A Soul Crushing Low

It wasn’t 1.8 or 2.5. In fact, maybe in regard to numbers it wasn’t even that bad. But for me  3.3 was absolutely soul crushing.

I’ve had Diabetes for 12 years. In that time, I’ve had lows that freaked me out, inspired determination or forced me to face habits that weren’t serving me. This low, however, was different.

I felt numb, not just numb in my extremities, but numb to everything. My sole focus was watching the minutes tick over on my timer waiting for the sugar to kick in. When it didn’t it was hard to stay calm. Downing even more glucose gummies, resetting the 15-minute alarm and watching my breath were my only allies. My husband held me tightly from behind promising me my blood sugar would come up. “It always does,” he reminded me. “You got this.”

I kept thinking, “Why don’t I have a hypo kit? Why are we so far from town? What if I lose consciousness? What will my husband do? How fast will an ambulance come in lockdown?

I don’t think we talk about our lows enough. Sure, we post pictures on Instagram, express our frustration, tell each other to feel better or commiserate. In the short term it helps. It’s the aftermath that gets me. Like how today not even 24 hours later I’m feeling a subtle anxiety after eating my breakfast or how that rebound high took hours to resolve. Or my feelings about the interaction with my husband during the height of the hypo and shortly after; how hard it was to explain the feeling of being held underwater for 20 minutes, starved of glucose, mind slowing to lead and then how just like that I’m up for air, without really feeling like I’ve stopped drowning.

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Photo by Taylor Leopold on Unsplash

Being determined to get it right next time doesn’t always work with so many factors at play. Are my ratios correct? Is my basal set? Was there more fat, less carbs, did the carbs spike or didn’t they? Did I wipe down the mirrors in the bathroom for a little longer than I’d planned? Did I wait too long to eat after pre-bolusing? Did I weigh that last meal correctly? Is my correction factor too low or high? Did my yoga practice make me more sensitive to Insulin today?

Even when I do everything right, it’s like dancing on a tight rope. Turning, extending one leg, teetering, lifting and falling only to land back on the same foot again. I love dancing, but not like this.

After a hypo I usually cry. This time was no different, except maybe wailing was my way of expressing my pent-up frustration in general at being quarantined. I miss my family, I miss the beach, I miss the feelings of certainty and safety.  It’s awful thinking that grocery shopping is potentially life threatening or that breathing, laughing and hugging in close proximity is no longer ‘normal’. I’m heartbroken at how many people just five minutes down the road from us have no food, nor adequate shelter in which to ‘social distance’. With all these personal and not so personal things going on most days I feel at a complete loss for anything to say when everyone ‘out there’ is saying it anyway. I know I’m not alone in this.

And it’s hard not to push down feelings of guilt that I am in a beautiful place even while challenged with having a chronic illness.

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Photo by Liv Bruce on Unsplash

I often mention in this blog how yoga is my lifeline. Yesterday was no different. Having gone super high after treating my hypo I decided to do a vigorous practice to kick start my metabolism. It wasn’t long before I felt energised, calm and rejuvenated. No matter how bad I feel physically, no matter what goes on emotionally, a simple balanced practice of posture and breathing sets me up for a good night’s sleep and a healthy mental attitude.

In particular it also helped me to put my soul crushing low into perspective. I caught it, handled it and recovered well. It’s all anyone can do.

If you’d like to join me for livestream yoga classes during isolation I’m teaching on Tuesdays and Wednesdays. Entry is by donation with 50% of the proceeds going to our local village for masks, food and medical supplies. Donations can be made via www.paypal.me/yoga4diabetes

Tuesdays at 8.30 am South Africa Standard Time/ Zurich Time  which is 4.30 pm Australian East Coast time

Wednesdays at 11 am US East Coast time and 5 pm South Africa Standard Time/Zurich time

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

The humble test strip

Something that bears the brunt of many jokes in the diabetes community is the test strip. If you haven’t a clue what that is. No worries, I’ll explain.

The test strip is a very small yet essential item for anyone living with diabetes. In order to keep blood glucose levels in check you have to take regular measurements with a blood sugar measuring device called a glucometer.  Even if I wear a CGM (continuous blood glucose monitor) which measures blood sugar through an implanted device, I still need to calibrate my CGM or double check that the reading I’m getting is accurate. Especially in an emergency. Nothing worse than getting a false reading on my CGM and treating it with either insulin or glucose and then having either a low or high. Sound complicated? Not even the half of it.

Anyway I digress…

The test strip is inserted into the Glucometer, I prick my finger with a lancing device, place a minute amount of blood on the test strip and within 5 seconds I see the reading on a screen. Then I take the test strip out and supposedly dispose of it. The big question is where? One lone strip usually lands in the side pocket of my meter case, eventually 1 becomes 50 or 100 and before I know it little tiny test strips covered in droplets of red blood are literally falling out of my meter every time I open it. Too lazy to throw them in the rubbish I put them back in the side pocket only for them to fall out again the next time I go to test my blood sugar.


Stray test strips end up in car seat crevices, on the floor, in the bed, in the toilet, on the pavement, in my hair. I’ve even found a test strip in my soup. Yuk!

Getting the test strip out of the little round container in the middle of the night in the dark is also a total drag. It’s bad enough having to get up to test my blood sugar but then when I waste a strip putting it in upside down and back to front… total headache! Plus if I don’t get enough blood on the strip the machine tells me I have to test again. That’s another waste of a strip.

Strips are made of plastic and as far as I know non recyclable. In fact most of what we  use to manage diabetes is non recyclable. Talk about feeling guilty every time I test or inject. I just wish someone could invent a recyclable paper, bamboo or hemp test strip. In fact why not invent insulin pens, needle cases, devices out of hemp plastic or some other compostable equivalent. Anyone want to start a movement ?

The test strip is also a conversation piece. ” What’s that? My aunt has diabetes. How many times do you test? Does it hurt?”

The test strip is certainly not something to be undervalued or ignored. Before the test strip made its appearance on the world stage, the only way to know what your blood sugar reading was was to use a special solution mixed with urine then boiled to get a rough sense of the levels. Eventually  a urine test strip was used and by the 80’s there were home test kits like the one pictured below, but it took 5 minutes to get a reading.

Screen Shot 2019-11-08 at 5.13.53 PMThink about it, before the invention of insulin and diabetes technology we didn’t know what we had. how to manage it or even how to stay alive. The humble test strip for all its foibles, annoyances and character flaws is an absolute life saver.

I for one will never leave home without it!

See you tomorrow for #NDAM #DiabetesAwarenessMonth

With great respect…

rachel

P.S. Check out the amazing Miss Diabetes and her latest cartoon about how to test your blood sugar here

A horrible hypo

I titled this post at 2 am this morning after a sudden hypo around dinner time. At 2 am I was thinking clearly, taking time to make a note on my phone so I wouldn’t forget. At 7.15 pm things were a whole lot more chaotic. Well not at first….

I was cruising nicely through my evening yoga practice after taking my basal shot (long acting insulin which keeps my blood sugar level over night) about 30 minutes prior. I’ve been playing around with where to take the shot to avoid insulin absorption issues, and decided to inject in the soft fleshy area in the top part of my bum. There was a sting on entry and when I pulled the needle out quite a bit of bleeding so I knew I hit a capillary. I wasn’t concerned. Usually this means the insulin won’t absorb as well and I’ll sustain a higher level overnight.

I hopped on my mat, forgetting all about the shot. It was towards the end of my practice that I noticed some itchy sensations around my waist. This is usually a sign that I am going low but sometimes that itch comes when I’m high. I actually find the itch super annoying. It’s not at all useful in helping me determine whether I should check my level or not. Luckily I checked.

3.4 mmol flashed large on my blood glucose meter. This is NOT a good result. This is a scary result. The last time I had checked I was 5.4 and usually it would stay that number until dinner. This sudden and fast drop could only mean one thing. My long acting insulin had hit my blood stream and was absorbing all at once. If I’d been wearing a CGM ( continuous glucose monitor) I could have seen the trend. Arrow pointing down on an angle means I can treat it with around 8 grams of fast acting carbs and it would come up in 20 minutes. Arrow pointing straight down would mean taking 15 grams and still having to wait 20 minutes.

Sadly I cannot afford a CGM. I had to fly blind.

After cramming two tabs in my mouth at once I sat back down on my mat. By now the itch had turned into a crawl which went from head to toe. My husband who was sitting next to me and in the middle of his own yoga practice reminded me to breathe.

I engaged whats called Ujayii breath a slow whispering breath, which sounds almost like a snore and tried to focus on lengthening my exhalation. It worked and I stayed calm but it did little to budge the numbers on my meter. I took another tab and a half and started raving and ranting This is the point where someone telling me to calm down doesn’t  work.  Me telling me to calm down doesn’t work.

Telling myself, “don’t react, don’t eat more tabs, just be here, it will pass, your blood sugar will come up” is like that feeling on the edge of orgasm when the thought comes “don’t do it… hold off… keep enjoying…” and then you go for it anyway.

Not the best analogy, because sex feels good while hypos are horrible, a total brain melt. 

It took 30 minutes and three and half glucose tabs to come out of the tail spin. The graph on the app which measures my data went straight up. When I pulled out my syringe to take some fast acting insulin for dinner my husband was confused. Why are you taking insulin when insulin just caused the problem? How to explain that if I don’t take some insulin to cover the meal I’ll rebound even higher.

Living with diabetes is a fine and tenuous balancing act between the horror of lows and the haunting of highs. No matter which way you look at it you can’t win. Best not to try. Thankfully I rarely have these testing moments. I chalk this up to a consistent and daily yoga routine. More of which I’ll share with you here during #diabetesawarenessmonth.

Want to learn the ujayii breathing technique I use to calm myself during a low? Watch this short video below and join in.

See you tomorrow

with great respect…

rachel

low blood sugar, hypoglycemia

That Low Blood Sugar

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It started just like any other day. Well not quite. I still hadn’t experienced a low low blood sugar even though I’d been taking Insulin for almost two years. To be honest I was terrified of the unknown. I’d hear the horror stories. People fainting, not being able to talk, brains not functioning. If you’ve ever had a low blood sugar you know exactly what I’m talking about.

But here’s the thing; having never experienced a hypoglycemic event I actually had no idea what people were talking about. I mean I could imagine it being awful, but I had never actually felt it for myself. So my fears weren’t based in fact. But that didn’t mean I didn’t have them.

And then it happened!

So randomly and for no reason. It wasn’t about over injecting, it wasn’t about exercising too much. I just started to feel really anxious and shaky and itchy all over. I assumed I was having an overdue panic attack. Except I was just standing over the sink, lost in quite a pleasant thought so what the F…ck. What was there to freak out about? I went over to my husband and mentioned I was feeling a rush of panic. He suggested we go outside and talk it through.

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I didn’t think to check my blood glucose levels, forgot my glucometer, didn’t bring a juice box with me. NADA

For the next 15 minutes or so while my sweet husband talked me through my ‘anxiety’ nothing budged.

Luckily I decided to check my levels. Casually, well not that casually because I was shaking from the inside out, I pricked my finger. The number that stared back at me was nothing like I’d ever seen before.

2.7 mmol!

Seriously? 2.7?

The strange thing was even though mentally I knew that was way too low and I was itchy and shaky and wanting to eliminate everything from my body with a good trip to the loo, I wasn’t frightened. I felt frustrated and curious instead.

Even though I’m sure it was only a matter of seconds, the walk from the living room to the kitchen to get some juice, felt like a lifetime.

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Photo by Pâmela Lima on Unsplash

It was only while I was waiting for my levels to come back to normal that I started to feel the terror. Why didn’t I check my blood sugar sooner? Why did I think it was something else? Why didn’t I do the most obvious thing? Where was my rational mind?

Umm… yep, that’s a low blood sugar event. You don’t think properly.

After my blood sugar came back to normal and in the subsequent years, I’ve had so much gratitude for that first scary low blood sugar. It helped me to face my fear and to lessen my anxiety about my levels in general. I was able to watch my blood sugar rebound and to see that I was okay. I learned subsequently to test how many grams of glucose I need to bring my blood sugar back to a safe range.

As someone who lives with LADA ( Latent Autoimmune Diabetes in Adults) and still producing a tiny amount of insulin I can get away with ½ a glucose tab, sometimes even a ¼  when I am just below where I’d like to be. I love the idea of sugar surfing keeping my levels in range with a little bit of sugar and a little bit of insulin.

I’ve also become more vigilant about checking blood glucose levels regularly especially when I feel slightly off. I.e. itchy around my tummy or vague in my thinking. And I’ve learned to let go of expecting perfection with my blood sugar management.

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So if I’m about to teach a yoga class and my blood sugar is at 4.3 I don’t hesitate to treat it. I’d rather not be checking my levels in the middle of demonstrating down dog.

Another super cool tool I use for soothing anxiety and settling the nervous system during and after a low blood sugar event is mudra. If you’ve been reading my blog for a while you’ll know how passionate I am about mudra for diabetes. A user-friendly tool which is literally at our fingertips.

In a recent interview with Lesley O’Brien from Ayurbotanicals, I go through mudras which help engender fearlessness, increase circulation and give pause for self-reflection.

Join me in the practice below

with great respect…

Rachel

P.s I’ve tried these gummies below and they work effectively to bring up my levels fast 🙂