Category Archives: exercise

Freedom

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I feel like my back and shoulders always hurt. There are a lot of reasons for this: my posture, the way I sleep, my workouts, sitting at a desk all day…but I’m also convinced it’s because I constantly carry around a heavy purse. I’ve always been envious of the people who can fit everything they need into a tiny bag, a small clutch, or even just their pockets. That’s never been possible for me. I never go anywhere without having a stash of fruit snacks with me in case of a low blood sugar. And then I also carry around my glucose meter. I’ve learned to always be prepared so throw in an extra bottle of test strips, a battery for the pump, a couple syringes and an insulin vial…just in case! And if I’m already carrying all of that, then I definitely have room for my wallet, keys, phone, a lip gloss…you get the idea.

I am tethered to my purse. I constantly ignore comments like “you can leave your purse, you won’t need anything.” But I might! What if I go low?

I am tethered to my pump. The cord physically connecting my body to a medical device at almost all times.

And I’m probably emotionally tethered to my phone, but that’s for another time.

Which makes the few moments of untethered freedom even more satisfying. Like taking a shower. Or going for a run.

I’m not a distance runner, the most I run is 2 or 3 miles at a time, so I made the decision to disconnect from my pump and leave my meter at home for those 30 minutes. While I still carry my fruit snacks, phone, ID and keys, this is probably the least amount of stuff I ever carry while being away from home.

I don’t know if it was the endorphins from running or the lightness of having little to carry, but recently on a run, I had a sudden euphoric moment. “I feel so free!” I thought to myself as I bounded down the sidewalk. There was no pump clipped to my pants threatening to fall off with every step, weighing down my leggings. There was no strap around my shoulders or back connected to a bag holding all my supplies, adding weight and pain to my body. It was liberating.

But then reality set in. My body started to feel shaky and weak, my head started to feel dizzy. My legs continued to propel me forward, but they felt numb and disconnected from my body. I was experiencing a low blood sugar. It was a cruel reminder that I’m truly never free from my diabetes. I can leave my medical devices and all the supplies at home, but I can’t run away from my broken pancreas. The timing of the low right after relishing my “freedom” made me laugh at the irony of that moment, “You got me, body! That was a good one, you son of a bitch.”

Dblog Week 2017 Day 5- More than Diabetes

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I’ve always liked to exercise, and over the years I’ve found various different ways to stay active: playing tennis, going on bike rides, spinning classes, bootcamp, zumba, online workout videos, the list goes on. The key is to find something that you enjoy doing so that exercise is something you look forward to instead of feeling like you have to force yourself to do it.

A lot of my workouts I used to do on my own or in my apartment, but when I started working from home full time, I realized just how important it is for me to get out of the apartment and be around other people. And since my schedule usually allows for it, I can do my workouts over lunch or in the morning, instead of after work.

I have some friends that were taking barre classes and invited me to try out a class with them. I was pretty skeptical- I’m not good at dance or ballet, I’m not very flexible, and I’m used to fast- paced cardio workouts. A barre class just didn’t seem like it would be a good fit.

Boy was I wrong. The strength-based class was incredibly challenging and was way closer to Pilates than ballet. My legs shook, my muscles completely fatigued, my heart rate went up and I was sweating. With the upbeat music, the encouraging and friendly instructors, and the fact that every class follows the same structure but with different, challenging moves every time, I was hooked!

3462FF48-7909-4511-B2C6-E65CBDB3D197I’ve been taking classes for about 6 months now, last month completing my 100th class, my first major Pure Barre milestone. I’m happy to have found a fitness class that I look forward to going to and a community that I’m proud to be a part of.

And while I’ve had some trouble regulating my blood sugars with some of my other workouts, I’m able to keep my pump on during the class and besides a few lows here and there, my blood sugar stays pretty steady throughout.

So while there are many other aspects of my life besides my diabetes (my love of brunch, traveling, musicals, dog fostering, to name a few) exercise is definitely a big one and I know something that will continue to be a lifelong journey.

 

Lessons from Levi

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My foster dog Levi and I spend a lot of time together. Since I work from home, he’s constantly curled up next to me, usually sleeping while I’m working. They say that owners and their pets sometimes start to resemble one another over time. I’d definitely say that’s been true of Levi and I.

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There’s a lot we can learn from our pets. In fact, I found a great list on Huffington Post of what dogs can teach us about what matters most. They remind us to live in the moment, to not hold grudges, to be loyal and dependable, and to love unconditionally.

Yesterday though, I found myself imitating Levi in a completely different way.

It was after my bootcamp class. My blood sugar was on the rise, but this was to be expected since this particular fitness class always seems to raise my blood sugar an hour later. Anticipating this rise, I had given a few units of insulin once class ended. I ate dinner, giving another bolus. But it was as if I was delivering water instead of insulin, it wasn’t doing anything to stop my rapidly rising blood sugar! By 9:30 pm I found myself staring at a staggeringly high number, the highest I’ve seen in a very very long time. I changed my infusion set and gave a correction through an injection.

At this point in the night, I was feeling truly miserable. I was thirsty, nauseous, my body and head ached, my brain felt foggy. But it was the end of the night and I had to take Levi out before bed.

LeviDance.gifThat’s when I realized that Levi was doing exactly what I needed to be doing! Tonight, I would channel my inner dog and follow Levi’s example.

Excited to be outside, Levi started pulling me to walk faster. Alright I got it, we’ll pick up the pace! Exercise, including walking, can be beneficial in lowering blood sugar. Great thinking, Levi.

While on our walk, Levi kept stopping to sniff and pee every 10 feet. While stopping so often on a walk is annoying, frequent urination to flush out your system is important when dealing with high blood sugars or even small amounts of ketones. Smart thinking again, Levi.LeviDrink.gif

When Levi finally finished emptying his bladder and marking every pole we passed, we went back inside. Levi made a dash straight for his water dish, lapping up the entire bowl. Drinking lots of water! This can help the kidneys flush out the extra glucose in the blood. Great and important advice, Levi!

I checked my blood sugar again, finally it was coming down! The rapidly dropping arrows confirmed that I was trending in the right direction and I was starting to feel a little bit better.

With the worst behind me, I followed Levi’s lead one last time that night.

Levisleep

By 12:30 am, my blood sugar was back to normal. Thanks for all the lessons, Levi!

 

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.

Yoga high…and low

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I walked down Main street with my yoga bag slung across my shoulder, already sweating in the evening heat. About 6 weeks ago I started taking a weekly yoga class after work. I snuck a peek at my CGM, it read 153, a comfortable number to be starting to exercise. I arrived at my yoga studio and removed my sandals, stuffing my bag including my CGM into the small cubbby and grabbed a pack of fruit snacks just in case of a low.

While I’m not new to yoga (my mom is a certified yoga instructor), I have never had much of a consistent practice. My choice of exercise has always been more cardio based: tennis, bike riding, boot camp classes, cycling, etc. There’s always the chance of dropping low while exercising, and it’s happened during all those activities. But there’s enough movement and noise with those exercises that treating a low can often go unnoticed by those around me.

yogaI’m not embarrassed to treat a low. I do what I have to do. But at the same time, I don’t like to be disrupted or disrupt those around me. Every time that I made it through yoga without dropping low, I would breathe a secret sigh of relief. It’s just yoga is so quiet, so calm. I don’t want my CGM breaking the silence of a meditative moment or the crinkle of my wrapper interrupting someone’s flow.

In the tiny one room studio, mats and bodies lined the floor like sardines packed neatly in a can. I rolled out my mat, careful to leave a respectful distance between me and the woman lying next to me. I set my fruit snacks at the corner of my mat, giving into a brief moment of insecurity where I picture everyone wondering why I have candy out in class. “Just focus on yourself, don’t worry about anyone else.” This is a yoga class after all, let it go.

The class was a blend of different positions. Although not too strenuous, I could feel the sweat forming as I attempted to hold each posture with good form. After ending with some twists, we made our way to our backs for savasana, or corpse pose. My legs  and arms out straight, I closed my eyes, feeling the meditative chants of the music reverberating through my body. My breathing became deep and full as every muscle in my body slowly began to relax. Fleeting thoughts danced in and out of my consciousness. I started to feel this strange sensation in my body. I felt heavy, yet electrified. Something is happening. “This is it,” I thought. “I must be having a transcendent experience.” 

And then I heard it. Buzz Buzz Buzz. Beeeeeep Beeeeep Beeeeeep. That feeling I was experiencing was nothing other than a sneaky low blood sugar. The still silence of savasana was broken by my CGM buzzing and beeping in the background. Even though no one knew those sounds belonged to me, I could feel my cheeks flush with embarrassment. Thankfully just in that moment the instructor began to stir the class back to seated position to end the class. I got up and checked Gigi: 52. I opened and ate the fruit snacks.

So I ended up experiencing the diabetic low instead of a yogi high. But it was a good reminder to myself that it doesn’t matter if its the middle of a yoga class or a presentation at work, there are moments when your health is more important. Just as yoga teaches, it’s about accepting what you can’t change and letting go of what you can’t control and instead focusing your energy into living in the now and being your best self.

Namaste.

The boot camp bond

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The sun burned brightly in the sky as sweat dripped down my face, falling on the concrete below. My legs burned as I jumped from one side of the block to the other.

“10 more on this side! Keep going!”
The instructor urged us on. It was halfway through the boot camp class, and today we were outside using stepping blocks, jumping up and down, side to side. 
My body was shaking, I was getting light headed. “It’s just the heat,” I thought, “Your body is just getting tired. Don’t give up now.” I encouraged myself, trying to push through. But this feeling wasn’t exhaustion, it was something different. 
As everyone continued with their workout, I pulled out my glucose meter and tested my finger. 52. Once I stopped, the low hit me full force. I rummaged through my bag looking for my fruit snacks. I couldn’t find them, but remembered I have a whole box in my car. I walked silently behind the class towards my car, ignoring the questioning looks. I grabbed a couple packets and poured the contents in my mouth as I headed back to my mat.
The instructor had moved on to the next exercise. I stood there awkwardly, waiting for my blood sugar to come back up so I could join back with the class. I don’t usually get self conscious while treating a low, but this time I did. I was sure everyone was wondering why I had suddenly stopped exercising, why I was standing there while everyone continued to jump around. When I tried to join back in, my body felt weak and dizzy. I couldn’t do it, I knew I would just have to wait it out. The class is only an hour, and I knew I would be wasting 10-15 minutes waiting to feel better. And while I know this is necessary, I was mad. I was mad that I was missing part of a workout that I wanted to do, that I paid to do. I was mad at how disruptive my diabetes can be. I was mad that I was being forced to eat sugar that I just worked so hard to burn off. And I was mad that my diabetes had singled me out once again.
I sat there as the instructor walked over to ask if I was okay. 
“I have type 1 diabetes and my blood sugar went low. I’m fine but I just have to wait for it to come back up.” My voice was full of emotion. I don’t know why, but this particular low had made me feel vulnerable. I was afraid that the instructor wouldn’t understand. I was fine, I just needed time, but I’m strong and capable. I didn’t want her to underestimate me.

But the instructor looked at me and said something that made me confident that she understood.

“My son has type 1 diabetes.”
I looked at her and smiled, instantly relieved. As a parent of a T1D, I knew she got it, and I knew I was in good hands.

Diabetes Blog Week- Day 6: The Diabetes Lens

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“Back for another year, let’s show everyone what life with diabetes looks like! With a nod to the Diabetes 365 project, let’s grab our cameras again and share some more d-related pictures. Post as many or as few as you’d like. Feel free to blog your thoughts on or explanations of your pictures, or leave out the written words and let the pictures speak for themselves.”

In many ways, diabetes has become a lens through which I see everything in life. Thus every picture becomes a diabetes-related picture. So for this post, I chose 4 pictures that at first glance don’t seem “d-related,” but as you’ll see, my diabetes is there in all of them.
Voted Best Tacos in My City
The newspaper of city where I live decided to have a poll to see what the best tacos in the city are. These are from the restaurant that won first place. Having never been before, my friends decided that we had to try them. I have to say, I definitely agree. But looking at this plate, I see more than the delicious food, I see a complicated equation of trying to figure out how many carbohydrates exactly I’m eating here and how much insulin I need to give.
Spring Is In The Air
On this particular day, my coworker and I decided to take a walk after lunch around the city. Since we’ve been having unusually cold weather lately, we were excited to see that the flowers were now in bloom and stopped to take a picture. My coworker walked out of the office for our walk carrying nothing besides her phone. I on the other hand knew that I had to be prepared while away from the office. As I pulled my phone out to take this picture, I reached into a bag that also had 2 packets of fruit snacks, my glucose meter, and a little money just in case. The thing is, I can never walk out of the office empty handed because I never know when I might drop low.
The New Dress
Wedding season is upon us and I’ve been shopping for some new dresses to wear. With any dress, I look to make sure that I like the style, the cut, the fit, the color, and the material. As I try on each dress I ask myself, will it match the occasion? Is it flattering? Will I get good use out of it? These are the normal considerations. But with every dress or outfit that I try on, I also have to consider my diabetes and specifically, where my pump will go. Does it have pockets? Will my pump show if I strap it around my leg or wear it on my hip? How easily will I be able to access it? My diabetes can influence what I end up buying and wearing.
The Bike Ride
 
Within the last year, I’ve gotten pretty into bike riding. My mom and I would go for beautiful, long rides in the summer together. I love the exercise, the scenery, and this quality time that we spend together. I look at this picture and I see the beautiful lake, my awesome jersey with the Detroit cityscape, and my bike. But what you don’t see are the 2 packs of fruit snacks and granola bar stashed in the pockets on the back of my jersey. You don’t see my CGM and more emergency sugar in the red pack attached to my bike along with my phone, ID, and insurance card in case of a real emergency. Having diabetes means always having to be prepared, especially when you’re out exercising.

Going to Extremes

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Two nights ago I had one of the highest blood sugars that I can remember in years. I wrote a whole post about what potentially may have led up to it, where my self-management went wrong, and just how horrible the experience was. I was ready to publish the post today, but then last night I had one of the lowest blood sugars that I’ve had in years as well. I can only think of 2 other times in the past 13 years when it was this low. I went from 515 one night, to 22 the next (for those who aren’t familiar with blood sugar numbers, I strive for a blood sugar around 100-120).

Both numbers are scary. The 22 was much more of an immediate danger, but the 515 was disappointing, perplexing, and just overall awful. Both numbers are extreme. Both are dangerous in their own way and both have left me feeling out of sorts.

As I write this, my blood sugar is at a comfortable 125, clearly recovered from both incidences. I’m mad at myself, especially for the high number. I know that it’s my fault. I wasn’t as vigilant and careful as I should have been, and because of that, I faced the consequences. Looking back there are certain moments where I could have intervened earlier so that the results weren’t as catastrophic, but at the time I did not realize how important those moments were. Even with the low, I heard my CGM buzzing, but I ignored it because I felt fine.

The high number was in part a result of my first spinning class.  Before I started the class I checked my blood sugar. It was 248. This number is too high, but I figured the intense exercise would lower it (my first mistake) and didn’t want to drop low during the class. So I didn’t give any insulin and disconnected my pump.

When I finished the class, I took out my CGM Gigi, but it was giving me the out of range signal and hadn’t been tracking my blood sugar. I should have tested my blood sugar at this point, but I didn’t. I went home and ate a low carb dinner, but I forgot to bolus for the few carbs I did have, only making the situation worse.

It was now a little before 10 and I started to recognize the symptoms of a high. I took out my meter and tested my finger. 439. WHAT?! That can’t be right. I tried a different finger, 498. Shit. One more finger, 515. At that point a said four letter word that I will not write here. I immediately took out a syringe and gave myself a shot of insulin and changed my infusion set. At this point I started to feel really sick, the nausea had started to set in. I laid in my bed feeling awful. It wasn’t until around 1 am when my blood sugar finally returned to normal.

I honestly don’t know what caused the 22 or why I didn’t feel it sooner. I must have overbolused for my dinner and just didn’t feel the symptoms early enough. I didn’t believe the number on the screen at first, testing 2 more fingers for confirmation. What was so strange about this low was that even though it was so drastic, the symptoms weren’t as strong as even when I’m in the 40’s or 60’s. Probably why I didn’t catch it earlier in the first place. I know that much lower I am at risk for passing out, so I ripped open 2 packs of fruit snacks and chugged some orange juice. I didn’t care if I went high, I just needed my blood sugar to go up. And it did, it kept going up and up until I was woken at about 2 am with a blood sugar now in the 300s. Clearly stuck on a roller coaster of highs and lows, I gave insulin and went back to sleep, waking up to a low in the morning. Low, high, low…it’s exhausting. And frustrating. And annoying.

No more extremes. I can’t take it. Even though it feels like my diabetes is all I think about at times, I have to do better. I have to be more vigilant, more cautious, more disciplined. I know it’s my responsibility. I cannot have another night like the past 2 nights, I hope that I never see either of those extreme numbers again.

The Problematic Pizza

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I’ve always tried to make my diabetes fit into my life, not fit my life around my diabetes. It’s a subtle distinction, but it makes a big difference. I generally haven’t changed my diet much since being diagnosed 13 years ago. I stay away from juices and regular pop and moderate what I do eat, but I rarely say no to foods. My philosophy has always been give enough insulin and anticipate the spikes in blood sugar it may cause, but you can still eat it. I’m not saying this is the best philosophy by any means, and my blood sugars have reflected that. But it’s the philosophy that has gotten me through my teenage years and early 20’s. I’ve read blogs where people talk about skipping meals because a blood sugar was too high, not that there’s anything wrong with that, but I’ve never been one to do that. “If it’s high, I’ll just eat and give more insulin, it will come down eventually,” was my thought process. Maybe not always the best decision for my blood sugars, but it was the decision I would make…until yesterday.

I had just finished my workout. Typically exercise drops my blood sugar, so you can imagine my surprise when I poked my finger and saw the 350 on the screen. I wasn’t feeling that well, and I realized that the feelings I had attributed to my workout was actually being caused by the high blood sugar. It was time to change my set anyway so I put in a new site and gave a correction. Then I went downstairs for dinner. It was pizza.

Pizza is a nightmare when it comes to blood sugars, for me at least. With all the complex carbs, it tends to skyrocket my blood sugar and I even change the way that I give insulin for pizza. Pizza is risky with a normal blood sugar, but starting in the 300’s is just asking for trouble. Even though in the past I probably would have given insulin, eaten it, and hoped for the best, I knew I couldn’t do it this time. So I refused the pizza, a difficult feat because it looked and smelled so delicious. I told myself that I could have a piece when my blood sugar was under 150. So I made myself a salad instead, allowed myself a small bread stick, and waited. I waited, and waited, and waited. Pretty soon it was time for bed, my blood sugar lower, but still at 190. No pizza for me.

I know people make dietary choices like this all the time. I know there are diabetics that would never dream of eating pizza. But for me, this decision was a big one. It felt like an “adult” decision and I was proud of myself for making it. Had I eaten that pizza, I probably would have faced high blood sugars for many more hours instead of the steady decrease that occurred instead. Although I gave up something that I wanted in the present, I knew I was making the better choice for my future. I didn’t get my piece of pizza, but life went on. And before I knew it, it was breakfast time with a blood sugar of 75.

One Annoyed Biker

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Dearest Gigi (Dexcom G4 CGM),

I apologize for how long it has been since we last talked, but really I saw our lack of communication as a good sign. Things were going so smoothly that I felt no need to address you personally…that is until recently. I think we both know what I am talking about, but allow me to refresh your memory.

It was the day of my big bike ride, 36.5 miles, an organized ride through the city of Detroit put on by the health system where I work. I had been training for weeks for it, building up for the long ride. I was prepared. I had plenty of fruit snacks and granola bars stored in every pocket in case I got low. In order to save room in my little bike pack, I decided to bring you, Gigi, and forego the bigger and bulkier finger prick glucose monitor. I figured you’d be perfect for this type of event. I could glance at you and see what my blood sugar was and if it was rising or falling. I wouldn’t even need to stop riding to check you. Plus you are so much smaller, you could easily fit in my pack.

My blood sugar had been running high, but I wasn’t worried. I knew that biking for 3 hours would drop it. I was just hoping that it wouldn’t drop too low while I was riding.

I checked you right before the ride started at 9 am. You were giving me the “out of range” sign, which made sense since I had walked away from you. The race started. You were stored under my seat in my bike pack. I didn’t think about you for the first 10 miles or so. Then I pulled you out to see what my blood sugar was doing. ???. You were giving me the question marks. Are you kidding me? Why weren’t you working Gigi?! I needed you. I had no other way to check my blood sugar on this ride.

I rode on. I paid attention to how I was feeling. When we got to the halfway point, I could hear you yelling at me from the pack. “Low, under 55.” I knew that wasn’t true, I didn’t feel low, let alone that low. I ate a banana and half a granola bar, but didn’t give any insulin. I didn’t know what my blood sugar was, and you couldn’t be trusted. You were suppose to tell me, Gigi! Maybe I should have eaten the whole granola bar. I didn’t know!

We were at 28 miles. I was starting to feel “off”. Was I dropping low or just getting tired? Gigi, you could have answered that question. I wanted to be safe so I ate a pack of fruit snacks and kept riding. We finally reached the end. It was a little after 12 pm.

Then the craziest thing happened. You started working! And you have been working fine ever since. But Gigi, where were you when I needed you the most?! It’s as if you were trying to spite me, working right before and right after my ride, but nothing in between. And you’ve worked fine on other bike rides, so I don’t know what your deal was today. Your behavior today was unacceptable. I’m disappointed in you and frankly kind of pissed off. Thankfully everything worked out fine, even without your help. You also reinforced the lesson to always bring back up. When I finally tested after lunch, I was 144.  But you completely abandoned your primary task and purpose and really let me down.

So no thanks to you Gigi, I successfully finished my first bike tour! All I can say is that next time, you better show up!
Sincerely,
One annoyed biker