this season has felt like a lot. Just putting one foot in front of the other has been a massive undertaking.

Tonight, though, I knew I needed to deal with that email. Get it done.

The subject line, dated August 27th, is a simple one: “Pump Training Video.” That’s it—just a 28-minute YouTube video my son and I need to watch as we prepare for his insulin pump.

I’d been avoiding it, and at first, I wasn’t sure why. But as I sit here writing to you, Dear Reader—processing as I go—I realize it’s because I’m educated out.

I’m tired of all the rapid learning we’ve had to do these past four months. Life-and-death learning. Not suggested learning. Not extra-credit learning. Required learning. And seeing that pump email…it felt optional, at least for the moment. Something I could safely backburner.

For now (since this all started in June), he’s been doing manual insulin injections, with the goal of eventually moving to a pump. But before we can start that, we need more education. And I just…needed a break. So I slowed the process down a bit (well, insurance delays contributed too—but honestly, I wasn’t mad about it).

But today, the pump arrived. The reality of it being time hit full force.

My son is excited—really excited—for what this pump could mean for him and his new normal. And don’t you worry, in true Megan fashion, I’ll take time in this entry to explain what all this insulin jargon means.

Side note: I got to speak with a Dear Reader in person the other day who asked how my son is doing. She thanked me for taking time to explain what this process has looked like for our family. Her niece, also a teen, was recently diagnosed too, and she said my writing helped her better understand what her sister-in-law has been going through. That meant so much to me—so thank you.

Yesterday was hard.

I got a text from our local pharmacy that prescriptions were ready to pick up for my son. So I headed over for another month’s supply of insulin and CGMs (continuous glucose monitors). As I got out of my car, I felt the anger rise again. Those grief stages…they keep washing over.

I was mad that I had to go in and pick up supplies my kid literally needs to live. To exist. Just mad at the reality.

“But Megan…these advances are amazing.”

Trust me—I wrestle with that too. I know that managing T1D today is the easiest it’s ever been, and I am so grateful for that. I’m especially grateful for the invention of synthetic insulin—something I’ve told many friends and family members since his diagnosis. Without it, my son wouldn’t be alive, which is of course a sobering thought.

Still, I’m learning to give myself space to feel both sides of it.

Grateful for insulin, but mad that I have to pick it up every month at the pharmacy. That it’s not optional. Whether I wanted to be tethered to this system or not, I am.

It’s okay to hold both ends of that tension. In fact, I’d say it’s normal—to be grateful and hateful in the same breath. And while I hesitate to even say the word “hateful” (it feels so strong), it’s honest. Because hate doesn’t always look like rage; sometimes it’s the quiet ache of “why does it have to be this way?” It’s frustration at the system, exhaustion from the learning, and the grief that this will never be simple again.

I hate that the innocence of before T1D is gone, and that I now live in a state of hyper-vigilance—not just for my son, but for all of my kids. The other day one of my boys “seemed” like he was peeing more than usual (and he mentioned he’d been drinking a lot). Instantly, my mind went there. T1D. It's not necessarily bad that my mind jumped to T1D but it sure is exhausting. I had him sit down while I grabbed the blood glucose meter that now lives in our house…in our reality. I pricked his finger and held my breath for those five seconds that felt eerily like waiting for a pregnancy test result. I was convinced the numbers would be off the charts—that this nightmare was about to continue in another child. The dots on the screen flashed: . . . . . . . 93. Normal. Totally normal. Deep sigh. I was grateful for those normal numbers. But I was hateful that the moment even happened.

And there it is again, that word—hateful. Oof. It still feels so strong, almost too rated-R to say out loud. Why is that? As I sit here in the discomfort of my own thoughts, I realize it’s because “grateful” feels like the safer word—the more acceptable one. I’m grateful my son is alive. Grateful insulin exists. Grateful technology is improving. Grateful it’s not something worse. I have friends who’ve walked the treacherous road of childhood cancer—one lost her daughter, the other didn’t. So I tell myself: be grateful.

And I am. But that’s not the whole story.

As a Christian who truly trusts my God, I default to "I should live in gratefulness." And while that’s partly true, it’s not the whole truth. It’s also okay to be angry…mad…even hateful about this reality. God created me as a human with a full spectrum of emotions for a reason. I wasn’t made to move through life like a robot, feeling only the “appropriate” things. Life invites us into the whole range—joy, sorrow, anger, gratitude, and everything in between.

And what a relief it is to know that God can handle these feelings of mine. Scripture shows us a God who feels deeply—forgiveness, compassion, anger, frustration, joy, sorrow, love. None of it too much, none of it off-limits. Those accounts remind me that I, too, can feel it all—justifiably, honestly, fully.

When the Sacred Meets the System

The pharmacy is cold. It’s dead. It’s so rote.

Nearly every time I walk up to the counter, the pharmacy tech—whatever the official title may be—utters three sterile words: “Date of birth.” That’s it. Flatlined.

I reply with eight vital numbers, XX/XX/XXXX. She punches them into the computer, walks away without speaking, and returns with a brown paper bag. It feels like she’s fetching me contraband. She tells me the total. I insert my debit card. A receipt prints. She staples it to the bag. I walk away.

Mad.

That was the most lifeless interaction ever…to pick up something my kid needs literally to live.

The dichotomy of it all is overpowering.

In a few weeks, I’ll be back—for more needles, monitors, insulin. Another brown bag, another reminder that the system keeping my child alive feels hollow and broken. Not because the people don’t care, but because somewhere along the way, the process lost its pulse.

…I miss KevHim (middle of entry #3). I truly thank God for him—for the timing of him being our first experience in this world of needles, monitors, test strips, insulin, emergency meds, and glucose tabs.

Look, I know not all pharmacies are like my local one. And I also know these people do this every single day, over and over again. I get it. And while I don’t need my hand held all the way, it would’ve been nice to have a little more human touch through one of the most traumatic experiences of my life.

Maybe that’s why God gave us KevHim when He did. He was exactly who we—who I—needed in that moment.

Let this serve as a reminder to all of us: we never really know what someone is going through. We have no idea what just happened in their day before we cross paths. Always assume the best of people. (Which, I admit, I’m absolutely not doing here with these pharmacy techs—so I’ll eat crow on that one. 😅)

Back to tonight.

Like I said, that email was staring me down. “Come on, Megan, you can do it.” Twenty-eight minutes of pump education. The pump is here, and we have to complete two training sessions—this video being one—before we can start using it.

So I did it.

I watched the video tonight and felt a flicker of something I haven’t felt in a while: hope. Rejuvenation for what this could mean for him. It will bring its own complexities, yes, but it will also free up so much of his mental load.

The next step is to schedule a Zoom call with his care team, where they’ll walk us through his specific pump and all the ins and outs of using it.

And of course—lest we forget—I’ll be back at the pharmacy this week to pick up the new insulin supplies. 🙃

The Work of a Failing Organ

Injections vs. pumps. Let me break this down for those of you who are interested.

As I’ve shared in previous entries, he has to inject insulin an average of four times a day—roughly with all three meals and then again before bed. There are two types of insulin he’s on: “long-acting” and “fast-acting.”

The long-acting insulin is what he injects before bed. It slowly releases into his system over a 24-hour period, meaning he always has some insulin working “in the background” throughout the day. This helps keep his BG (blood glucose) within a normal range.

Then there’s the fast-acting insulin, which he doses and injects at mealtimes—or anytime he eats more than about 5 grams of carbs (so a snack, dessert, etc.). That insulin goes to work almost immediately, helping his body convert carbs and sugar into usable energy.

He has to have both types working together to keep everything balanced—and to keep him from ending up in the hospital again (like where this all started in June).

These injections are manual. Meaning, he injects himself using an insulin pen with a teeny-tiny needle on the end.

He does this at least four times a day. He also has to rotate injection sites—upper thighs, back of upper arms, stomach, and butt—so the skin doesn’t get scarred or calloused from repeated pokes in the same spot.

So, what is an insulin pump, you ask?

An insulin pump replaces the daily need for manual injections. The one he’s getting looks like this:

It’s used with something called an infusion set, which attaches to the skin with adhesive. Inside that set is a cannula—a tiny flexible tube that inserts just under the skin. That’s how the insulin gets delivered. The tubing from the set connects to the pump, which holds a small reservoir filled with 2–3 days’ worth of insulin.

The pump connects to an app on his iPhone—yep, iPhone only—so here we are, giving our teenage boy a phone for medical reasons. (Definitely not where I thought we’d start with a reason for a phone.) Whenever he eats, he'll simply enter the number of carbs he’s eating into the app. The pump will calculate how much fast-acting insulin he needs and deliver it automatically—from the reservoir, through the tubing, into his skin via the cannula.

He will no longer have to inject himself. He will no longer have to calculate ratios of insulin to carbs. The pump will carry that load for him.

And that nightly long-acting injection? He won't need that anymore either. Instead, the pump will deliver tiny amounts of fast-acting insulin continuously throughout the day and night (called the basal rate) to keep his blood sugar steady between meals and overnight.

This setup is designed to mimic what a healthy pancreas would do—releasing small, steady amounts of insulin all the time and larger “bursts” when food is eaten.

The pump relieves parts of the daily mental load.

It will come with its own challenges, of course—technology hiccups, site changes every few days, and the constant need to stay aware—but overall, it will lighten his mental and emotional burden. And it will make his Type 1 management less publicly visible.

Now he will be able to discreetly open an app on his phone instead of getting out insulin pens, needles, and alcohol swabs every time he eats. It’s a little more private, a little less invasive.

And while he’s handled injections like a champ—both in public and in private—it’s a relief to know it doesn’t always have to be so visible.

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There’s your basic education on T1D management with insulin. Of course, there are nuances to all of it.

For example, he has to factor in whether he’ll be active around mealtime—usually shooting hoops in the driveway, as he loves to do. And while we haven’t had to navigate sickness yet, we’ve already spent hours in training for what’s called “sick-day management”—what to do when he eventually catches a stomach bug or cold.

Think about how you feel when you’re sick: you probably don’t want to eat, and it can be hard to keep fluids down. For someone with Type 1 Diabetes, that alone can throw blood sugar levels off dramatically. During illness, stress hormones can raise blood sugar, but not eating can also cause it to drop—so it becomes a delicate balancing act that requires constant checking and adjusting. And when fluids are low, it raises the risk of developing ketones—those dangerous acids that build up when the body doesn’t have enough insulin or hydration to use sugar for energy.

And honestly, for someone like me—who’d rather just let a cold run its course, trust the body to do its thing, and keep things simple—this level of intervention goes against everything in me. But his body is missing the function of a key organ, and now we stand in its place. It’s another layer of learning, another area where time and trust alone aren’t enough.

Even as we step into that role, his pancreas is still trying—doing just a little bit of the work on its own. He’s in what’s called the honeymoon stage of the diagnosis. That means his pancreas is still working—just a smidge—producing a little of its own insulin. This phase can last weeks or months, and it makes dosing tricky because his body’s insulin needs change day to day. As the honeymoon stage fades, his pancreas will slowly stop producing insulin altogether.

Does that make you feel sad for his pancreas? It makes me feel sad. I picture it giving its last hoorah before fading off into the sunset. Tragic, really.

Once his pancreas taps out for good, he’ll be completely reliant on synthetic insulin. Practically speaking, that means his dosing ratios will change. Right now, he doses about 1 unit of insulin for every 12 grams of carbs. As his pancreas stops doing its part, that ratio will shift—he’ll need more insulin for the same amount of carbs.

He’s basically doing the work of an organ most of us never even think about. Every Type 1 Diabetic is living this reality—acting as their own pancreas. Wild. Absolutely wild. Six months ago, if you’d asked me about the pancreas, I couldn’t have told you a thing about it. 🫣

Anchored in the Middle of It All

In this season, I’ve found myself reaching for songs that speak for me when the world feels heavy. This one felt appropriate for today's entry—reminding me I can lean into the most sure Anchor of all…

Anchor by Beautiful Eulogy & Josh Garrels

Last little piece of education for today: know the symptoms of Type 1 Diabetes—for your own awareness and your kids’, too.

Just remember the Four Ts:

Toilet (excessive urinating)
​Thirst (drinking constantly)
​Thinning (unexplained weight loss)
​Tired (persistent fatigue)

If you ever notice all of these symptoms together (not individual of each other), ask your doctor or pediatrician to do a simple blood sugar test.

I don’t share this to stir up paranoia—truly, I don’t. But when my son was “off” this past May, just weeks before our family trip, I couldn’t quite put my finger on it. He wasn’t sick by any normal signs. It wasn’t until we were in the van, mid-trip, that the pieces started clicking together: drinking a lot means peeing a lot, add in the weight loss and exhaustion, and—badda bing, badda bam, badda boom—you’ve got the picture.

So that’s where I'm at for now—somewhere between gratitude and grief, furthering education and dosing insulin. Every new piece of this journey teaches me something different about trusting God, about letting go, about learning to stand in for an organ I can’t fix.

Type 1 Diabetes aside—did you catch last week’s newsletter for the store? You’ll see TMBTC in the subject line (that’s The Mom Behind the Counter—the title of the store newsletter). I didn’t put a Just Me out last week since my writing time went there instead, but it’s worth a read if you haven’t seen it yet. There’s some storytelling in it, a few favorite product features, and maybe even a coupon code 🤫

Oh—and I’ve made a new page where you can see all the previous Just Me entries in one place. If you’ve been enjoying these letters, I’d love for you to forward this email to a friend who might relate or need a little of what we talk about here. Word of mouth means the world to me, and it helps this little corner of honesty keep growing.

Until next time,

-Just Me[gan]