Dear 7 year old Ciara,

First of all, Happy Birthday. You’ve just turned the ripe age of seven and a month from now you’ll have to process news that will change your life. Now, I know that sounds dramatic but it’s true. In one month and thirteen days, you’ll be diagnosed with Type 1 Juvenile Diabetes. Though you would have been battling the symptoms for months prior (there was a reason you kept falling asleep in between chugging water at The Nutcracker production), it won’t be until March 31st, 2002 that a doctor will sit down with your parents as you lay in a hospital bed going in and out of consciousness to tell them how your pancreas has failed and will no longer be able to produce insulin. The result is Type 1 Diabetes. This will mean manual insulin injections and constant monitoring of blood glucose, not to mention learning how to count carbohydrates.

The doctors will do their best to educate you and your family on the limited textbook facts they know about Type 1 Diabetes. They’ll give you cute books and animated cartoons that make it easier for your 7 year old brain to process the complex information that comes with the diagnosis. But it won’t be for years until you actually feel like you have a grip on everything your body can and can’t do. Years later is when you’ll discover which foods your blood glucose levels won’t permit and which ones do, years later you’ll learn where the insulin is best absorbed in your body through trial and error with different pump sites and needle injections.

This letter is written for what I wish I could tell you in addition to or even in place of the doctors directions. Because though they know the calculations and the science behind this disease, learning the emotional impact it’ll leave on you is something beyond their expertise. So I want to tell you what I now know nearly 17 years later with the same broken pancreas and an unquantifiable amount of emotional highs and lows induced from the highs and lows of blood glucose levels, in hopes that it will speak to those in your situation trying their best to grip the ever-tugging reigns of Type 1 Diabetes.

First, diabetes will change your body. That should sound like a given, I mean, your pancreas flipped a switch one day and now you self inject a hormone every time you eat the food that you have to carefully weigh and measure before you can eat and enjoy. But it’ll change as you grow and become an adult. When you change, you might feel as though you stand out amongst the beauty standards set by the unavoidable media. As you learn more about this disease, it might be an easy target to blame for how you look. You learn that the more insulin released by your body to count for the carbohydrates you’re eating is correlated with weight gain. You blame the reason you can’t work out the way others can is because your blood glucose keeps dropping when you exercise and figuring out the correct basal rate to set for your sporadic workout schedule is just…too much.

For this, I want to tell you that this isn’t your fault. In the face of Type 1 Diabetes, you are capable of playing sports and you will grow strong. Whether diabetes is to blame or not for the way you see yourself in the mirror, that body is a part of who you are just as this disease is. And just like trying to fight this disease, fighting with your body will get you nowhere but lower than where you started. You don’t have to love this disease, but you can live with it. But love your body and love the curves and scar tissue that come as a result of growing up and being you.

Second, the day you’re diagnosed is the day you’ll grow up faster than any seven year old should have to. You’ll be terrified of finger pricks and drawing blood several times a day, and the thought of injecting insulin before diving mouth first into your favorite foods will terrify you more than the thought of sharks swimming at your feet. But something you have’t learned yet, is that you are so brave. Your first dinner after spending a week eating hospital food will be a bowl of macaroni and cheese (fuel for when you go see Paul McCartney in concert that night) and you’ll prick your finger and draw blood because you have two options 1) wait for you mom to come do it for you but she’s getting ready so it’ll be a couple minutes more than you’d like to wait to eat or 2) press that little plastic button and draw the tiniest dot of blood so you can enjoy that melted cheese covered pasta as soon as possible. You’ll choose the second option because that’s who you are. Strong as nails.

Before you know it, you’ll be administering your own insulin shots and when you start wearing a pump, you’ll be inserting that as well. So don’t forget that, because your bravery will be tested when elementary school boys call you “Diabetes Girl,” and someone accuses you of pretending to have diabetes for the sake of attention (I know, seriously?). But man, I would’ve loved to have seen those punks go face-to-face with their flu shot that season. Very quickly you’ll learn that a flu shot is nothing but a tiny pinch to you. Take this opportunity to educate those who clearly have no idea of the bravery inside you that is dealing with the repercussions of a lazy pancreas every day.

Part of the repercussions is that you’ll learn how your body works (or in this case, doesn’t work), and you’ll be able to excel with this knowledge. Not many seven year olds memorize the carbohydrates of 1 cup of Fruity Pebbles and even fewer know what carbohydrates are. But you’ll be surprised and eventually tired of the big humans, three-times your age that also don’t understand your disease. Take a (very deep) breath and prepare a 60 second elevator pitch to deliver to them when they assume you can’t have a slice of pie or that too many slices of pie is the reason you have diabetes. With this, you’ll be fine. You can cry, you can be frustrated, you can deny Type 1 Diabetes, but don’t let those feelings fester and become a part of who you are. You’re capable of holding so much positivity and sharing it with those enduring the same struggle. Type 1 Diabetes will be a part of who you are until a cure is found, so take my advice above and be the most brave, confident girl and eventually woman people have ever met.

Love always,

23 year old Ciara