Flying Blind

When I was little I was convinced a monster lived under my bed. Every night just after brushing my teeth and getting into my P.J’s I’d make a bee line for the bed and hide under the covers. Spending the night terrified that if I moved or breathed the monster would get me. Even though at night I was frightened for my life, I woke up every morning refreshed and unafraid. Somehow, I knew the monster could never survive the light of day.

After years of yoga, personal reflection, and trauma work I now know why I was so afraid. Having lost my mother suddenly at the age of 10, I projected the shock and fear into an external threat. As an adult and the author of my thoughts, I understand that I can only ever be the source of anything I project. The monster wasn’t separate to me, it was a part of my psyche supporting me to make sense of the incomprehensible. Mothers aren’t supposed to die and leave their 10 year old daughters.

Being with fear and uncertainty is something I deal with every day as someone who lives with type 1 diabetes. I spend my whole day managing risk. Most of the time I get it right. But every now and then I don’t.

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To describe the onset of a mild low is easy. There’s the feeling of ants crawling around my middle. The rushing to the loo, the increased heart rate. A kind of hyper vigilance and anger all at the same time.  But when the low is severe? With no warning? That’s something that defies words.

Last night was just like any other. We’d gone for our afternoon walk and I decided to water the plants. I’d kept my CGM in my coat pocket, so I could keep an eye on my levels. Often around sunset I dip low as my long acting insulin wears off. As my numbers were more than steady I decided to do some weed pulling. No more than 10 minutes, knowing that any kind of gardening induces a low. Still, after checking my blood sugar I was in the clear. A nice steady 5.0 mmol.

I came inside, prepared my dinner and then decided to have a shower. I took my long acting shot for the evening ( I split my dose), checked my level, it was 5.3 and hopped in the shower. I checked again when I got out and due to my CGM getting damp it read 5.6 with an upward arrow. Great, I thought to myself, I’ll check again in five minutes when the heat from the shower dissipates. On my mat, I started my evening practice. After a few poses I felt a strange tingling around my middle. Knowing that that is one of my ‘tells’ for a low, I checked my CGM, it said 5.4… I  decided to cross check with my glucometer just in case.

Thank GOD I did! It said 2.9!

I freaked, checked another finger, while at the same time trying to wrack my brain as to where my glucose tabs were. Once the other finger came back with the same number I ran upstairs, realised they were downstairs and ran to them and shoved four tabs in my mouth at once. My heart rate was through the roof, I had no idea if 12 carbs was enough. Everything went into soft focus. All I could do was feel my heart rate pounding, the sweat running from every pore, the thoughts in my mind jumbling with no coherence. While John went upstairs to get his phone (in case he had to call the ambulance) I ate another glucose tab thinking 15 carbs would be better than 12. Then suggested we get the hypo kit out of the fridge, unused, not even looked at since purchase.

I tried to read the instructions to John. “What is this for? “He asks, “Just in case I pass out.” I am trying to read the instructions and stuck on number 2, which says, slowly inject the water into the vial. I’m thinking but where is the water? Do we have to get the water from the tap and put it in? John is saying there are pictures of what to do on the inside lid of the kit. I don’t understand the pictures, I don’t understand the instructions, I’m sweating profusely now. I check my CGM it’s a straight down arrow

NOT GOOD! I down another three glucose tabs so that’s 15 + 9= OMG don’t even know how much I took. Was it too much? Not enough? I can’t set my timer to make sure its been 15 minutes since I took the tabs. I can’t do anything but try and explain that we only need the hypo kit if I am unconscious. “Whatever you do John, don’t put the needle in the vial we cant waste the kit.”

We hang in the balance, check my blood sugar with the meter which is much more reliable than my CGM at this point and see it’s the same number as it was five minutes ago. Not going down. Phew, but not going up.

I start to really feel the low now. I feel faint, sick to my stomach, weird as F…ck.

And then inch by inch it creeps up. John puts away the hypo kit. I sit in a stupor. Even though my blood sugar is back up past 4mmol (that’s a normal range) my brain is not online. It’s worse than the feeling after a panic attack. I’m literally numb. All the while my only thought is why?

Why did I drop in 20 minutes from 5.4 to 2.9? I knew it had to be something to do with the long acting Insulin, somehow it had absorbed too quickly. Maybe the shower and the heat? But how much was absorbed and how long would it last. Was there a danger of going low again? This had happened just before dinner and I had to inject meal time insulin for that. Would they interact? Was eating and injecting going to endanger me again? And why didn’t I know more about this? Where are the formulas and strategies for this unexpected scenario? Why can’t our HCP help us to be prepared for these kinds of situations? They send us home with the basics. Eat, inject, treat a low with 15 carbs. That’s it? Talk about flying blind.

Once I could properly operate machinery again I sent a message to some of my allies in the DOC (diabetes online community). Their response was so immediate that I cried.

One friend mentioned that I should split my meal time dose just to be safe. Take a unit at the start of the meal and maybe another one two hours later. Another friend assured me that at 2.6 mmol 24 carbs worth of glucose tabs was the right amount to treat the low and my levels would soon stabilise. She also mentioned taking less insulin for the meal and watching every 30 minutes to see what happens. If I saw my levels spiking, then that was a sign to take more insulin. After a ton of messages back and forth, she admitted she couldn’t ‘tell’ me what to do and that I would have to trust my intuition and decide. Everybody reacts differently to every food.  She reminded me that I have diabetes, it’s okay to have high levels, better to be high than low.

I decided to dose 15 minutes after the meal when I saw the upward trend and took ½ a unit less than normal. My blood sugar spiked. I survived.

It’s morning now and the sun is shining. The monster firmly back in its cage. I am in awe of the women I reached out to and their instant support. I know they have had soul crushing lows and impossible highs and just like me make it through. Without those who have gone before us, how would we know the path to tread? How would we tame the monsters under the bed?

If there is one lesson, this low has taught me it’s to reach out and keep reaching out. Ask for help. Know you are not alone. Yes, ultimately, we have to make our own decisions when it comes to how to manage our diabetes. But for every potential choice there is a person with lived experience out there willing to support you, you need only ask.  

With great respect…

rachel

15 minutes I can do

I’ve been setting the timer on my phone to 15 minutes a lot lately. 15 minutes to pre-bolus, 15 minutes to wait out a hypo, 15 minutes of yoga and meditation practices no matter what.

Before I was diagnosed I absolutely hated time. I never wore a watch or even looked at my phone. Even as a kid I never wanted to learn to tell the time. Why be constrained by a limitation like that?

Everything had more validity to me when time wasn’t involved. Why does anything ever have to end? Like a yummy meal, or time with a beloved or friend, a day at the beach. Maybe my abhorrence of time has to do with losing my mother at a young age. Having to face endings for me was complicated and traumatic. Being forced to rush through something felt unnerving. As a dancer I was bound by time and timing, but it never bothered me, because the timing of the music, or the timing of the movements to the music uplifted me, reminding me that all creative endeavours are happening in the presence of timelessness. Not that I could put that into words when I was dancing. It was something that touched me and made me cry with inexplicable joy.

me and my cousins with grandad

By the time I was nine my grandfather insisted I learn to tell the time. He bought me a Timex with a red strap. We went painstakingly through the details of the big hand and the little hand, what all the numbers meant and what each part of the day represented. My mum bought me a digital clock which rolled over numbers like cards. And then I got a clock radio, even cooler because I could wake up to music.

After I met and started traveling with my husband we would wander through international airports looking at expensive watches. He’d point out all the brands. I knew nothing about Panerai and Patek Philipe. I didn’t even know the difference between a Swatch and a Tissot. When I would badger my husband to tell me what time it was he would say, “you need a watch darling” and I’d reply, “my smartphone is good thanks.”

Then one day when I was stuck in an airport on my own, I decided to splurge. If I was going to buy a watch it would have to be the purchase of a lifetime. I decided on a gold Tissot with Roman numerals and a simple link band. I’ve only taken it off a handful of times since then. When I point at my watch to tell my husband, “it’s dinner time, lunch time, time to go, time to clean, time to ‘whatever’” he likes to chide and say, “I wish I’d never mentioned you needed a watch”.

Watches aside, time has changed my life.

Recently I’ve been navigating some soul crushing lows. Waiting for my blood sugar to come up sends me into a wild panic. What if it doesn’t come up? What if I run out of low snacks? What if…

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Initially I set the timer on my phone to 15 minutes so that I would know when to check again. But when the lows are scarier, in the low 3’s (below 70 mg/dl) watching the minutes tick down is a lifeline. If I can stay focussed for just 15 minutes, I’ll be okay. If it levels out at the end of those 15 minutes I can relax. If it still goes down after those 15 minutes, I can take more glucose, dates etc and start again. As long as I can watch the clock I know eventually I’ll be back to compos mentis.

Knowing I have a tool to support me during a low blood sugar has absolutely changed everything. I have a deep-seated fear of lows. It’s why I insisted on sticking to a regimented low carb diet for 7 years. It’s why I timed every single part of my day to avoid any deviation, and I why I would restrict my social activities.

My goal for 2020 was all about opening up to life, food and freedom. It’s been interesting to be stuck in one place while I navigate this new perspective. Asking myself…what do I want to eat?  What do I want to do today?

If I want to eat heaven in a bowl (a fruit smoothie bowl with crushed seeds and dates) I can. If I want to garden, go for a walk, do a strong yoga practice, I can. If I flub the ratios, don’t reduce my insulin enough or take too much, I’ll be okay.

15 minutes is easy. 15 minutes I can do.

with great respect…

rachel

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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

 

 

 

 

 

To clean or not to clean

This post may contain affiliate links to products I trust. Please read Disclaimer for more info

So, this I found out is a thing… A cleaning hypo. I thought it was just me. Not long after picking up a mop, running the vacuum cleaner or even just sorting and tidying my closet I get the tell-tale signs. Skin crawling, thoughts scrambling, confusion and an overwhelming sense of fatigue.  Doesn’t everybody feel like that when they clean? Apparently not!

I’ve got friends who tell me they get high on the buzz of a hoover and the sweet smell of lemon floor wax and don’t get me started on how Marie Kondo and the Konmari craze has taken over everybody’s households.

But seriously…having to stop and drop a glucose tab in the middle of my cleaning foray is super inconvenient. Like who wants a low when your packing and tidying for a trip away? Or worse at the storage unit when you’re supposed to be a helpful hand to your husband?

It wasn’t until I happened to see my diabuddy Christel Oerum’s post about having to treat a hypo in the middle of vacuum session that I realised, this happens to everyone. According to Christel, the reason why vacuuming affects blood sugar so much is that it’s basically steady state cardio. The heart rate comes up a little and you end up moving around quite a bit even if you have a small place. She suggests making sure not to have too much insulin on board ( IOB) before cleaning.

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My problem is that I’m in such a routine with my insulin dosing that I have trouble planning ahead. I.e cleaning in the morning when I have dawn phenomenon would be better than an after lunch declutter session.

The other thing I’ve noticed with a cleaning hypo is it lasts for hours. No other form of exercise seems to do that for me.  If I was keen to clean I could actually use that as a great form of blood glucose control.

Move over Yoga, lets scrub, mop and vacuum the sh..t out of everything right?

Fuggedaboudit! I’d rather roll out my yoga mat, do a leisurely sun salutation, cross my legs and meditate.

Wishing everyone a super wonderful start to September

with great respect…

rachel

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low blood sugar, hypoglycemia

That Low Blood Sugar

This post may contain affiliate links to products I trust. Please read Disclaimer for more info

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 🙂