Hypo Hot Mess

You’d think I’d be used to being on the razor’s edge but I’m not.  Like a mother who forgets the pain of childbirth, I keep forgetting what a fine line it is to live with diabetes. Maybe it’s because my memory is selective, or that I still find myself going into denial. More likely it’s because I’m burnt out from all the nitty gritty stuff I have to do to stay alive.

Hypos are the worst. Every time a low comes on I think, “Sh…t  I’m going low. What time is it? Can I wait 15 minutes and then eat lunch. Nope? Ok, just take ½ a tab. That’s probably not enough. Wait 15 min. Sh…t still going low take another ½… No, strike that, take 1 tab. Wait 15 more minutes (by now I actually feel low… sensation of ants crawling all over my body, mind like a wobbly wet piece of jelly). Ok, just take another tab and be done with it. (check my blood sugar 10 times in 15 minutes). Crap my fingers hurt.

After it comes back up I cry a lot. Later I think about adjusting my basal but worry that if I do I’ll go high. Eventually, I adjust my basal, wait to see what happens and tell myself, “Next time I’m going to take ¼ tab. Next time I’ll trust my body and my intuition. Next time I’ll take less insulin.”

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My last big hypo happened right before I was supposed to teach a yoga workshop on mudras ( yogic hand gestures). I was sitting in front of 15 experienced yoga teachers while furiously checking my blood sugar. The trend arrow on my mySugr app wasn’t looking good.

I freaked out! I’d driven all that way, spent weeks preparing had gathered an awesome group of yogis, only to have the whole thing crumble because of my broken pancreas and stupid carb to insulin miscalculation. I kept telling myself, “Push through you’re stronger than this maybe it won’t keep plummeting. Start teaching you’ll be fine.” But no matter how strong I thought I was, I couldn’t fight reality. My body wasn’t going to kick in and save the day. I had to share through my vulnerability. It was either that or bale.

Stepping up meant sharing with the group that I was in the middle of a hypo, that I’d taken some glucose tabs and had to wait 15 minutes before I could teach. I felt awkward, my brain wasn’t clear enough to communicate, but the smiling and compassionate faces of the group gave me heart.

“Living yoga is about being with what is,” I continued, “and sometimes ‘what is’ sucks.”

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Luckily within a few minutes, I could feel the glucose bringing my brain back online. The class flew by and was loads of fun, but later I felt drained, weak and really emotional.

Before my diagnosis, I would get tired after teaching, but it was a good tired. The kind where you knew you had worked hard enough to deserve a rest. Hypo fatigue is something else. 24 hours later I still find it hard to focus, my nervous system is overly sensitive and I’m prone to panic attacks. In a way, it’s akin to burning oneself accidentally. At contact, it burns sharp and hot, but that’s not the problem. It’s the lingering throbbing pain that’s tough to withstand. Plus Hypos aren’t always just a one-off thing. When a Hypo, builds on another Hypo it takes days to recover. It’s a challenge not to lose heart or worry that I’ll never get on top of things.

As I mention continuously in my blog posts I really have to take my hat off to yoga. The physical practices of posture and breathing definitely help. Lately, I have been using the deeper practices like mudra (gesture) and mantra (sound) too. Holding my hands in certain positions really calms my emotions and repeating a mantra like OM is soothing for all the systems in the body. In fact, so soothing that chanting lowers my blood sugar.

In honor of being a Hypo Hot Mess, this weeks offering is a simple 5 element mudra sequence. As you go through each mudra feel harmony coming into the body, relax and breathe. You can do this anywhere anytime, focusing on one element for your practice or including all five.

With great respect…

Rachel

 

Back on track with yoga

A few days ago I hurt my back. I was overzealous and lifted a couch and twisted slightly the wrong way. Immediately my back went into spasm and I had to lie down. Never mind the fact that I had to teach two classes the next day, or that I hadn’t even landed in our new home or unpacked my bags.

I don’t hurt myself often but when I do I get annoyed. The frustration is in the fact that I could see it coming. I am a compulsive over-doer, overachiever and I have been working for years to curb my enthusiasm. My husband calls me “Squirrel”. He says it’s because I never stop moving.

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In yoga, the ones who love to do are called Pitta types. Pitta is composed of fire and a small amount of water. We are literally on fire, passionate, hot and often don’t stop until it’s too late.

With all the excitement of the last 9 months, I am so glad I live and breathe yoga. Without my practice, I’d probably have done more damage than strain my back for a day or two. No matter what goes on in my life, no matter how tough things get having a variety of yoga practices in my toolkit means I never hit empty.

My first stop is always the breath. Whether it’s waiting for my levels to come up from a low, or dealing with a dreaded hot flush ( yep… I am post-menopausal) or just feeling like it’s all getting too much. Stopping, dropping and taking ten slow breaths are my kind of pushups.

And it’s not just any kind of breaths it’s ten full complete breaths. I wrote about it a while back in this post and video practice. You’ll love it!

Next, I get my stretch on. Stretching is much more than just a feel-good exercise. It super connects you to the highway of your nervous system. The nervous system is designed to be your ally. When you need energy it ignites you so you have the fuel you need to get stuff done. It’s also your ultimate chill pill, enabling you to move through life without ‘sweating the small stuff”. The nervous system takes quite a beating when you live with diabetes. All the fluctuating blood sugars wreak havoc throwing you into the fight or flight response. Most of us, diabetes or not spend about 80% of our time in flight or flight. It should be the reverse. Stretching signals the nervous system to relax. Clasping your hands and reaching your arms up overhead and leaning from side to side is enough to bring you back to the relaxed part of your nervous system.

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My last and most favorite practice is to work with Mudra. Mudras are hand gestures which also work with the nervous system. Bringing the hands into specific positions concentrates the mind and calms the emotions. Learning to do yoga with your hands is the easiest and best kind because you don’t have to be fit or flexible to practice. Recently I shared a mudra sequence with patients recovering from various forms of cancer. Most had limited mobility and energy. Being able to bring the hands into a shape was blissfully relaxing and restorative. Here’s a short mudra practice I posted on the blog if you’d like to try it.

With some deep breath work, stretching and my mudra practice I’m no longer flat on my back. Phew, it feels good to be pain-free again.

I love how Yoga always gets me back on track!

with great respect…

rachelIMG_3616

When Gratitude Steps In

About two weeks ago I had my worst low ever. We were on the road driving. Luckily I wasn’t at the wheel but being somewhere between Jugiong and Gundagai (yes those are names of Aussie towns) it was still scary.

As it was happening I kept racking my brain trying to figure out the why. I hadn’t over injected for lunch or had I? Did I take an extra unit of basal insulin in the rush to leave that morning? I’d already had a near low the day before. Was I just that little bit more sensitive to Insulin from our sunset walk the evening before?

Whatever the reason, the one and a half tabs I popped weren’t working fast enough.

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I had to play the waiting game. We stopped at a fancy pub and I made an obligatory visit to the loo. Every time I go low I might as well have a tiger chasing me. The feeling is exactly the same. While in the lavatory I kept a close eye on my levels but sadly the numbers weren’t looking good. I couldn’t make my trusty mySugr app lie. The numbers surrounded in color-coded circles kept going lower. Orange had been replaced by red.

I popped another tab while my body began to shake. Everything looked blurry, I felt blurry and at the same time, my thoughts were like sharp bubbles that I could catch and get lost in. I made my way back to my husband who was waiting for me at a lone picnic table and told him I was still low. He held me and we waited. I kept testing and finally ten minutes later it came up a few points. We got back in the car. Disaster averted.

The rest of the day I felt fragile like I’d been poked with a stick. The days that followed were filled with unmanageable high readings. And I was scared to take insulin. I took it but I was still scared. I went to sleep at a higher level just to be on the safe side. And when I woke up higher I didn’t correct. Instead, I waited for it to gradually coast down by midday. Every time I tried to gather the courage to be a bit more accurate with my dosing I couldn’t do it.

And it dawned on me. This is what burnout looks and feels like.

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It’s taken me two weeks to find my confidence again. Gratitude has been the first step. In the depth of the low, I remember thinking quite clearly how grateful I was that I could still think clearly enough to test my blood sugar, that I had glucose tabs on hand, that my partner would come find me if I hadn’t come out. I felt grateful for my breath which I began to watch rising and falling in my chest. As the next two weeks unfolded, I was even more grateful for my daily yoga practice.

The ability to step on the mat and feel peace, calmness, stillness. The reminder that the experiencer, the seer, the one having the highs and lows is unaffected. As much as I want to believe I am my body, I cannot be my body. My body is something I have. As much as I think I am my thoughts about my disease. My thoughts are something I have. As much as I want to think that I am the disease, diabetes is something I have.

The depth of gratitude cannot be underestimated. I know it is a way of being that works in any situation, any crisis. I believe it is an essential yoga practice.

If you want to know more about gratitude and how it shapes my life with diabetes I recently sat down with my good friend Lauren Tober the creator of A Daily Dose of Bliss and A Grateful Life Podcast to share about Yoga, Diabetes and why I practice in my P.J’s.  Listen to the podcast and if you’d like to join us on a Daily Dose of Bliss registrations are open now.

Podcast on Gratitude with Rachel Zinman

with great respect…

rachel

 

Diabetes: A total head spin!

I love certainty. Knowing exactly what to expect in a situation keeps me calm. When I don’t know I try to guess… But living with diabetes is different. I can’t really make a guestimate when my life is at stake.

After my first rapid-acting insulin injection a few weeks ago, I had a total meltdown, my blood sugar skyrocketed and I had to make several trips to the loo. It reminded me of one of those dares your friend gives you when you’re a kid like; I dare you to take off all your clothes and run around in the snow or, I dare you to tongue kiss Danny Marsden. You want to do it, but you’re also terrified. What if you freeze your butt off or end up swallowing his tongue!

There were definitely things to be paranoid about. Not getting the dose right, reacting to the insulin, the insulin not working, injecting into a muscle and crashing my blood sugars. Not to mention that the sheer mechanics of getting the shot ready were a nightmare.

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I had no idea you had to prime a syringe, that a ½ unit is a tiny tiny amount so tiny you can hardly see the plunger moving when you push it in and that pulling insulin out of a pen without all the proper handling techniques can make your syringe fly across the room.

It became obvious quite quickly that listening to my CDE tell me what to do and doing it were two different things. In the beginning, there was a lot of insulin wastage. Something I don’t like doing as I am very aware of the cost of this life-saving medication. As those of us living with diabetes know, insulin does not grow on trees!

After two days of trial and error and wondering if it was ever going to work, it did. My postprandial blood sugar coasted up a mere 10 mg/dl and then 2 hours later coasted right back down.  I couldn’t believe it. Working with long-acting insulin to cover meals meant I always went up between 40 to 50 mg/dl after every meal… I’d gotten so used to the spike I didn’t see it as an issue. Even though logically I know it’s those spikes that give me a higher A1c.

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Success didn’t last long, just because it worked perfectly once didn’t mean it worked like that again. The day after my very successful bolus I wrestled with lows. urgh.. the frustration… now I had to wait for my blood sugar to come up again to try bolusing with a meal. I even lowered my long acting to see if that was the issue and then WHAM…the next day blood sugars were too high.

Count carbs, prime needle, take the shot, monitor blood sugar, treat a low, check blood sugar, take a correction OMG! It’s a total head spin.

I am in awe of every single person living with diabetes. I am stunned by how inaccurate the treatment methodology is. No wonder we need diabetes coaches, peer support, better and better technology’s and smarter insulin and did I mention YOGA!

with great respect from the trenches…

rachel

 

 

What brings me to my knees

When I was pregnant and about 6 years into my yoga practice I was asked to start a prenatal yoga class in my local town.  Looking back, I am amazed that everyone survived. I was inexperienced, teaching from a book and making grand claims about how the pain we were experiencing while stretching our legs was exactly like childbirth.

Then I gave birth. The pain was unimaginable and nothing like a hamstring stretch. How could I have been so blind!

Today after my second low blood sugar in two weeks, I feel like that.

Up until three weeks ago, I was a novice. Sure I’d had a few numbers teetering on the edge, but like a graceful dancer about to fall in her first performance, I’d somehow catch myself just in time and leap away with the perfect smile.

But yesterday brought me to my knees.

I’d woken up at 3.30 am with a perfect 5.5 mmol (in diabetes land we call that a Unicorn). I knew it would be better to get up, make myself a snack and get into the day than toss and turn and worry about a low.

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After completing a few administrative tasks and enjoying the efficacy of working before dawn, I took my morning basal dose (long-acting insulin). I’d been working the different spots on my tummy to avoid potential pitfalls. I.e. popping a blood vessel and injecting straight into a vein, and was trying a new technique to spread the skin rather than pinch so the needle didn’t go in too deep.

The needle went in without a hitch, I depressed the plunger and then waited for a count of 10. When I pulled the needle out there was a huge drop of blood and I could see a hard bubble forming under the skin.

Instead of panicking I decided that eating consistently all day would help to keep my levels on track. I enjoyed having a bigger lunch and a few extra snacks. Things were looking good. I’d stayed balanced for most of the day.

Then I took my 2nd Basal shot

I prodded my belly again for the perfect spot. Primed the needle, sunk it in and then… oh… no… ANOTHER BLEEDER! I stayed calm. This time there was no bubble and no mark. It was going to be fine

I happily made my dinner, ate my desert and headed to the computer to do a few tasks before a scheduled online evening meeting with one of my yoga students. I felt a strange itchy sensation on the right hip and just to make sure I wasn’t going low, checked my level.

2.6!!!!!!

Two friggin . 6

The shock of it was worse than the feeling. In fact, I felt absolutely ZERO, nada, nothing! I felt totally normal…I screamed, and my husband came running. We were on repeat (see my last blog). He’s telling me to breathe, stay calm and I’m chugging juice. He reminds me (like he did the last time) I really don’t need to drink the whole 250 ml.

2.6? I’m drinking it!

Then I sit on the couch and wait. My heart has stopped pounding and everything feels surreal.

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I feel sad. I’m sad for babies diagnosed at birth, for the mothers and fathers who get up all through the night to make sure they stay alive. For all the people in the world without insulin. For the adults like me who are diagnosed after a full life who now have to grapple with their new circumstances. For the lack of awareness and understanding that accompanies this disease. For the injustice from pharmaceutical companies who use diabetes for profit. I want to strangle someone, scream and pound the wall. But I’m actually too spaced out. I check my blood sugar every 5 minutes and gratefully watch the numbers on my meter rise in slow steady increments. When I hit 5.5 I relax.

I had no idea, I don’t know what I was thinking…. but I had no idea

Slow steady breaths definitely helped. Stretching out on my mat the next day also helped. Putting my hands together at my heart at the end of my practice just that little bit longer to acknowledge the absolute precious gift of life… that’s helped as well.

But really I don’t know how we can ever recover from the circumstances we find ourselves in until there is a cure. As someone said recently ” Insulin does not solve the problem”

So what does?

Knowing I am not in this alone and that there are millions just like me, doing their best to meet the challenges every day with courage, strength, and grace!

If you’d like to make a difference in the life of someone living with diabetes please consider donating to any one of these amazing charities.

Beyondtype1,  We are Diabetes,  The Betes,  T1international,  Diabetes Sisters