Just drop it

Writing every day about diabetes for diabetes awareness month is giving me the opportunity to share my innermost thoughts and feelings about diabetes. Hopefully it also sheds some insight into the inner world of anyone dealing with a chronic illness. Whatever crisis or challenge we face, it’s the ability to overcome, that transforms into a shared wisdom. I know for myself when I’m feeling at a loss as to how to deal with an aspect of diabetes management, finding out how someone else approached that same issue helps me enormously.

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I’m someone who likes to get it ‘right’. What I am learning ( slowly but surely) is that right is just a word I have been conditioned to believe in. There is no right way to do diabetes or anything for that matter. There is only what works for each individual.

Today I had an injection blunder. I put the needle for my long acting insulin in and it bounced straight back out squirting blood and insulin everywhere. When something like this happens it’s totally different to say dropping a pill on the floor. If I fumble and drop a pill, I just brush it off and swallow it. An insulin mishap however is totally different. I can’t determine how much insulin actually went in, so if I take another injection it could mean a hypo at some point in the future. All future bolus (fast acting insulin) calculations need to be taken into account. I’m hopeless at math so that’s a big issue right there. My motto for this one is better safe than sorry. So no extra insulin for me today which means possible higher levels all day. Total bummer!

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Stepping on my mat for practice it dawned on me that in spite of my earlier mishap, I make up the rules. I can’t change what happened, but I can change my reaction. A story from my teacher in India comes to mind. “When you hold something in your hand,” and he demonstrated the example by holding a red hibiscus in his hand, “holding it takes effort. But how much effort does it take to let it go? Dropping the flower is effortless.” He demonstrated this by letting go of the flower. As it effortlessly fell to the ground he added, “This is just like us. We hang on tight to our ideas, beliefs and ideologies until we are shown how easy it is to let go.”

Exactly my plan for today!  Just drop it.

See you tomorrow for #NDAM #DiabetesAwarenessMonth

with great respect…

rachel

The Good News

I’m not one to write about the latest news on diabetes. It’s not because there aren’t amazing new technologies, cures and treatment protocols on the horizon. It’s just that I’d rather focus on what’s tangible and practical in my personal day to day management. When someone sends me a message with the latest ‘cinnamon’ cure I find myself ranting about the differences between type 1 and type 2 diabetes and how there is no cure for type 1. There are only useful management protocols that may or may not consistently work. A lot of my friends who were diagnosed years ago were told not to worry because a cure was coming in five years.  More than five years have come and gone and we are all still waiting.

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One of the biggest and scariest moments for me was realising that I had a life threatening, incurable disease. I was on the yoga mat in a pose when it dawned on me. I cannot adequately describe that moment. It was a mixture of shock, disbelief, denial and confusion. Coming to terms with that feeling and finding acceptance has been the core of my practice since.  I guess anyone when faced with any kind of diagnosis, or crisis goes through this. That’s why community and support are so needed.

What I am excited about in the diabetes space is how we can thrive with diabetes. There are some really cool organisations out there to tap into. As a regular contributor to Beyond Type 1 I am inspired by how they raised awareness through brilliant community building campaigns. It isn’t just about finding a cure, it’s about networking, inspiration and collaboration. Another powerful resource is Diabetes Daily. Daily updates and articles on all types of diabetes, recipes and research and a thriving community, I feel blessed to have so much information and support on tap.

In fact, today I received an email from the team at Diabetes Daily about a large study that identifies the habits of successful diabetes management. Compiled by the thrivable insights research panel the study looked at what habits those with optimal glycemic have in common? They surveyed 1,938 people and I’m pretty sure I was one of them.

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The survey analysis data demonstrated that those with type 1 and type 2 diabetes who have optimal glycemic control are significantly more likely to:

  • utilize low-carbohydrate diets
  • use insulin pumps
  • exercise regularly

Moreover, patients with type 1 diabetes were significantly more likely to:

  • use a continuous glucose monitor (CGM)
  • eat consistent meals daily
  • incorporate the protein content of their meal in calculating their insulin doses

The comprehensive data report was published on October 16, 2019 and can be found here: Habits of a Great A1c Survey Data Report. The lead researcher, Maria Muccioli, Ph.D, is also available for interviews about the findings. 

To me the best way to control my diabetes is a no brainer. I have heard many people in the diabetes space talk about diabetes as carb intolerance. It’s not that we shouldn’t include carbs its just how much. I find that about 100 carbs per day is my maximum. In my last blog on diet I talked about eating at the same time and roughly the same thing every day. I have also emphasised how important it is to have some way of seeing blood glucose data in real time. The more I know what foods do what, the easier it is to manage my levels . And you know how much I love exercise. Yoga for diabetes is the bomb!

That’s why I get all nerdy about these kind of studies. The more evidence we have of what enables us to live well with this condition, the more health care providers will come onboard. Believe it or not up until a year or two ago my doctor was still giving me a hard time for my dietary choices. Luckily education around this is shifting.

When I personally reflect on how I feel about diabetes management and the resources we have available I feel lucky. When my great grandfather had diabetes, there was no insulin and no education around diabetes. He died of diabetes complications. Ironically my birthday falls on the month and day of his passing. A powerful reminder of how grateful I am to have the education, choices and support to live a long, healthy and happy life with diabetes. Thats the good news!

See you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel

Chair yoga for everybody

There have been two times in my life where no matter how much I wanted to I couldn’t do yoga. Near the end of my pregnancy and 2003. Late stage pregnancy for me was a killer. Every joint and muscle had softened to the point where stretching just caused more pain. The baby was sitting low and towards the back of my spine. It felt like I was carrying around a bowling ball. Every try to do yoga with a bowling ball in your belly? Forget it.

2003 was the year the sh..t hit the fan with my nervous system. I had been having strange symptoms after 9/11 in 2001, but things really got heavy after holding my breath too long in a yoga class. A few hours later I was out with my girlfriends at dinner and started to get crazy dizzy. The six of us ended up in the ladies room, with me stooped over the sink feeling like my whole world had upended. A few days later I had some sort of heart arrhythmia in the middle of the night. My yoga mentor thought I might be dealing with a nervous system overload and looking back he was sort of right. It was most likely the beginning of my beta cell breakdown, but not knowing anything about diabetes I assumed it was some sort of spiritual emergency. You know…WOO WOO stuff.

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I now know it wasn’t but at the time I found anything that made me feel ungrounded which included yoga, breathing and meditation a no go zone.

Many of us diagnosed with diabetes struggle with all sorts of physical issues. We might have tight muscles, restricted joints, injuries or trouble getting up and down from the floor unassisted. Luckily there are simple ways to get around these challenges by practicing yoga on a chair.

When I work one on one I like to tailor a practice to what’s supportive and accessible. A group class doesn’t give me as much leeway, so in the practice below there might be some things that still feel challenging. I encourage you to do what you can and leave the rest.

As always your feedback is invaluable. Let me know how you travel.

see you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel

Who am I without my diabetes?

What’s the single most powerful tool from yoga that’s helped me manage my diabetes? Atma Vidya. Atma Vidya is Self-Knowledge. Atma means Self and Vidya means knowledge. What do you think of when you hear these two words put together? Before I was led through these beautiful teachings I thought SELF meant me, my name, my ideas, my beliefs, my broken pancreas. KNOWLEDGE referred to knowing this, getting this.

I was mistaken.

It’s easy to know what I have. I have a name, a job, a relationship. I have thoughts, ideas and beliefs. I have a condition called diabetes. It’s obvious that I know about things that I have. The deeper question is who does the name, job, relationship, idea, disease belong to? Who is that?

I travelled to India and to the heart of the tradition to find out. The tradition I studied with is thousands of years old. Knowledge shared orally in an unbroken lineage. This kind of teaching is not available in your neighbourhood yoga studio. It has only just recently been brought out of orthodoxy and secrecy. It’s a legacy that was reserved for the priests in India. It’s only due to my teacher and his teacher breaking with tradition that enabled my partner John Weddepohl (who teaches this knowledge) to study this methodology for 7 years in India. And lucky me, after meeting John in 2011, also having the privilege of studying with his teacher.

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Going through the teaching on an ashram in India while dealing with diabetes wasn’t easy. I wasn’t on insulin at that stage and was trying to control my levels with diet. With special permission I was able to set up my room with a fridge and cooker. That way I could cook low carb meals and control my levels.

When I started the course, I was nervous about how I would manage. We were told we would have to sit in the teaching hall without leaving for the duration of the lecture. I needed to pee every hour so that freaked me out.

The structure of the course was three 1.5 hour lectures a day, in between we were expected to write out our understanding of the lecture and then hand those notes to our teacher. That way the teacher knew exactly how we were assimilating the teachings. Sitting on a cold marble floor 4.5 hours a day learning about the SELF that wasn’t what I thought it was was confronting.

We spent days dismantling our ideas about everything and I mean every single thing! Imagine being shown without a doubt that the idea that the body is sick, imperfect, unfixable is just that…an idea. Even my thoughts about my ideas where stripped bare. Revealing the ‘I’ thought. This idea I have about myself.

If you’re reading this and thinking…WHAT?

Yep that was me in India too. Until the whole teaching reached its peak.

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You know when you’re trying to untie a knot and how it takes ages to loosen and then finally you find that one part of the string which unravels the knot? That’s what it’s like when you are shown the nature of Self.

Once I understood the nature of Self, my relationship to diabetes completely shifted. I no longer felt burdened by it. Something my teacher emphasised when I met with him privately, was that the body is not our business. We don’t know why it does what it does. Our job is to get out of the way, to see the body as something that is happening in our presence. We can do one of two things hinder or aid the body. If the body requires food, water or sleep it’s up to us to provide that. If the body needs medication, again we must give it what it needs.

I have often shared in my posts that I have diabetes I am not my diabetes. The knowledge I gained in India is the essence of that phrase. I can never be what I have.

Knowing this has kept me sane.

See you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel

Staying in range

I’m feeling motivated to get my levels back to where I want them. Not that their not in a good range, its just I know I can do better. At the beginning of the year I worked with the Diabetic Health Journal. It’s a great way to stay accountable, set goals and track patterns. When I was using it my Hba1c went from over 6% to 5.5%. For anyone living with diabetes that’s a perfect number, but really hard to maintain. As much as I know that time in range (keeping my levels between 4-8 mmol) is ideal, there have been a few too many peaks and troughs for my liking. So when I opened the journal and set my goal for the week, I thought I’d try some intermittent fasting.

Intermittent fasting is different to a regular fast. I’m still eating, just spacing out when I eat. The last two days I had my last meal at 7.30 pm and broke the fast with lunch at 1.00 pm. That’s 18 hours between meals. The idea with IF is that it increases insulin sensitivity. It means I assimilate the insulin I am injecting better and blood sugar levels are lower. When I’m really sensitive to insulin I can even reduce the amount of insulin I’m taking which means less low blood sugars events. It’s a win win.

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The only issue for me is I am a huge fan of my avocado and egg breakfast. Day 1 was easy because I distracted myself by going to yoga. Day 2 (today) was harder. I was pretty hungry from about 10.00 am onwards.  I also haven’t seen any concrete results yet. I.e lower levels and increased sensitivity. Patience Rachel Patience…

After I started taking insulin in 2014, I came across a book by Ginger Vieira called Your Diabetes Science Experiment. I read it from cover to cover and learned a lot about the variables that affect diabetes. I learned that even though there are  guidelines and formulas for managing diabetes, it’s not one size fits all. Flexibility and a willingness to experiment are key assets. I’ve been using my yoga practice for years as my personal laboratory to see what my body is capable of. Having diabetes has made things tricky. Sometimes I’m not sure what’s affecting what. Is the sequence or practice supporting what I am doing or is a day of higher or lower levels affecting my practice?

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I feel like I am drawing a giant question mark on a blackboard.

Not having all the answers is something I’ve grown accustomed to.  I was the child that had to be ‘right’ or else. I thrived on competition. That’s why having diabetes has been a bonus in my life. It’s taught me to stop comparing, be kinder to myself and take a gentle approach.  So even though I’ve set a goal for myself to get back to the numbers I feel healthiest at I’m also open to the possibility that where I’m at now is absolutely fine.

See you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel

Catching a relax

Today the whole of our shire is blanketed in a smokey haze. The smoke is everywhere. It’s awful and there doesn’t seem to be much respite on the way. Meanwhile life seems to continue as normal…or does it? It’s pretty hard to ignore what’s happening not just on a local but global scale. The word that comes to mind is chaos.

When I think of managing diabetes I also think of the word chaos. Not because I can’t manage it, because overall I do that really well. Rather its the unpredictable nature of diabetes that keeps tripping me up. One day I’m struggling to stay above 4 mmol and the next I can’t get under 9 mmol (in range numbers are between 4-8 mmol). There is no X=Y with diabetes. The pancreas is a strange and elusive animal which doesn’t like stress. And how many times have I been stressed without even knowing I’m stressed? A lot.

The opposite of stress and what the pancreas loves is relaxation. Recently I’ve been catching those moments when I’m relaxed. Noticing a nice deep relaxed breath, a feeling of calm, soft tingles through the body, mind slow and centred. Every time I feel a ‘relax’ coming on I remind myself with a verbal prompt. This is me relaxed, this is what it feels like. Simply acknowledging these moments has helped me to sleep better, digest better, even think better. In fact, Relaxing makes everything better.

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This morning I went to a yoga class with my teacher and friend Louisa Sear. Her classes are hard. Not because there are complicated postures or sequences, more because she asks you to be in the pose with every fibre of your being. She instructs the class to hold the pose, fix the gaze and still the mind. Every pose is taught like this so that by the end of the class there is a sense of being cleansed from the inside out.

The ultimate agitation is our habitual need to identify with the moving miasma of the mind. Thoughts will always be there, including thoughts about diabetes, its up to each one of us as to whether we uptake that thought or not. Thoughts don’t have power. You do!

Understanding the triggers for relaxation and  fixing the gaze on that is a profound way to deal with the constant stress of living with diabetes. Instead of focusing on the tension you’re experiencing, mentally, emotionally or physically try and find somewhere in your body that is at ease. It could even just be your big toe. As soon as your mind goes there all the awareness and focus goes there too. When I do this, within seconds I’ve forgotten what the problem was.

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As I write this I’ve decided to take my own advice. There’s not much I can do about the external factors such as the choking smoke or annoyance with erratic levels. What I can do is take a full breath, be kind to myself and catch a relax.

See you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel

The number of tests?

“How many times do you test per day?” this was the question put to me this morning by the Accuchek Guide rep while I was trying to replace my meter. “About twenty,” I replied adding that my blood sugar can tend to be volatile. The rep murmured a sympathetic sound. But I wondered what she really thought.

I know what my Endo thinks. He’s mentioned to me on more than one occasion that I am obsessed with checking.  Do I really need to wake up throughout the night to check? Ummm…YES!  It’s not like I set an alarm or anything, I seem to naturally wake up between 1-3 times per night anyway so why not check?

Overnight lows are the worst. In the days before I had the whole diet thing mastered I’d wake up and have to eat at 2 am. Nothing worse than sitting by myself in the kitchen watching the clock tick over while I wait for my blood sugar to rise.

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And what about in the day? Do I really need to check every hour? I actually don’t check every hour, it depends on whether I’m insulin resistant or have had some sort of injection blunder. Most mornings I can go from breakfast to lunch without even checking. I know my liver is doing its thing, dumping some extra glycogen into my system so it’s rare for me to drop. It’s usually between 12-5 pm that I like to be vigilant. I can never seem to get my lunchtime bolus right, and then there might be some extra exercise thrown in the mix around 4 pm.

Checking vigilantly when you live with Type 1 Diabetes is a make or break situation. Especially if you can’t tell when your low. Its called hypo unawareness, it happens when you have too many lows and the body stops recognising the feeling of being low. Like my horrible hypo two weeks ago, before I knew it I’d dropped to 3.2 mmol. Scary!

It was also after that horrible hypo and sharing it here that some friends encouraged me to use a CGM (continuous glucose monitor). This is something I would love to have but sadly here in Australia there is no subsidy for someone like me. To be eligible for the Dexcom or Medtronic CGM you have to be hypo unaware and admitted to hospital more than once or under the age of 21.

The Freestyle libre flash glucose system is also on offer here, but this has no subsidy at all. I have written before on the blog about how much I love this product. Sleek, discreet and accurate using it has increased my peace of mind and saved my finger tips. I’ve attended  product launches and #dx2Melbourne and can honestly share the company, its ethos and care are palpable. I’ve even lobbied the government to make access affordable for people like me and had a small feature in the Noosa News. In spite of my passion and efforts, I still can’t justify spending $100 every fortnight.

But wait ho… my wonderful parents, after reading my blog, gave me the best early christmas gift ever! A 6 months supply of the freestyle libre. I am touched and grateful.

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Here I am ready to launch. So excited to have some time off from the drudgery of test strips and the ability to see whats actually happening minute by minute with the food I am eating, the insulin I am taking and the sleep I’m sleeping. I’ll probably put one in starting next week so stay tuned…

See you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel

Dance 4 Diabetes

There’s a picture of me performing in a dance piece somewhere in an old photo album in my storage. When I think about that picture I think about a life time ago. Pre diabetes, pre marriage, pre child, pre yoga.

Being a professional dancer was a childhood dream. By the time I was twenty one I had performed, taught and choreographed in dance companies throughout Australia. There was a moment though where I came to a crossroads. I decided that if I wasn’t going to get into the company of my choice, which at the time was the Australian Dance Theatre, I was going to call it quits. I auditioned, didn’t make the cut and was devastated.

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Me dancing at 22 on the far left in Tasdance

I gave up and devoted myself to yoga, but my resolve didn’t last. Eventually I was asked to teach, choreograph, perform and serve as the Head of Dance at a local performing arts college. It was around the age of 35 that I hung up my professional dancing hat for good. Not because I wanted to but more because the demands of my job as a yoga teacher took over.  Living in NYC at the time and having to support the family meant there was only so much time for ballet classes and auditions. It was a reluctant decision, but I have no regrets. Sometimes the things we think we’re born to do turn into the things we are called to do. For me that’s yoga. I never asked to teach and share yoga but here I am.

Just before my diabetes diagnosis dance had reappeared in my life. I did a healing retreat which included dance as therapeutic release. It felt incredible to move again and I loved how the movement wasn’t about impressing an idea on anyone ‘out there’ instead it was about what was longing to come out.

To dance is to free oneself of grief, expectation, anger. A return to joy, freedom and peace.

When I saw this months campaign from Diabetes Australia, dance 4 diabetes I got excited. Now here’s something I’m good at and can get behind. Dancing takes the difficulty out of diabetes, it’s uplifting, inspiring, motivating, fun and good for blood sugars. It reminds us to be light hearted in the face of it all and inspires community and support. I love seeing people share their love of movement while shedding light on such an important cause.

The campaign motto is: Stop what you’re doing and dance! Then donate and dare (share) by tagging three friends and asking them to dance, donate and dare too.

Fun right? Here’s my entry below and the link to join Dance4Diabetes


See you tomorrow and happy #WorldDiabetesDay for my US friends!

#NDAM #DiabetesAwarenessMonth

With great respect…

rachel

World Diabetes Day…again

Today is World Diabetes Day and to be honest I’m flat.

The fire emergency here in Australia combined with higher blood sugars have kept me from my usual enthusiasm. But it’s not just that. It’s hard to put a positive spin on diabetes all the time.

All I can say is my daily yoga practice pulls me out of the doom and gloom. It reminds me that as much as I like to get lost in the details around my health management it’s never going to be perfect. Control is necessary but there has to be some wiggle room. Giving myself a hard time isn’t productive. I’ve learned to relax in the tougher poses, to breathe deep and find stillness. These mini lessons are perfect metaphors for the ups and downs of this disease. And believe me I need that right now.

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Today marks the birthday of  pioneer Frederick Banting and as such celebrates the discovery of insulin in 1921. Before 1921 they didn’t even know what insulin was. Every time I think of this I’m gobsmacked. 1921 is not that long ago yet I take so much for granted when it comes to all the available medication and tech. Here in Australia there is subsidy for our medication and equipment. I am stunned that this isn’t the case in other countries. No one should have to pay for life saving medication!

Luckily there is an initiative out there to help those in need. Its called Type 1 International and their mission is to support local communities by giving them the tools they need to stand up for their rights so that access to insulin and diabetes supplies becomes a reality for all.

Please join me today on World Diabetes Day in supporting this wonderful organisation.

See you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel

The one truth that can’t be faked

I have been obsessed with Twitter since September. Growing up in the United States in a liberal democratic family means I have a keen interest in U.S. politics. The election in 2016 floored me and I have watched the steady decline of ‘the facts’ over the ensuing three years. Not that facts are all they’re cracked up to be. Think about it, as much as science claims a finding to be reality that same theory can also be disproved. Guaranteed change is a constant. That doesn’t mean we shouldn’t aim for justice and liberty and all those other principles though. It pains me to see so much division, hatred and frustration emerging in a country where I was taught that no matter what your circumstances you could achieve the fulfilment of your dreams.

In a new paradigm of ‘alternative facts’ it’s hard to know what to believe, who to trust and what’s real. With all the fake news out there I’d like to note there’s one truth that can’t be faked.

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Diabetes.

Diabetes is a fact. Pancreatic beta cells have tanked. Insulin is required. Life is on a knife’s edge.

I can remember thinking early on after my diagnosis that there must have been a mistake. Maybe the lab messed up my blood tests. I wasn’t the type to have this disease and I was so healthy. A few health care providers even corroborated my theory. Even as late as 2008 some practitioners in Australia didn’t know that out of the 40,000 people diagnosed each year with type 1 diabetes, 50% are adult onset.

Fact: “According to the ADA, 1.25 million Americans have this disorder. This is about 5 percent of all diagnosed cases. The ADA estimates that 40,000 people receive a type 1 diagnosis each year in the United States.” Source: Healthline

Swallowing this fact has been a total reality check. Coming out of denial changed everything.

When it comes to chronic health issues especially ones that are invisible it’s hard for people to validate or understand our struggles. Keep in mind it’s not up to anybody else to verify what we are going through. Empathy and compassion is a powerful ally but in the end when the bugger’s hunkered down and immovable. What to do?

Flush out the tiger!

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It’s only through coming out and spreading awareness that truth can come to light.
It’s why I’ve been posting relentlessly here and all over social media. Plus writing about diabetes is therapeutic. It gives a voice to my inner world.

It’s also how I feel about the state of the union at the moment. Lets get it all out in the open. Let’s get to the bottom of this whole debacle. Let’s see the naked truth.

Once you know the truth about anything you’re free.

See you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel