The missing piece

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When I started writing my book, Yoga for Diabetes in 2015 I knew I wanted it to be something that would be a game changer when it came to diabetes management. If I couldn’t cure my diabetes at least I could use my lifelong passion and knowledge of yoga to manage it and share those life skills with others.

I was diagnosed in 2008 but didn’t start writing the book until starting insulin therapy in 2014. I wrote the book without having fully experimented on myself. Up to that point I didn’t need insulin, in fact I was in denial about my diabetes. However, I did have a deep understanding of yoga and Ayurveda and how potent this combination is in managing any health challenge. Especially in mitigating stress, balancing the nervous system, working with mental and emotional health and overall immune resilience.

How to put insulin into the mix was my personal nemesis, and even though I offered a chapter on insulin and exercise in my book. I was an “insulavirgin.”

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It was after launching my book and connecting with other Type 1’s that I popped my cherry. I decided that injecting once a day and having okay levels (my HbA1c at the time was around 7) wasn’t good enough. Why not at least try having some insulin with meals? Maybe it would make a difference?

Living with LADA ( Latent Autoimmune Diabetes in Adults) means diabetes has been a slow progression for me. I still produce some insulin. I had a lot of anxiety around increasing my insulin use and dosage and at the same time I kept questioning myself, “why stay stuck with what I felt was an “okay” HbA1c?” Surely, I could do better.

I took the plunge with some help from Gary Scheiner, author of “Think like a Pancreas”. Gary suggested I start small and take insulin after each meal. We worked out that I’d need about one unit of insulin to cover thirty carbs and that I should start with half units. I was already on a low carb diet sticking to around thirty carbs a day, so I wouldn’t need much insulin at all. Less insulin, less risk of lows.  My diet at the time consisted of eggs, green vegetables, pumpkin, carrot and avocado. I was so embarrassed to tell anyone that I only ate seven foods. I am not exaggerating S E V E N!

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Being on a full insulin regime even on such a restricted diet was amazing. I was able in a year to reach my goal of having an HbA1c of 5.5. I felt like a champion. There were other days though that I felt a sense of hopelessness. Was this my diet for the rest of my life? Living on seven foods because of gastric distress and food sensitivity? Being afraid to eat for fear of low or high blood sugars? Feeling a literal fear of food?

I’m nervous to share how defeated I felt around this aspect of my diabetes management. I had authored a book all about how to bring yoga into daily life, how to find the perfect practice, how to manage stress, how to live well with diabetes and here I was stopping myself in the one area that’s the foundation for everything.

Nutrition.

When people would ask me what sort of diet I was on I’d change the subject or suggest eating for their Ayurvedic constitution, but to be honest because I couldn’t or rather wouldn’t follow my own recommendations keeping quiet was the better option.

Everybody is different, every body is unique. We eat according to taste, conditioning, circumstance, and what we feel works best for us. Whether you are low carb, keto, paleo, AIP, high carb, standard American, or Australian Diet etc. there is no one size fits all. Or so I thought.

My breaking point happened on an innocent outing to our local farm stall for some Haloumi cheese. Something I indulged in every now and then because it was low carb/high fat and isn’t Haloumi the best taste ever?

I was in my car, cheese on the passenger seat, when I saw a newborn calf still covered in afterbirth being transported in a pickup truck. The mother cow was running after the truck trying to get close to her calf. She was obviously very distressed, her body still raw from giving birth. The farm handlers seemed completely unperturbed by what they were doing. It was just a normal part of farm life. The babies were separated, fed and then sold for veal, while the mother was kept for milking. I felt my heart ripping out of my chest. It was one thing to read about animal cruelty or factory farming, it was another to witness it with my own eyes. As I drove home, I made myself a promise, even if I am afraid of going low, afraid of getting sick from foods, afraid of trying something new, I couldn’t live this double life any longer.

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My will to align my lifestyle with my heart had to be my priority. It was time to step up and drop all animal products and embrace a whole food plant-based diet.

They say it takes seven different influences to make a change for the better. I think of that moment at the farm stall as number seven. I had already heard about going high carb/low fat/plant based from a fellow T1D yoga teacher, I’d seen a fellow T1D fitness and nutrition coach document his journey transitioning from keto to vegan, I’d watched several different webinars and documentaries with the founders of the Mastering Diabetes Program and I had started to struggle with my levels after almost every meal, needing more and more insulin to cover the same thirty carbs a day.

I think of the day I changed my diet as a crucial turning point in my life. Like the day I decided to move to Australia, or the decision to travel to India to meet my now beloved husband. There was a feeling in each of those moments. Something indescribable and deeply exciting.

Starting a plant-based diet hasn’t been a walk in the park, I’ve been lucky to have an expert diabetes and nutrition coach to walk me through some sinkholes and to cheer me on. I started by letting him know I was basically sensitive to every food imaginable and he started by saying “start with what you think you can tolerate.” Then when I had awful symptoms he’d commiserate and suggest they might go away as my body made the switch out of ketosis. “I believe in your metabolism, that it can kick back in and do its job. The more foods you can tolerate, the more diverse your diet, the more your body will thank you.”

Never were these words truer.

I don’t think I fully understood what he meant until I read Fiber Fueled by Dr. Will Bulsiewicz. This book is the bible for anyone wanting to go plant based. In just a few short chapters Dr. B makes the case for a diverse plant-based diet. Did you know that that out of the 400,000 plants on the planet, 300 of them are edible? And that we just eat a small percentage in our standard American diet? Or that there are 40 trillion microbes in our gut micro biome? We are more microbes than human. Did you know that these microbes feed on fiber? The more fiber we have the healthier our gut, our immune and nervous system. When we get into mono foods, or food restriction we deprive our microbes and that’s why we get gut dysbiosis. I.e. gut issues like leaky gut. He even explains how autoimmune disease and gut health are intrinsically linked.

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Since going 100% plant based I’ve noticed huge changes. My thyroid levels have normalised, I’m extremely sensitive to insulin, I’m eating up to 45 different plants in a day. My tolerance of foods has improved, my digestion has improved. My little arthritic aches and pains have disappeared. Besides all the physical changes, it’s my relationship to food that has excited me most.

I am finally loving cooking and creating meals again. Exploring recipes, trying new foods, incorporating miso, seaweed, legumes and grains. Nothing in excess with no restrictions. Managing my diabetes in the mix of eating this way takes dedication. I track my food in an app, I keep tweaking my insulin to carb ratios and checking in with my coach when things start to go awry. As I learn to feel my body in this new way I’m surprised at how easy it is to have steady levels and maintain a healthy Hba1c.

It took a long time, nearly 20 years for me find the answers I so desperately needed to get well. Now that I’m here it’s like the last few moments of finishing a puzzle.  There’s a sense of excitement and expectation and WOW that’s it, I finally found the missing piece!

If you’d like to find out more about Dr. B and his book you can go to his website or order the book here

With great respect…

rachel

A little goes a long way

Oatcakes it’s been a while. A long while, I don’t think I’ve even so much as looked at you since 2014. 2014 was when I read Dr. Bernstein’s Diabetes Solution, learned about the benefits of low carb eating, the law of small numbers and laid down my carb habit for what I hoped would be forever. So far, it’s worked well… but there have been some issues.

The biggest one being my ongoing food intolerances which includes reacting to seeds and nuts. Cutting them out of my diet has meant less flow in the plumbing department and it’s starting to bum me out. (literally!)

Over the last three days I’ve been reintroducing oats into my diet. Day one I took ¼ of an oatcake, which made me a mucous ball. It didn’t deter me though. Day 2 I had ½ a cracker and my blood sugar pretty well stayed stable. Day 3 I lashed out and had a whole 4.7 carb of a cracker with my egg and avocado brekky, took the same amount of Insulin as always (1 unit) and watched my blood sugar go up up and away.

I did crack open a fresh pen, could it be that? Not sure…because yesterday I had too much insulin and went low.

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I also made a post into the DOC to get advice and someone suggested I try switching up the timing of my bolus. Someone else said I should eat fat with fat and carbs with carbs to get the dose right.

To be honest I am actually terrified to add more carbs into my diet because I am still working out how to manage my lows. At the same time my goal for this year is to be able to eat a broader range of foods and to be relaxed around food. I’d like to feel comfortable eating out, eating in… whatever.

It’s been super interesting to observe my attitude change towards my blood sugar levels since I’ve nailed my A1c goal. I used to see a spike and be like, “oh well, try again next time” I had a no sweat attitude because I didn’t realise how important it was for my health to have better time in range. But now after nearly 6 months of flat lines and what I perceive to be excellent control a few days of peaks and troughs has me completely agitated and freaked.

Not a good look for someone who is touting the mind calming benefits of yoga. If I can’t maintain my cool during a breakout experiment with an oat cracker well what the F…k?What Sarah Said BlogDiayogi Sarah Macleod, shared in her latest Instagram post that non-judgement, one of the attitudes we can adopt through our yoga practice, is about stopping ourselves from labelling a blood sugar level as ‘good’ or ‘bad’. In other words, practice with the attitude of going for the best outcome while letting go of the end result.

Not so easy for a type A like myself!

As a few days have gone by since I started writing this post I ended up invoking the principle of flexibility from my yoga practice to help me work up to adding foods into my diet.

When I go into a yoga pose and feel challenged and inflexible I initially hold back from forcing myself in the pose. I watch my breath and wait. After about a minute I can feel all my muscles soften, then I can creep deeper into the pose. A little bit of movement actually takes me a long way.

So even though I was keen to get going with oats, I’ve stopped taken a breath and adopted a wait and see attitude. Oh and I added psyllium husks into my diet instead ( a great low carb option) and wouldn’t you know… a little goes a long way….

with great respect….

rachel

Rachel Portraits 2015-40

When I go Low, I reach Higher

I can remember having a conversation with my doctor early on about my condition. I kept telling him I was afraid of going low because I’d read about it online. He kept telling me not to worry. “You can’t go low because your problem is high blood sugar. You’re not on insulin so we don’t need to even go there.”  

Now that I’ve been properly diagnosed as a Type 1 LADA and on insulin things are different. I’ve learned that balancing your blood sugar is like playing Russian roulette and that a low blood sugar happens because I’ve either miscalculated the amount of insulin I need to match the number of carbs in a meal, or I’ve exercised and injected too much insulin, or my basal insulin ( long-acting insulin) is set too high.  

Luckily I’m not hypo unaware (a condition that occurs when your body can no longer sense a low blood sugar due to repeated hypoglycemic events) but that doesn’t mean I don’t have anxiety around a low.

Being hypo unaware is probably the single biggest issue anyone has living with type 1. To remedy this we prick our fingers and check our meter’s incessantly, use CGM’s, have something called Glucagon (a shot which has to be mixed and prepared on the spot by someone else to get glucose into the blood stream fast) or have special diabetes alert dogs who can smell the change in our blood sugar levels, to remind us through barks and nudges to check that we are going low.Parents of young kids who live with diabetes set their alarms throughout the night to finger prick their kids, or check their CGM’s making sure they are in range. Imagine a young mum waking through the night year after year hoping their little one is still alive.

I don’t want to paint a horrific picture but it IS horrific.

So what happens when we are conscious enough to treat a low? Well often the fear and impatience of having to wait 20 minutes to see if your levels rise means 2 sips of juice turn into eating the entire contents of the fridge (no joke) By then, your blood sugar is screaming high and you have to inject again to bring it back down.Because I still produce that little bit of insulin and because I eat such a low carb diet my levels are very stable.

I’ve only gone below 3.9 a few times and have experimented enough to know exactly what will raise my levels. But I have had a few fridge binge moments that I’m not proud of. Like the time my meter said I was below 3.9 and I actually wasn’t and by the time I checked again it was too late!

For me having a steady yoga practice to help me deal with the stresses associated with the complexity of this disease has absolutely saved me.

It’s the number one reason why I jump on my mat, work with my breath and explore all aspects of this beautiful and ancient discipline. When I go low I reach higher inside myself to be grateful and accepting of whatever comes along. And sometimes a little thing like a flower on my afternoon walks makes all the difference.