Category Archives: burnout

Diabetes Blog Week Day 2- The other half

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Diabetes Blog Week

Today’s topic: We think a lot about the physical component of diabetes, but the mental component is just as significant. How does diabetes affect you or your loved one mentally or emotionally? How have you learned to deal with the mental aspect of the condition? Any tips, positive phrases, mantras, or ideas to share on getting out of a diabetes funk?

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I’ve experienced all the emotions above as well as many others. I have good days where I feel proud of my blood sugar control, encouraged by the support that I receive from my family, friends, and online, and optimistic about the future. And I have bad days where I feel frustrated by my roller coaster of blood sugars, tired of having to constantly think about and manage my diabetes, and fearful about future complications. And sometimes when the emotions get to be too much, I become indifferent and burnt out.

What helps me when I find myself in a funk is to have outlets where I can essentially vent. I know that when I blog about my frustrations, that I’m not alone, and that others have been there too and got through it. When I talk to friends and family, they may not completely understand what I’m going through, but they validate my feelings and listen to what I have to say.

Finally, there are 3 phrases or mantras that have really helped me find perspective and get through tougher times.

You can find more The Other Half of Diabetes posts here.

Blackout

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I know better than to compare a fictional story to real life. But yet I found myself doing just that, trying to comprehend the experiences of a character that were so foreign to me, but unfortunately probably familiar to many others. In the book, the character is an alcoholic, often drinking so much to help her cope with life that she blacks out. Multiple times she wakes with a feeling of guilt, knowing that she did something wrong, something embarrassing, something out of character, but not being able to remember what she did.

“I wake with a crushing sensation of wrongness, of shame, and I know immediately that I’ve done something stupid,” she says.

I’m not going to get into the struggle and devastation that alcoholism can cause for the person and those around them. That is not what this post is at all about. What I do want to focus on is the fact that what troubled this character was the need to remember these missing memories so that she could take full ownership of them and their consequences. Without being able to remember what the character had done during those missing hours, she felt unable to take responsibility for her actions and to feel fully accountable.

As she says, ” I know what I’m responsible for, I know all the terrible things I’ve done, even if I don’t remember the details- but I feel distanced from those actions. I feel them at one remove.”

Why did this aspect of the book strike me so much? It’s not like I could relate to the character. In fact, I think it was exactly my inability to relate to the situation that stuck with me. It’s not that I haven’t made mistakes that I’ve felt guilty for. I’ve regretted or questioned decisions, but I’ve always been able to remember what led to them and fully take responsibility for them. And until I read this book, I’ve completely taken this simple fact for granted. While we do make mistakes and have regrets, we are still in control of our actions. When you take responsibility for what you’ve done, you can learn from it, put it behind you, and move forward.

A couple months ago, I made some changes to my lifestyle. I started following a nutrition and exercise plan. And for 2 months I stuck with it for the  most part. I saw changes in the way my body looked, I lost a little weight, I became leaner and stronger, and my A1c dropped, I felt good. And then the holidays came. With the countless holiday parties, eating more meals out, going on a cruise, and being off my normal schedule, I started making less healthy decisions. I ordered dessert, I snacked into the evening, I ate the fries instead of switching to a healthier side, I grazed through parties eating even though I wasn’t hungry. I got off track.

About a week ago, I woke up in the morning full of regret. On my CGM was proof of the decisions I made the night before, my entire night dancing above the 180 line, dipping and rising. My stomach not quite itself, I knew I was still feeling the effects of my earlier choices. But unlike the character in the book, I remembered what led me to this point. I could recall the unhealthy decisions that I had made. But instead of feeling defeated, I felt empowered! Because by knowing what got me to this point, I also know what I can do differently next time. I can prevent this feeling. Your memories and emotions, as negative as they might be, don’t need to be what holds you back, they can be motivators to propel you forward.

This past week, I got back out my nutrition plan and started fresh. I know that I’ll slip up from time to time, but I’m on the right path. And the regret that I felt, while not desirable, was a catalyst to get me back on a healthy path, and for that, I can’t regret my regret.

Diabetes Social Media Burnout Day

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Burnout. I’ve been there. In fact I just returned from about a two month hiatus from blogging. But my burnout was more self-imposed, independent from the happenings of the DOC. I’ve been fortunate that I haven’t encountered any hurtful, argumentative, or mean comments directed at me or what I wrote. That doesn’t mean they don’t exist in the DOC, but I’ve never felt personally attacked. But I’m sure that has to do with my own level of involvement. The more you put yourself out there, the more you dive into the DOC, the more vulnerable that makes you.

With anything on the internet, if you search hard enough, you’ll find information, opinions, and support for both sides of any issue. So while you’ll find people who have the opposite viewpoint as you, you’ll also find like-minded people. Everyone has opinions and everyone is not going to agree. But by putting your thoughts out into the vastness of the Internet, you have to be prepared for and strong enough to handle people who disagree with you. But that doesn’t mean your thoughts are not still valuable to others.

When you reach a state of burnout for whatever reason, instead of thinking about why you stopped, remember why you started.

Why did you start blogging? Why did you first become active in the DOC? What was and is your purpose for being here?

I started blogging because I wanted to hold myself accountable. But more than that, I wanted to share my unique experiences with a shared community. I wanted to educate those who don’t know what it’s like to live with T1D. I wanted to connect with others. I wanted to be inspired and to inspire others. I started sharing my story so that others could see bits of their own life in my posts, and for me to find pieces of myself in theirs. I started so that together we would strengthen one another, support one another, and together help each other through the ups and downs.

Sometimes I get so caught up in the day to day that I forget why I started. Sometimes when I don’t get comments on or offline about my blog, my purpose starts to drift away. Comments aren’t the reason why I blog, but they are good fuel. All it takes is one person telling me that they love reading my blog or commenting that I’ve inspired them to make some difficult changes that keeps me going. The hard part is remembering that even if no one tells me these things, there are lots of people who read my blog without commenting that still find value.

So from this social media burnout day, I’ve decided that the next time that I feel like I need to step-back and take a break, that I instead will write 3 nice comments on someone else’s blog. Because those comments might just be enough to help that person through their burnout.

It’s Not A Pager

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“Is that a pager?”

I had pulled my pump out of my pocket to what I thought was discreetly bolus for my dinner. I was at a large dinner seated with friends, strangers, and acquaintances. That question has always been a great opener to a usually educational conversation about type 1 diabetes, a conversation that I never minded having and actually often looked forward to. But this time I didn’t even look up from my pump as I worked out the carbs and calculations in my head.

“No, it’s an insulin pump,” I replied, not even bothering to lift my head.

That’s all I said. Not, “No it’s actually an insulin pump, I have type 1 diabetes and I give insulin this way instead of shots.” Not, “Hah no, its an insulin pump, I have type 1 diabetes and I have to give insulin when I eat.” No explanation, no education, no discussion.

“Oh sorry, it kind of looks like one.”

“Don’t worry, she gets asked that a lot.” My friend seated next to me took the opportunity to chime in.

I should have said that to him, I should have made sure that he didn’t feel awkward, that he knew that I didn’t feel awkward by his question, but I didn’t. I finished entering my bolus and put my pump back in my pocket. And that was the end of it.

It was not my typical response when someone inquired about my diabetes. I wasn’t trying to be rude, I wasn’t offended, or embarrassed. I’ve thought about my response, or lack there of, for the past few days. Why was this time different? Why this time did I find myself to be slightly…well, annoyed?

It’s happened many times where I’ve known a person for years before they find out that I have diabetes. That’s because most of the time, you can’t necessarily tell. I keep my cords tucked away, my pump in my pocket, my infusion sets covered by my clothing. But other times, I don’t care who sees. I test my blood sugar at my desk or on my lap at the table. I wear my pump clipped to my side, my tubing dangling below the edge of my shirt. And when questions are asked, I explain. I teach, I answer questions, I demonstrate and I educate. I usually like doing it, I like talking and sharing my experiences and life with diabetes.

But not that night. I didn’t want to talk about my diabetes. I didn’t want to explain what it was and what I was doing. I didn’t want the next 20 minutes to be about me or about diabetes or about anything related to it. I didn’t want my diabetes to be at that dinner, at that table.

For the past month, I haven’t worn my CGM. And while I still tested my blood sugar, it was less frequent. It was a month of not constantly being summoned by buzzing and beeps. It was a month of a sort of denial of my blood sugars. Without my CGM to tell me otherwise, I had a tendency to trick myself into believing that they were in range when mostly likely they weren’t. It was a month of drastically less lows, but probably more highs. But it was a quiet month, a necessary month. A month where everything wasn’t about my diabetes. Where my focus and energy, for better or worse, was spent elsewhere.

So when I was asked if my pump was a pager that night, I didn’t want a diabetic discussion and my response reflected that.

Today, after a month, I took my CGM back out of the drawer and started wearing it again. Today I stopped pretending like diabetes isn’t a part of my life and can be ignored, even for a month. I know I don’t always have to talk about my diabetes, that I can decide when I want to keep it to myself and when I want to share it. But whether it’s today, or tomorrow, or the day after, not talking about my diabetes does not mean that it isn’t there and that it will go away.

“It’s not a pager, but I get asked that a lot. I have type 1 diabetes and this is an insulin pump, I can tell you more about it if you’re interested…”

Energy Burnout

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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?

Nonchalance and Capillaries

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I’ve entered into a brief period of nonchalance with my diabetes. Not quite diabetes burnout, but definitely not the level of vigilance and care that I currently was operating at. While I don’t want these feelings of apathy to last, I’m okay taking this mini break. I’ve learned that for me, my self-management kind of ebbs and flows. I’ll have periods of high motivation, followed by some time where my diabetes seems to take a back seat. I don’t want to get as far as burning out and having my self-management truly suffer, so if I need a week or two where my diabetes isn’t the all consuming focus of my life, then so be it. Luckily, I have my CGM to keep me on track and alert me when I’m too high or too low when I forget to test or check.

So what does nonchalance in my management look like?

Well, allow me demonstrate.

A few days ago, I was changing my CGM sensor. I still don’t like inserting the sensor, so I try to just get it over with. I started to push down the inserter into the left side of my stomach and felt this incredibly sharp pain shoot across my left shoulder. Um that’s never happened before.

I had stopped pushing when I felt that sudden pain, the inserter only halfway down. Awesome. I held my breath and pushed down the rest of the way. Luckily, there wasn’t any more shooting pain. I looked down at the sensor and saw red begin to seep through under the plastic. Yeah that’s not suppose to happen.

Common sense would say “okay just don’t touch it, it will probably stop bleeding.” But sometimes common sense goes out the window. So I pressed down a little bit and even more blood started to gush, filling the plastic. Oops. While it didn’t hurt, apparently I may have hit a capillary and maybe a nerve that caused that shooting pain in my shoulder. Who knows.

Here’s where the nonchalance comes in.

What I probably should have done:

  • Removed that sensor
  • Taken rubbing alcohol to clean the area that was bleeding
  • Inserted a new sensor somewhere away from the old one
  • Called Dexcom to explain what happened and request a replacement
What I actually did:
  • Nothing
I just didn’t feel like doing anything above, mostly I just didn’t want to have to insert another sensor. So I figured I would leave it in and see what happens. Well the first day it seemed to have a hard time getting a reading with quite a few gaps in my graph. Then it started working more consistently, but the number on the CGM would be way far off from the number when I tested my finger. But I decided to keep the sensor in (yes, lazy), checking my finger more than usual and eventually it started working fine. Will this always be the case? Probably not. Should I have changed the sensor earlier? Probably. But knowing that I could always just test my finger like I did before my CGM, I just figured I’d let this one go. 
I pick my battles with my diabetes, and even though this was a bloody one, it wasn’t really worth the fight to me.