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

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

Meditation for diabetes

Yeah so diabetes is no picnic. I think I’ve pretty well established that in the last 10 blogs. There are however so many ways yoga can help. Working with a strong focus for the mind through sound and imagery is one. When we give the mind something to do and draw it out of its habitual need to identify with thoughts, our sense of individuality is suspended leaving us with SELF, the nature of which is peace, contentment, oneness or more aptly put, YOGA.

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I learned the beautiful meditation in the video below from my teacher Alan Finger when I was living in NYC. I invoked it quite often, especially after being in 9/11. I found that taking my feelings and releasing them back to source was a profound way for me to come to terms with all the emotions that seemed to be piled up on top of each other as my body worked to release the shock.

My diabetes diagnosis was also another moment where I worked with this meditation. I was actually terrified at diagnosis, felt ashamed and alone and had no idea how I would recover from something that I knew had no cure. These feelings of helplessness dissolved into the simple focus of the practice and soothed my worried heart.

If you live with diabetes, or are just needing something to soothe and support your nervous system I invite you to join me for the meditation below

See you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel

Diabetes is an opportunity

It’s burning in the hills behind the town where I live in Australia. I am grateful not to have to evacuate but am concerned for those who do. The entire valley all the way to the beach is in a blanket of smoke. It’s hard to breathe. We just went to the beach for some relief but there was none. It was strange to see people out and about in cafe’s and shops as per normal. Apparently it’s only going to get worse. So many more friends are leaving their homes to be safe. It’s heartbreaking.

I feel this way about Diabetes too. Even though I live with it myself I feel for every single person who lives with this condition. It’s heartbreaking when anyone is diagnosed. I know all too well the challenges ahead. Every day can feels like Russian roulette. It’s a massive learning curve and you can’t get away from it.

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In spite of all the feelings that come up after diagnosis I also see diabetes as an opportunity to live differently. Instead of taking things for granted I wake up each day grateful to be alive, I’m learning through yoga and other modalities to regulate my nervous system, to react less to the stress of variable blood sugar levels. My diet is refined and I maintain an active life. This kind of approach takes focus and sustained effort and there are plenty of times where I feel frustrated and defeated.  But I try not to let my down days take over. I have always been an enthusiastic participant in life.

Today as the smoke chokes the air around us I think about all the people all over the world in crisis. How do we rise above, stay resilient and not give up in the face of uncertainty? How can we make a difference in spite of circumstances beyond our control? I draw strength from a simple Ayurvedic principle.

You can’t fight fire with fire. The softness of water is what douses the flame.

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The softness of water is about slowing down, tuning in and calmly moving forward. Flowing with change rather than pushing against it. Connecting with water is about dispersion and delegation. In the face of disaster it’s coming together in community and supporting each other. If we all share the burden we’re stronger together.

It’s the same with diabetes. When I reach out into the diabetes online community I find like minded friends managing their health in myriad ways. All of this forms my pool of inspiration. Even better is going to a support group or event where we all meet and share. I’ve learned more about my condition from these brief in person events than I have from my doctors and diabetes educators.

Knowing there is a community out there to answer a question, share a technique, help me find the best product or device is priceless. Before diabetes I would never have outsourced, researched or informed myself in this way. Diabetes has literally inspired a whole new me. My mission for diabetes awareness month is to share from the heart how diabetes affects me personally but its also about sharing how yoga is an incredible balm.

In this very difficult time, no matter what the struggle, it is my prayer that the varied practices and teachings of yoga become an important part of the healing journey.

More on that tomorrow…  #NDAM, #DiabetesAwarenessMonth

with great respect…

rachel

7 Things or thereabouts

There are a lot of things that influence blood sugar.  42 to be exact, according to Adam Brown from diatribe.org . If you’re keen to know what those are you can check out his handy chart here.

In the spirit of Diabetes Awareness Month and to share more about what its like to live with diabetes, I’ve put together my own short list based on personal trial and error. For those who don’t have diabetes and are just coming along for the ride, your blood sugar levels might also be influenced by these ‘things’ the only difference between you and someone with diabetes is. When your blood sugar rises your pancreas produces insulin to lower your blood sugar level, mine doesn’t. So unless I inject insulin or do something else to lower my level like exercise, I can’t just kick back and let my body do the work. When blood sugar levels go low in a non-diabetic , the liver kicks in with a drip feed of glycogen, to bring them back to homeostasis. My liver kicks in too, but as there is no insulin to meet the liver dump my blood sugar goes up again, hence the need for more insulin and round and round I go. Fun, fun fun…NOT!

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So here’s my list in no particular order.

  1. The Sun. Every time I lie in the sun for more than 20 minutes, I have higher levels for 24-48 hours afterwards. Apparently its the oxidative stress. It’s a double edged sword because if I avoid the sun I don’t get enough Vitamin D. I’ve worked out that if I limit exposure to 15-20 min and only sunbathe every two days I stay in range.
  2. High Fat Foods. I absolutely love my avocados and olive oil. I also love Haloumi and Feta cheese. My blood sugar however is very fussy when it comes to what I eat when. I’ve learned to avoid fatty dairy products before bed because I go high over  night and for 24 hours after. Avocados are a little more friendly, they actually help me keep my blood sugar from tanking while I sleep. So I load up on a hefty avocado with my dinner. But sometimes it backfires and I am still high when I wake up. I’m still trying to work out how to dose for fat. I feel like if I could figure it out I’d eat pizza again.
  3. Not enough sleep affects everything. Sleeping less than 7 hours a night for me definitely messes with my levels. I wake up about 1-2 times a night too so not sure what would happen to my levels if I was able to sleep through the night. I’d probably have lower levels in general.
  4.  A Daily Walk can either reduce my blood sugar level, which can be a bonus when I’m high, or raise my blood sugar level which is not ideal. When I walk, for how long and at what pace is also a factor. Walking directly uses the thigh muscles which burn glucose for fuel. It’s suggested that when levels are higher, or you’ve had a carb heavy meal, a walk will help insulin to work more effectively and reduce blood sugar. In my case a long walk (over an hour) on flat terrain  raises my blood sugar whereas a short 20 minutes hike up and down hills reduces my levels.
  5. Cleaning definitely drops my blood sugar in spades. All I have to do is look at the vacuum and I’m low. No joke!
  6. Travel. This is also very specific to the type of travel. When we travel by car anywhere over long distances I have lows. When we fly I usually have lows and then struggle with a stubborn high when we land. Jet lag is included in travel and wreaks havoc.
  7. Any kind of stressor like unexpected news, seeing a snake on the path, (that  happened yesterday) a loud noise, change in routine, fears, emotions, frustrations. So that covers the gamut right? All of this always gives me higher levels. Especially emotional outbursts.

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The one thing that doesn’t affect my levels is my yoga practice. That includes postural yoga, breathing and meditation as well as adhering to an ayurvedic daily regime. No matter how often, or how intense the practice my levels stay steady. In fact they flat line. That’s why I personally use yoga as my goto when I’m getting stressed out about my blood sugar levels. It’s like pushing the reset button.

It may not lower a stubborn high or fix a scary low, but it will calm me down enough to handle it.

See you tomorrow

with great respect…

rachel

I have diabetes, so what

Today ‘diabetes’ was the big topic of conversation amongst everyone I spent time with. I love how friends are curious about how I manage my daily life with this condition. I enjoy clarifying the differences between type 1 and type 2 diabetes, why we take insulin or sugar and the ins and outs of daily management. There are many diabetes myths out there, like people with diabetes can’t have sugar, or we take insulin for every situation, whether low or high, or that our diets caused our diabetes.

Diabetes is so much more complex and mysterious than that. It’s a bit like trying to put a square peg in a round hole. What I deal with in my iteration of diabetes is different to every other person with diabetes. That’s what makes it both frustrating and predictable. Living with diabetes means you can rely on its uncertainty.

And don’t get me started on how each person living with diabetes relates to their condition emotionally and mentally. In a recent conversation, a friend with type 2 diabetes stressed how exhausting it felt having to stay so vigilant with daily blood tests and visits to the doctor. In the end her way of dealing with it was to say, “I have diabetes, so what.”

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Listening to her take on diabetes made me reflect on my own approach. I could completely understand her position. Taking anything so seriously that it restricts your life can make you more unwell.

This is where I segway into my personal approach to management. It’s definitely the serious approach, where fear of complications such as loss of vision, amputation, kidney damage,and neuropathy give me the discipline and impetus for strict control. I’ve used my body my whole life to express myself through dance and yoga. The body being my joy meter. I remember thinking as a teenager that if I couldn’t walk, or dance I didn’t know how I’d cope. I feel the same way now as an avid yoga practitioner. I see the body as a powerful tool for health and wellbeing. If you can open, stretch and strengthen the body you can directly affect how you deal with any physical , mental or emotional stressor.

Luckily the daily discipline required of a dancer and yogi has its benefits, I utilise it  to be comfortable with eating the same kinds of foods at every meal, taking approximately the same amount of insulin, walking at a specific time each day, checking my blood sugar often and using yoga and meditation to mange my mindset. When I veer from my daily routine it takes days to catch up. It’s hard for me to experiment and try new approaches even when I know those changes would benefit me. I don’t want to beat myself up about my approach though… I’m fine with it. As one of my diabuddy’s once said,  “You do diabetes your way and if it ain’t broke, don’t fix it.”

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Walking with my friend today we talked about how it feels when I see a positive number on my glucometer or I know I’m doing good time in range. ” Do you feel like you can take a moment to soak in the tone of that feeling? In other words stop and feel how good it feels to know your managing well? ” I absolutely loved the way she put this. If I can acknowledge the good feelings, really soak them in then perhaps those more challenging moments i.e low or high blood sugar freakouts, will be less stressful. I like the idea that even something as stressful as diabetes gives me the opportunity to embrace those feel good vibes and to heal my nervous system.

A nice way to acknowledge that even though I have diabetes, so what.

See you tomorrow

with great respect…

rachel

It’s not up to me

Setting myself the task to write something every day for 30 days about diabetes to spread diabetes awareness is definitely daunting. I live with diabetes for 365 days a year and deal with it 24/7 so it should be easy to articulate that right? In reality the way I deal with diabetes is deeply private.

After spending 6 years ignoring it and then spending 4 years shouting about it via writing a book and being a fierce advocate through social media, it’s been interesting to spend this past year taking a break from the need to externalise my experience.

In 2019 I set a goal to lower my Hba1c, heal some of my underlying digestion issues and be brave when it comes to taking Insulin. I started 2019 using the Diabetic Health Journal, created by yogi and  diabetes health coach Lauren Bongiorno, with incredible results. Writing down daily goals, things I was grateful for and staying accountable made a big difference. My Hba1c went from 6% to 5.6 % in 6 months. If you’re not sure what that means it’s like dropping your cholesterol levels or blood pressure. Moving it from a pass to a win.

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I also went into hyper drive with my digestion, adding different supplements, bone broth and more variety into my daily meals. I worked on stored trauma with network spinal analysis and neuroimmunology sessions. Finally I made sure to keep up a daily walk and my twice daily yoga practice.

Making a concerted effort to shift some deep seated patterns has been an interesting process. I didn’t necessarily make great strides or have major revelations, instead I settled more into accepting what is.

“What is” might not be what I want but if I can accept it that’s a pretty good place to be. It’s how I dealt with diagnosis after fighting it for so long and pretty much how I manage my finicky digestion and volatile blood sugars and everything else that comes my way.

My latest go to phrase for everything is, ” It’s not up to me” That’s not about not doing everything I can to stay balanced. It’s about understanding that I don’t know the recipe of creation.  Letting go of needing to know, enjoying the gifts I’ve been given and trusting that whatever comes is perfect, goes a long way in helping me manage my condition.

I never expected to be diagnosed with diabetes but now that I have been I can honestly share it’s a blessing in disguise.

More on that tomorrow  #NDAM #DiabetesAwarenessMonth

With great respect…

rachel

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6 tips to bounce back from a rebound high

The first time it happened I was clueless. People living with diabetes often talk about blood sugar roller coasters but I thought that just meant highs and lows in a short period of time. What I didn’t understand was that when I go low I also go high and not just right after correcting a low blood sugar. The high lasts for days. My body starts resisting the insulin I’m injecting and I need more insulin to manage the highs which means more risk of lows. When I was a kid I hated rollercoasters and for good reason. They made me feel sick, scared the begeezus out of me and I’d come off the dang thing with a sore throat from screaming my lungs out.

It took quite a few hypo’s for me to work out that the high’s that followed were to do with the lows. At first I just thought there was something wrong with the insulin, or maybe I hadn’t dosed enough. I even speculated that maybe my pancreas had finally hit the dirt and I really didn’t have an ounce of beta cell function left. Because I live with LADA ( latent autoimmune diabetes in adults) I still produce a minute amount of  insulin, this means that sometimes my body squirts out a tiny amount when I first start eating. It also means that if I am already low when I start eating I could go even lower and have a hypo. Not having the recipe as to what my pancreas will do when means there’s a lot of guessing going on. So when I’m high for days on end and doing everything exactly as I did it the days, weeks and months before it feels like I’m in the middle of a crap shoot. Lucky me!

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When people meet someone living with diabetes, the decision making and daily micromanagement is largely invisible. You might see a CGM or an insulin pump, but on the whole it seems as though the whole process runs smoothly.

Here’s what actually goes on most days for me. I wake up, inject. I eat, inject. Go a little below range, take a glucose tab. Go high, take some insulin.  I check my blood sugar every hour to be on the safe side except for at night where I place my faith in morpheus, the god of sleep trusting that the amount I take for my long acting insulin will keep me in range all night. 20 fingerpricks and up to 6 shots a day of insulin is not easy or seamless no matter how doable it is.

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What do I do to deal with the physical and mental blood sugar challenges during a rebound high? Here’s 6 things that have really helped me.

  1. Do some physical exercise which I know increases insulin sensitivity, like a walk with some hills,
  2. Do a yoga practice which works with the larger muscles of the body and includes standing hip openers and balancing postures
  3. Talk to myself in a positive and supportive way when I see a high number on my meter. I.e. This too shall pass, this is a normal response to a low blood sugar, everybody goes through this
  4. Do things in my day that give me joy, like writing, yoga, connecting with a friend or have some hang out time with my husband
  5. Go to bed early, there’s nothing more healing then a good nights sleep
  6. Reach out in the #DOC ( diabetes online community) to find out how my diabuddies deal with the same situation

And if you live with diabetes I’d love to know… How do you deal with a rebound high? Lets start a conversation in the comments below!

See you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel