The Ticking Time Bomb

Posted on February 28, 2014 by Reva

I held in my hand a ticking time bomb.

One of my worst fears was unfolding right before my eyes. But I was too late. The wheels were set in motion, I couldn’t reverse it, take it back, start over. I would have to let it play out and hope that I was wrong.

This had never happened before. At least not to this scale. My heart rate started to quicken and I began to prepare myself for the worst.

I held in my hand my insulin pump.

I had just finished an incredibly heavy italian meal including sangria, bread, appetizers, pasta, the entree, and dessert. I started the meal with a high blood sugar and counting the carbs in this meal, I knew it would be a lot. I had given the insulin. It was already in my body, there was no taking it back. I was uncomfortably stuffed, so full that the thought of eating more made me feel sick.

My CGM buzzed, but instead of telling me that I was high like I expected it to say, it was telling me that I was quickly dropping. I looked at the number, 190 and dropping fast. I pulled out my pump, there was an alarming amount of active insulin in my body, wayyy more insulin than I would need. I knew I was going to crash. It was only a matter of time.

Tick. Tick. Tick.

I pulled out a pack of fruit snacks, and although it physically pained me to eat more, I swallowed them down. I was determined to catch this low before it got bad. An hour later I was still dropping, but it seemed to be leveling off and I started to think that maybe the low wouldn’t be as bad as I thought. I was right around 70 and so I took another pack of fruit snacks.

Tick. Tick. Tick.

At 11 pm, it hit me. In the span of 10 minutes, that 70 turned into 42 and then that 42 turned into 28.

KABOOM!

I was falling, crashing. I stumbled out of my room, downstairs and grabbed a small gatorade and another couple packs of fruit snacks. At this point the low had hit me full force, I couldn’t think straight, walk straight, or make much sense of anything around me. I’m moving out of my parents house in a week, but today I was glad that my dad was just a few doors down. I knew that I was in danger of passing out and just wanted someone to make sure I was okay. I knocked on the door. “My blood sugar is 28” I slurred, falling into bed. After confirming that I had already treated the low, my dad continued to ask me questions, making sure that I stayed conscious. The words felt heavy in my mouth, my sentences barely reflecting the thoughts in my head. I could hear myself slurring my speech. Eventually my sentences and speech became more coherent as I became more aware of my surroundings. I tested my blood sugar again, 67.

I knew the worst was over and I made my way back to my own room, drenched in sweat from the low. My stomach hurt from all the sugar I had just consumed on top of my heavy dinner. And while I was sure I would probably be facing a high blood sugar in a few hours, I was relieved that the worst was over.

The low has come and gone, but was has managed to stick with me is that feeling of both impending danger, but also of the unknown. I’ve never experienced such a helpless awareness. It was like being in a runaway cart rolling down a hill, knowing that you would crash at the bottom, and not being able to stop it. And yes, sugar could and did slow it down, but I didn’t know how much would be enough to stop the crash, but not send me soaring in the other direction.

My insulin pump is my lifeline, but that night it truly felt like a ticking time bomb.

Energy Burnout

Posted on February 21, 2014 by Reva

A couple weeks ago, I attended a 2 day course all about energy management. Energy management is a term that I had heard thrown around occasionally, but I wasn’t entirely sure what it meant besides well, managing your energy. Basically the idea is that energy is our most critical resource we have as human beings, but most of us fail to manage it effectively. Think about it, we manage our time, but few of us think about how we can skillfully invest our energy each day. Many of us find our productivity slipping at 3 pm, or we come home from work or school exhausted or irritable, or perhaps we are too drained to do the things we need to do when we finally have the time. These are all examples of ineffective energy management. Ask yourself, are the people who matter most to you in your life getting your best energy?

When you manage your energy, you find that you are able to fully engage, that you are giving your full and best energy right here, right now. The course talked about 4 distinct, but connected dimensions of energy: physical, emotional, mental and spiritual. I learned techniques for managing and expanding the energy that I have. This includes both moving and eating for energy. While the premise of the eating for energy, eating light and often, makes sense for people without diabetes, I had some issues with this component. The moving for energy meant that at least every 2 hours, you get out of your chair and stretch and move your body. This could be going for a short walk or even doing small stretches at your desk. Finally, we spent some time in the course on self-awareness, coming up with our “missions” in life. This mission is an overarching statement of purpose that can help you make decisions and navigate through your life. It’s the greatest driver of engagement and helps you decide how to best invest your energy.

After the course, I started thinking about where in my own life I have the biggest problems with energy management. Yes there are times when I could be more engaged at work, or with family and friends, but the blaring and obvious answer is in my diabetes management. And I don’t think I’m alone in this. We even have a term for when we run out of energy taking care of our diabetes, diabetes burnout. Managing a chronic condition takes tremendous amount of energy in all 4 dimensions, but especially physical, emotional and mental. It requires constant vigilance and attention. You’re always preparing and planning. Your body is continuously being subjected to glucose tests, insulin administration, and going through high and low blood sugars. You worry, you get frustrated, you get annoyed, and sometimes you just burn out.

But burn out with a chronic condition is dangerous! We aren’t talking about being too tired to get a work out in one day or not being as productive in the afternoon or as engaged with your partner. No, energy management with a chronic disease is vital! When someone isn’t managing their energy effectively, it effects how they take care of their disease which can have immediate, dangerous, and damaging consequences. I know that when I’ve gone through phases of burn out, I am less careful about carb counting and low and high blood sugars can become more frequent and extreme. This can lead to both short and long term consequences for my health.

So what are the strategies that someone can use so that the amount of energy that is necessary to care for a chronic disease does not lead to burn out? I don’t know. I have some thoughts, but it’s something I still struggle with myself. But the thing that I think may be most helpful is having your life “mission”. I know, you’re probably thinking how some statement is going to help with your health. But for me, poking my finger to check my glucose level is not about the number. It’s not even about my A1c. For me, it’s about being healthy so that I can get married, travel the world, have a family, be there to watch my children grow up and have the joy of becoming a grandparent. I want to live a long, healthy and fulfilling life. That’s my mission, that’s what drives me to do the little things each day: making sure I have enough test strips, counting my carbs, testing my blood sugar, remembering my fruit snacks, bolusing on time. That’s what I remind myself when I start to lose energy, when I see my self-care slipping. Maybe this will help you, maybe it won’t. But when it comes to your life, why do you want to take care of your diabetes? What is your mission? Who/what matters most to you? What makes your life really worth living?

Energy is our most critical resource as human beings. How are you managing yours?

My Dearest Diabetes

Posted on February 14, 2014 by Reva

My dearest Diabetes,

On this Valentine’s Day, I’d like to take a moment and express my true and honest feelings towards you. After all, as the men I have dated have come in and out of my life, you have stuck to, er I mean by, my side. You have been with me through the highs and the lows, never mind that you caused many of them. But you’ve never abandoned me, you’re always here, even despite my best effort to get rid of you. I have to admire that kind of persistence.

Our relationship is unconventional. You were an unwelcomed force in my life, bringing with you many changes, disruptions, and emotions. Dare I say, I hated you when we first met. But you made it clear that you weren’t going anywhere so I learned to make the best of our relationship. I want you to know that you can be a real pain. Sometimes I wonder why you’re such a prick. But other times you can be so sweet, so it’s hard to stay mad at you for long.

You’re needy, demanding, and all consuming. I think about you all day, every day. Sometimes you’re even in my dreams. It’s hard to remember my life before you, and to think of it without you, should that day ever come. I complain about you all the time. To my friends, family, strangers. Some understand completely, others try to, and some will never know what it’s like to have you in their life. You bleed me dry.

But you’ve changed me. I would not be who I am today, where I am today, without you. While you’ve taken so much from me, my time, my energy, my fears, my health, you’ve also given me so much in return. You’ve given me determination, a strong sense of responsibility, strength, a community, and purpose. I hate you, I wish you never found me, but I cannot deny that deep down, you’ve made me a better person.

Happy Valentine’s Day, Diabetes. I hope it is a sweet one.

Love,
Me

Diabetes Art Day 2014

Posted on February 3, 2014 by Reva

I’m so pleased to be participating in the 5th Annual Diabetes Art Day! This is my second year participating. Art has always been valuable to me in my life as a form of expression, and I love creating art with a purpose. It’s a way to express thoughts or feelings that can sometimes be hard to articulate when it comes to my diabetes, and Diabetes Art Day is a great opportunity to share those feelings through a unique medium.

This year my piece is called “The Low Journey”. It’s an abstract interpretation of what low blood sugar feels like for me using sharpie and water colors. It begins in the first picture with the realization that you are going low, that dark, confusing feeling of being disoriented and out of sorts. The feeling is confirmed with a finger poke and reading on the meter. In the next picture, the treatment of the low is depicted. I use fruit snacks to treat my lows. Then comes the agonizing 15 minutes of waiting to feel better, but feeling helpless in the mean time. Finally, the last picture shows how the dark clouds hanging over you eventually begin to lift as your blood sugar returns to normal and the sun finds its way through the dark clouds.

The Low Journey

Thank you to Lee Ann Thill from the Butter Compartment for organizing Diabetes Art Day. Be sure to check out everyone’s wonderful submissions in the 2014 Diabetes Art Day Gallery!