Stubborn lows at inopportune moments

THIS IS TYPE 1 DIABETES…

I was tired and wanted to go to bed. The problem: stubborn lows prevented me from going to bed.

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This happened twice last week.

Although these incidences were outwardly similar, my reactions were significantly different.

Whereas, during the first incident I reacted stoically, during the second I reacted with a cocktail of self-pity, anger, and other negative emotions. During the former, I felt no need to express myself; during the later, I felt the need to rant on twitter.

Despite reacting differently while they were happening, I felt the same way the day after. It is difficult for me to explain exactly how I felt, but it was not a bad feeling.

(I do not believe in taking a half-assed approach. Therefore, I am going to at least try to express how I felt…)

True…I felt tired; however, tiredness did not dominate.

I felt proud…a sense of accomplishment…triumphant.

Although I felt the same after each of these instances, my thoughts differed.

After the first incident, my diabetes-related thoughts centered around how I was emotionally impervious to the problems that diabetes had thrown at me the night before. I thought about how emotionally mature I was in handling it.

After the second incident, my diabetes-related thoughts centered around how, even when diabetes causes me to stumble, I will continue marching forward.

Context:

• For the last few weeks I have been getting a decent amount of sleep (given my repeated “bouts” of insomnia, I often go through long periods of limited sleep);
• My sister was diagnosed with type 1 diabetes on April 1st;
• I have recently been experiencing more hypoglycemia;
• Since mid-April I have felt immensely proud of myself;
• Generally speaking, I have felt pleased with my blood sugars;
• I have not been exercising frequently;
• I have not been meditating regularly;
• I have been reading quite a bit;
• I have been writing prolifically;
• There have been no major sources of stress in my life recently;
• I was not aware of feeling stressed out.

 

Dealing with diabetes: my way isn’t your way

There is no right way to adapt to diabetes.

There is no wrong way to adapt to diabetes.

My way is the only way!

As individual human beings who just so happen to have diabetes, it is imperative that we remind ourselves of this from time to time.

“Your diabetes may vary”? Taken literally = Nonsense! More like “Your diabetes will vary.”

I am my own chief executive.

I am my own legislature.

I am my own judge.

Thankfully, I have numerous well-qualified advisors helping me shoulder the burden.

Perhaps my way is conducive to me flourishing in life. Perhaps it is not. Ultimately, it does not really matter all that much.

Right focus. That is the main thing.

Adapting to diabetes in a beneficial manner is absolutely essential. To focus on how one has adapted is foolish and, potentially, futile.

Right focus. Focus on what is in your control.

How the hell am I supposed to know whether or not my way is beneficial?! Magic? Visiting an oracle? Luck?

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Analogy: Life is war. What the Eastern Front was to World War 2 diabetes is to life.

More often than not, an indirect approach is superior to a direct one. In war and in life, this strategy holds good.

I can decide to try to change my habits.

Whether or not I will or even can is not completely in my control. This is irrelevant.

Options: to let my habits stay the same, or to take action and discover if they can be improved.

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I focus on meditating frequently, self-reflection, and writing. These are what help me the most.

These form my foundation for self-discovery.

Ultimately, it is up to you to find your own.

The power is in your own hands.

 

Putting together the puzzle pieces

My sisters diagnosis with type 1 diabetes has brought to light just how sloppy I have become.

She has shown much greater care in managing diabetes than I currently do.

She changes her lancet every other day; I change mine every time it dawns on me that I cannot remember when I last changed mine.

She still uses alcohol wipes; I do not.

She still shows discipline in her eating habits; I am inconsistent.

If I desired to, I could innumerate many other contrasts between us. I do not desire to do so.

I am lazy at times. Openly so. This post is not meant to conceal this…

“…who wishes to concern himself with such dangerous “Perhapses”! For that investigation one must await the advent of a new order of philosophers, such as will have other tastes and inclinations, the reverse of those hitherto prevalent–philosophers of the dangerous “Perhaps” in every sense of the term.”

~ Friedrich Nietzsche

Does laziness get unnecessary flak? Perhaps sloth has been unfairly maligned. Of course, this flies in the face of everything you and I were brought up to believe.

Honorable custom tells us that to be lazy is a bad thing. That it is something to be avoided in oneself, and shunned in others. Why should I bow down to such a stern master?

(On second thought, there are exceptions. Laziness is not always bad. At times, when we are in a merciful mood, we will describe slothfulness with the phrase “laid back”.)

Conversely, why should I make laziness my idol? Is sloth a benevolent master?

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Own thyself.

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Both knee-jerk nonconformism and mindless conformity are less than ideal.

Admittedly, I have engaged in both. Who hasn’t? With that said, I prefer opening myself up to accusations of hypocrisy to selling my ideals for a little comfort.

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I fall short. You fall short. We all fall short. Does this justify giving up?

 “I found that the men most in repute were all but the most foolish; and that others less esteemed were really wiser and better.”

~ Socrates

Having picked up on the contrast between my sister and myself, I began to think…

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Not all sloppiness is equal.

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Examine & probe assumptions.

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Exercise:

Periodically ask myself “have I been sloppy in managing my diabetes lately?” List them. Examine. Judge on case by case basis.

Change of Plans

My 12 year old sister was diagnosed with type 1 diabetes on April 1. Needless to say, my thoughts are centered around helping her to transition to her new life. Therefore, I’m going to put the series of posts that I was planning on hold indefinitely. Doing what I can to help her is more important than this diabetes blog.

With that said, I’m not disappearing from the Diabetes Online Community. The DOC is essential for my well-being.

If you want to stay updated, follow me on twitter @T1DME

Personal Enemy Number 1

Self-complacency. Things are going well. My blood sugars have remained – with the exception of a few aberrations – at a satisfactory level. The one possible threat: me. If I allow arrogance through the door, it will cause mayhem. If I invite laxity inside, my hospitality will be the axe that fells me. Self-complacency = more hyperglycemia. Period.

To prevent myself from acting complacent, I need to remind myself that it’s my actions that are keeping my type 1 diabetes under control. Testing frequently, being comparatively physically active, etc. If I don’t do these things, my level of control will be diminished.

Victory!

My blood sugars have been, on average, much better than before. So long as this trend continues, they’ll be excellent in no time.

In the last 2 months I’ve made observable progress in how well I manage living with type 1 diabetes. Alas! I am winning my competition against diabetes. So long as I don’t become complacent, I will be victorious.

May the bitterness of defeat remain far from my lips from this point forward! In The 12 years I’ve lived with diabetes, I have tasted defeat far too often. Never again!

For the latter part of 2013, diabetes remained ahead of me on the scoreboard. It wasn’t until mid-December that I started turning things around.

My rally from behind began when I strengthened up my defenses against diabetes burnout. Introspective writing was my means of doing so.

With my defenses shored up, I went on the offensive. My initial target was blood glucose testing. Raising my testing frequency was a preliminary step for adequate control over my diabetes.

When the time was right – during late January – I began to increase my physical activity. That’s when things really began to improve.

As of right now, my 7 day average is 174, whereas, previously, it was in the low to upper 200s. This decrease hasn’t come at the cost of more lows. This improvement is, therefore, sustainable.

Going forward, my strategy will remain the same: to reduce my average blood sugars while trying to prevent hypoglycemia. So long as I stick to this strategy, I will defeat type 1 diabetes.

Join the Crusade

Test Guess and Go

Medicare guidelines do not provide for coverage of Continuous Glucose Monitors . I am an advocate for my husband who desperately needs a new CGM and previously received CGM coverage under private insurance before reaching age 65.  I am a crusader for the entire diabetes community, whether you are on Medicare, will soon be on Medicare, have a Continuous Glucose Monitor presently, or might need one in the future.

In December 2013 Representative Carol Shea-Porter [D-NH1] introduced a bill into Congress, H.R. 3710: Medicare CGM Coverage Act, which provides for coverage of Continuous Glucose Monitoring Systems by Medicare if recommended by a doctor. My recent post Baby Steps talked about the bill and many members of the Diabetes Online Community (DOC) asked how they could become involved in this crusade.

I have just received an email from Congresswoman Shea-Porter’s Legislative Assistant, Marjorie Connolly, and she suggested the following:

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Strugglin’ to rebuild

This week hasn’t been the best…all thanks to Mr. D. To be less obscure, I had moments of laxity in how I managed my type 1 diabetes. My testing “pattern” became erratic, and I had a few high blood sugar readings that would have been caught earlier if I hadn’t been so lax.

Previously, the process of recovering from diabetes burnout went swimmingly. All this changed when I got my guitar restrung. In the days that followed, I spent an obsessive amount of time on it. Unfortunately, I became too distracted from diabetes. 

When I play/noodle on the guitar, all my thought’s melt away, and I become completely absorbed in a tumultuous sea of sound (I’m not the best guitar player). For me, this is a much needed stress reliever. Unfortunately, it’s equally adept at “relieving” me of my sense of time which, in turn, screws up how frequently I test.

Luckily, the intense interest in playing my guitar has lost its edge, and no longer poses a threat to my effort to rebuild my skillful diabetes management habits.

This incident was relatively minor. It only caused me to miss testing a handful of times. The period where I was unmindful of having a chronic condition only lasted a handful of days – not long enough to crystallize any unskillful management habits.

Those handful of days earlier this week were an aberration. The journey shall continue…

Not all things are created equal

Got meters?

A month ago I was testing 2-3 time a day. On most days, my numbers remained above 200 all day, and I’d often see at least 1 number over 300. Numbers in the 400s – which had formerly been rare – happened almost every week.

Fast forward to this month. I’ve been testing 6-10 times a day. On most days, my numbers remain above 200 for most of the days, but I’m starting to see due some decent numbers. Numbers in the 400s – which been all too common a month ago – are now non-existent. Improvements have been made.

Being a pessimist, I’m adept at seeing the negative aspects of any situation. In my present situation, I could easily choose to focus on the fact that my blood sugars still remain, on average, higher than what I’d like to see.

Although I could choose to see my present situation through tinted glasses, I have decided not to. To interpret my situation in a negative manner would do me no good.

It’s essential that I keep things in perspective. Although my blood glucose readings are important, they’re not what’s most important to me. Of far greater significance to me is  the fact that I’m testing my blood sugar frequently.

My current blood glucose readings are irrelevant to me, so long as I’m in the habit of frequently testing my blood sugar. Although, by itself, it won’t have a major impact on the extent to which I have my diabetes under control, it will form a firm foundation for me as I continue to recover from diabetes burnout.

Discernment is essential.

Rebuilding after the storm

My kit: a necessary tool in my efforts to rebuild

Diabetes burnout struck me like a tornado. Where skillful diabetes habits had once stood, there remained nothing. A once-magnificent city had been replaced by a vast field of rubble.

In the immediate aftermath of the storm, I was left in a state of shock. After gaining an appreciation of what had transpired, my shock turned to self-pity and despair. Being stuck in the position I was in felt like an injustice, and the magnitude of the task at hand inspired nothing but despair.

These days are now behind me. Having freed myself from self-pity and despair, I was able to focus on the process of rebuilding.

This  process started in December of 2013, and has continued into the new year. Although a noticeable amount of rubble has been removed thus far, a significant amount remains.

I’m starting the process slowly by continuing to test my blood sugar more frequently. When I’m ready to move on to another task, I will focus on being more physically active again. For now, however, I still need to focus most of my attention on the first task.

Despite the large quantity of work that has yet to be done, the outlook is optimistic. Things will be restored to their former glory.

Diabetes Burnout: The Psychological Challenges of Recovery

I want to write about diabetes burnout – in particular, my most recent bout with it. I want to find a way to incorporate the posts I made on tumblr a month ago, when my burnout was at its peak. As I attempt to achieve these goals, I’m continually falling short. I’ve hit a brick wall – and keep hitting it over and over again. Writers block has reared it’s ugly head.

After writing and re-writing this post repeatedly, I’ve decided to give writers block the finger, and write about writers block. I ain’t gonna let writers block slow me down…

If you can’t tell already, this post is essentially going to be a free write until I’m able to magically transition to the topic I had initially planned on writing about.

As a writer, beginnings are my archnemesis. I need to find my groove; after I’ve done so, it’s takeoff! If I don’t, my writing’s a train wreck.

Perhaps it’s because I try too hard. Rather than putting my trust in my own abilities, I try to force myself to write rather than allowing myself to write. Perhaps having a preplanned subject matter adds extra pressure. Perhaps, like a guitar player, I simply have to relax my mind and body, and then just write.

The part of this post that is actually about diabetes begins after this sentence.

Now my groove is coming back to me and, of course, now I’m starting to feel low…

I’m actually 123 (a nice number for more than one reason).

That unpleasant interruption brings us to today’s topic: the psychological challenges of overcoming diabetes burnout.

When your blood sugar is high all of the time, you adapt to it. Chronic hyperglycemia is miserable to live with, but I get accustomed to living miserably. It also tends to make me feel depressed after awhile, which means I…lack of motivation.

In other words, chronic hyperglycemia eliminates possible motivations to improve my blood sugars, while also making it more difficult to feel motivated in general.

To complicate matters further, I know that, as I improve my blood sugars, I will both experience more lows and start to feel low when I’m not. Psychologically, there is little difference between the two. Both of them make me feel the same, and this feeling isn’t one I desire.

Do you remember how I mentioned wanting to incorporate something I wrote on tumblr into this post? Well…I’m about to do just that.

Here’s something I wrote while I was experiencing burnout:

Didn’t I exude positivity?

The first sentence is the part of that post that’s relevant to this one.

Pulling yourself out of diabetes burnout involves making a decision between two shitty options. It’s not as black and white as it may seem.

If you’re stuck in a negative mindset, this taints your judgement. Both of them can appear to be equally bad if this is your mindset.

All of these things make diabetes burnout an incredibly difficult hole to climb out of.

What I have been describing is, of course, an extreme example. What I’m describing is a case where diabetes burnout and chronic hyperglycemia fed into each other.

It probably would have made more sense for me to organize the last three paragraphs into bullet points but what has been done has been done.

In conclusion, I don’t like writing conclusions, therefore this post will abruptly end here

New Years Resolution

My New Years resolution for 2014 is to fully recover from the diabetes burnout I experience from September-December of 2013, and to be more careful about not wearing myself out in the future.

Going forward, this blog will play an important role in staying faithful to my resolution.

In the coming weeks, I plan on exploring what this resolution entails, and I’ll be setting smaller (and more specific) goals that’ll help me stay faithful to this resolution. More on that later…

Happy New Year!