I’m Pumped to Announce This Week’s Wednesday Warrior: Ashley Biehl
Ashley and I connected online through a mutual friend (one I also met through Sugar B- thank you, Christine 😊)
After getting to know Ashley, I was humbled by her story and the journey she’s experienced. She has had diabetes for 11 years and is the definition of a Warrior.
Without giving too much of her story away, Ashley is a lawyer, an athlete, and heart transplant, recipient. After experiencing a heart attack just last year, Ashley states she continues to fight every day to live a healthy life and to honor the second chance of life she’s been given.
The pills and steroids she now takes to manage her heart make it hard to control her blood sugars. Also, not to mention, Ashley is insulin resistant…. told you she was a Warrior 😊👊
I could keep going about this amazing human, but you’ll get more benefit hearing her story from Ashely, herself.
Ashley, you have inspired me in so many ways and I’m honored to share your story.
Here is her story:
I was diagnosed on July 24, 2007.
I’ve been living with diabetes for eleven years.
I’m living in Las Vegas, Nevada.
My current occupation is an attorney at the Legal Aid Center of Southern Nevada, in the Children’s Attorney Project.
- What type of diabetes do you have?
I’m a Type 1 Diabetic.
- What were your first thoughts when you were diagnosed?
I was in complete and utter shock.
My mom is also a Type 1 Diabetic and had been since 2000 (about 7 years before my diagnosis). I was 16, and a four-sport varsity athlete, and I was diagnosed between my junior and senior year of high school.
I would workout about 3 hours per day, practicing for swim team before school and running track after. I was at a leadership conference when I noticed that I was urinating excessively, so I set an appointment with my doctor to see what was going on.
She said: “We want to run some fasting labs because we think you’re a diabetic.”
I remember telling her, “Nope, that’s not possible. In AP Biology, I did an experiment on my blood sugars in May and they were totally normal. There is no way I developed diabetes in two months.”
Obviously, I was wrong, but it did mean that we knew I was diabetic very soon after it happened. I was also TERRIFIED of needles, so the first time I had to give myself a shot, I think it took me thirty minutes to work up the courage. I was so scared, because I had seen my mom struggle and fail to control her diabetes, and I knew how difficult it would be.
- How has your management changed from when you were first diagnosed now?
It has changed a lot. When I was in high school, and college, I cared more about having fun and eating what I wanted, than effectively managing my diabetes. My A1C was often between 8 and 9.
Once I graduated college, I started to take my diabetes more seriously.
I thought to myself: “If I want to have kids someday, and if I want to be able to safely carry a pregnancy, I need to learn how to control it.”
I began checking my blood sugars regularly and using a carb to insulin ratio to dose my insulin more effectively.
Throughout law school, my A1C ranged from 6.0 to 7.3 and was much more tightly controlled.
I’ve been struggling a little recently, due to other medications (see more on #7), but still trying to keep my diabetes as controlled as it can be, to give myself the best chance at having a long life, free of complications.
- Did you ever try to hide your diabetes?
No, I never tried to hide it. I have a huge, boisterous personality to begin with, so I was always super outgoing about my diabetes. I’d give myself a shot anywhere, anytime, in front of anyone. I’ve even had people at lunch be like: “Oh my god! Did you just give yourself a shot?!” and I’m like: “Yup, I did.”
It’s no big deal to me, and definitely not something to be ashamed of.
- What are the biggest challenges of being diabetic?
I’ve had three major struggles with my diabetes, although the first two are definitely intertwined.
First, I am incredibly insulin resistant.
What this means is: Each person’s body needs a different amount of insulin to deal with the same amount of sugar. Essentially, my liver and muscles don’t respond well to insulin and can’t take the glucose from my blood easily, so I need to use more insulin to help the glucose enter the cells.
For example: If my mom and I went to dinner and ate a plate of pasta, she might give herself eight units of insulin to cover her meal and keep her blood sugar at an acceptable number. I would give myself thirty units for the same meal. (So, her insulin to carb ratio would be that she gives herself 1 unit for every 15 grams of carbs she eats, while I give myself one unit for every 4 grams of carbs I eat).
The second, related, issue is my weight. A common stereotype is that ALL diabetics get diabetes by eating poorly and not exercising. This is, of course, not the case for type 1 diabetics, whose pancreases simply do not create insulin at all. My experience has been the opposite of most diabetics. I was quite thin when I was diagnosed. However, due to my insulin resistance, I have to take an extraordinarily large amount of insulin (some days over 200 units!). A side effect of insulin is that it makes your body store fat.
After being diagnosed as a diabetic, I gained almost 30 pounds in my first two years. It is a terrible cycle because the more you weigh, the more insulin you need, and the more insulin you take, the more weight you gain.
Losing weight has been SO difficult for me, and my fitness and body size is a fight every single day.
My third and final struggle is that I am allergic to Humalog insulin, which is the most generic fast-acting insulin. I get large welts at the injection site. This allergy occurs in less than 2% of diabetics. Some hospitals only carry Humalog insulin, so I have to bring my own insulin if I know I am going to be admitted to the hospital.
- Are you diabetic proud? Why or why not?
I am definitely Diabetic proud.
I take huge offense when people make jokes about getting “diabeetus” when people eat one bad meal or dessert. Dealing with diabetes takes concentration and effort, every single day. Every person who deals with it is a warrior. I even got sick of wearing my medical alert bracelet and just tattooed the medical alert symbol and “Diabetic” on my wrist, so it is plain as day to anyone.
- Can you talk a little bit about your heart attack and the experiences you’ve had after receiving your heart transplant?
On April 15, 2017, I rode my bike a few miles from my house to the local ballparks, had my first softball practice of the season with my recreational team, and rode my bike home. On the ride home, I started to feel intense pain between my shoulder blades, that I attributed to the fact that it was the first practice of the season. Later that day, I threw up, and the pain started to move over my shoulders, down my left arm, and into my chest, and I ended up going to the Emergency Room.
The doctors ran an EKG which showed that I was having a heart attack. However, the staff dismissed it, because I was “too young to have a heart attack”. About 6 hours later, they ran a second EKG and my heart attack was so extreme that they life-flighted me to the University of Utah, where I was placed in an induced coma on life support.
Long story short: half of my heart had died from the time the heart attack started until I was placed on life support and it was unable to recover.
I was listed for a heart transplant in May of 2017 and on June 29, 2017, I received my new heart. That journey has been a whole rollercoaster of its own. I take about 35 pills per day to keep my body from rejecting the new heart and to provide the specific supplements my body needs, such as iron, and calcium. I have to take my pills every 12 hours, exactly. A lot of my pills are immune suppressants, so I am very prone to getting sick easily, and sometimes my body can’t figure out how to get rid of a simple illness (for example I ended up hospitalized for 8 days after I got food poisoning).
I also have to get biopsies regularly, in which the doctors insert a catheter through my neck veins, down into my heart, and pluck off a few pieces to send to the lab, to look for signs of rejection.
As it relates to my diabetes, some of the pills I take make it very hard to control my blood sugars. I am currently on steroids, which absolutely skyrocket my blood sugars. At one point, I had to give myself a unit for insulin for every gram of carbs I ate.
I just accepted a new job recently, where I represent children who are in the foster care system in Court, and I love it. I also competed in the 2018 Transplant Games of America in swimming, track and field, and the triathlon.
“I continue to fight every day to live as healthy as I can and to honor this second chance at life I’ve been given.“
- Where do you get your support from?
My family and my friends are all so supportive of me. Sometimes my dad struggles to understand my diabetes. I had to stop an activity to drink some juice after my blood sugar dropped too low. He exclaimed “don’t you know how to take care of this by now?” with great exasperation.
And the answer is: Yes. I know exactly what makes my blood glucose go up and what makes it drop, but I am NOT a perfect diabetic; no one is.
There are a million little factors that can affect it: stress, alcohol consumption, being sick, the time of day, etc. I could literally check my blood sugar ten times a day, and still not be a ‘perfect’ diabetic, because it is impossible to always anticipate which factors will impact my blood sugar at that given time, but I take the reasonable steps that I can to generally be “controlled”.
But, in general, my family and friends are really supportive. They played a huge role in my recovery from my heart transplant last year, and they always support me.
- What is a piece of advice for someone who was just diagnosed?
I would say: Be patient.
It takes some time for you to figure out how your body reacts to different things, and it might take a minute to figure out how to control it. I’d also say: never be ashamed or afraid to manage your diabetes as needed. If that means stepping out of a class to check your blood sugar–do it. If it means giving yourself a shot in front of people–do it. Also, find an endocrinology team that you trust and feel comfortable with. I had one endocrinologist who felt super judgmental and that did not help my situation at all.
- What would you like someone who doesn’t have diabetes to know about your diabetes?
I would say: We need your support and awareness.
We need you to be understanding when we have to take a minute to check our blood sugar before an event. We need you to not make a big deal of it when we have to give ourselves a shot. We need you to stop mocking “diabeetus” as a disease that people only get because they are out-of-shape and stop telling us we did this to ourselves. Regardless if someone is a Type 1 or Type 2 Diabetic, it is a damn hard disease to deal with; we are constantly thinking about whether out blood sugar is too high, or too low, or what we will do if it becomes too high or too low, and a little compassion goes a long way.
If you would like to personally connect with Ashley, please don’t hesitate to reach out! She would love to connect.
You’re not in this war alone. We’re fighting this TOGETHER.