The Seasons of Diabetes

I wrote this post last fall -- and left it to 'simmer' under my drafts, until I felt I could more fully, and more maturely, develop it. 

It's cool outside. The air is crisp, and clean; tinged with so much moisture that I can feel its mist on my cheeks. Wondering home after work, in the early afternoon, gives me pause. The crunching leaves underneath my feet, the neon yellow colors, and the scent of trampled ginkgo biloba wakes me right up. Ginkgo biloba is pungent, that's for sure; it's scent is something between icky bodily functions, and rotting flesh.

No matter though. The heavy atmosphere begins to release a mild rain... and though there's no umbrella and it's quite cool outside, I find myself embracing the very awareness of being alive that the new season brings upon my senses.

I realize, suddenly, that I love Fall. But then, don't I also hate it sometimes? I know I've told myself that before... Why is that?

[Walking gives one much time for thought. Deep thoughts by Jack Handy kind of thoughts, I guess. (If you hate walking for the exercise, well, at least love it for the thinking.)]

So... what is it that I love about Fall, or any season, anyway? The answer is both obvious, and not so obvious; one of those much clichéd "Aha!" Oprah kind of moments. I love seasons because of their promise of RELIEF.

This brief moment of relief brings my soul much healing from the previous season; a much needed break from the burden of dealing with whatever else was before. Yes, relief. You see, I start out loving a season, and then it slowly becomes annoying to me, and outright burdensome... I then get sick of it, or even depressed from it. I get sick and tired of the stupid season! It seems long, and never ending... and there's only so much of -20°F or 100°F (and everything in between) one can tolerate. So, every new season brings me relief from the previous season. It brings me a much welcome change of pace. It brings me an opportunity to love life again. To smile... to take in the wonder of how much nature can change from one moment, to the next.

And it's much the same with diabetes, and our "seasons" of self care, isn't it? We make up our minds to begin caring for ourselves, anew, and start out with the joyful promise of good things to come... and then we get sick of it. We seem to perpetually live in one season, and one season only -- often with little flexibility with our routines; we impose the new "season" on ourselves --with strong militance -- and then we burn out. Then after a little while, we start yet another season, but with the mindset of 'rectifying the previous bad behaviors.'

But, should we change things before our "season" changes us into something we don't want? Maybe we ought to begin a new season simply pondering what lead to the 'bad behaviors' in the first place... I know I'm guilty of it, particularly with my routines. With it's dietary calculations, carbohydrate juggling, testing, supplements, medication management, exercise routines, and doctors appointments -- diabetes can be one long, and boring, and often, depressing season. Some people thrive in that kind of season, just like some love perpetual sunny days... but once in a while, my soul needs a little rain.

So, how do we avoid this cycle? What can we do so that we don't get stuck being miserable, in a crappy season, and completely giving up on diabetes management, over and over again? Well, it's obvious that we're creatures of spontaneity -- we need, and crave change, so wherever we can, we must allow ourselves some flexibility. With this in mind, we must take a moment to consider...

a.) Which things are negotiable; and
b.) Which things are not negotiable.

And we must be realistic. We need to sit down with ourselves, and realize that we simply cannot put everything in the "not negotiable" camp. For example -- as much as I, in principle, would love to eat nothing but eggs, every morning, so that I have the best blood glucose numbers -- I know that I am quite sick of eggs. I don't want eggs all the time; I don't want flax seed meal muffins, I don't want weird food. I want to eat a chicken soft taco, with lots pico de gallo, lettuce, and a little hot sauce. It's about 35-40 carbs. IT'S FINE. My morning blood sugars aren't below 100, but quite frankly, they don't go over 150, either... and I'm okay with that.

Will I have a bunch of cereal, of any kind, for breakfast? No. Cereal is not negotiable for me, and not even because of the spike. It's just not satisfying to me -- psychologically, it doesn't seem like I've eaten anything, and physically, it just doesn't fill me up. It makes me need more food, and I'm not much of a pleasant morning person to be going around, making extra things. I tend to like regular meals at that hour, OR, a light snack and a brunch later on. If we think about it, most breakfast foods are just an excuse to eat desserts in the morning, anyway. So... I'm not going to kill myself with eggs, nor cereals, nor weird substitutes.

Now, in my desire to eat with awareness, what I seek to avoid is binging; that is not negotiable. (As non-negotiable as completely giving up testing.) Overeating may happen from time to time, as we learn our limits -- but binging is not negotiable. So, what does my body want to eat, intuitively, the most? These days, my body wants and craves veggies the most. Non-starchy veggies, and lean proteins. Sometimes, though, I might crave a bit of creamy tomato soup, with a small portion of gnocchi in that soup -- and I can have that. I need to recognize, though, that I will NOT and CANNOT live forever on just veggies, and just protein. That the occasional starch and/or grain is okay -- even if it's not 'whole.' I am perfectly aware that this is not deadly, that it is not untenable, and that some people make the change, without issue -- but if I did this, I know I would soon fail.  I am not a person, psychologically, to endure such a restriction -- to endure deprivation and strict eating rules. I do eat low carb most every day -- but every once in a while, I am OKAY with my blood sugar not being perfectly below 120 after every meal. If it's below 160, sometimes, it'll do. Yes -- it'll do. So... I tend to cycle some days when I eat very low carb, with some when I eat moderately low carb, and with some when I allow myself a treat. Studies have shown that an intermittent low carb diet is still much better at reducing insulin levels in one's blood, than a Mediterranean diet (or standard dieting). We're not speaking of insane changes, here... It's not like I'm going to sit out in the rain all day, because I got tired of sunny days. (No, no... sorry, there's not going to be an "all brownie day." Put down the icing.) But maybe one or two days of splashing in some puddles might do me some good. After all, who wants to go to a favorite restaurant and ALWAYS have to stick to the same food option?

No one. They'd soon fail. So then, we must learn to be realistic, and keep a balance between our own desires for freedom, spontaneity and change -- and our limitations.

Another change in season which we may consider, is simply changing how we view the way a meal affects us. Not every meal is going to be perfectly within blood glucose goals -- but perhaps the bigger question should be: "how well do I feel when I eat it?" Quite frankly, I have to limit heavy breakfasts -- proteins with too much fat, or calories, will make me feel bogged down and sick -- even if they give me great numbers. Most of the time, I cannot handle a great work day, if I'm bogged down in a very heavy breakfast. I also can't eat very bitter or tart foods at that hour, like yogurt, or grapefruit. Hey, I admire the people who eat that every day, and can get away with it -- but it seems to be unsatisfying to me, both physically, and emotionally. On the other hand, a home made tomato soup, with lots of veggies, and a bit of gnocchi -- while giving me blood glucose levels sometimes in the 160s -- make me happy, joyful, and healthy. And the highs do not last very long. Since I've started eating more like this, I've also had better fasting numbers in the mornings -- usually in the 80s.

But perhaps, by far -- one of the things we ought to consider when managing our 'seasons' with diabetes, is to enlist the help of our friends and family. If one has a "Type 3" person enlisted in one's care, one should use this moment now to plan out a 'new season' with them. That could be as simple as choosing one or two weekends a month, where they are the person who makes meals, so that you don't have to be the main meal maker ALL the time. Or, it could be the other way around... maybe we can be the main meal maker, so that we give one's Type 3 a break from having to make our meals all the time. Learning to plan, and prepare, diabetes-healthy meals can be a lot of fun, sometimes.

What concessions are we willing to give ourselves in order to learn why the caged bird sings? Diabetes is a steady stream of seasons; it's best to let ourselves change and flow with the wisdom they bring. I'm only 36, and I have a good 30+ more years with this disease, so I have to learn to run a good race... and be consistent at it. This, for someone like me, is a HUGE challenge... and though I may seem like I have it all together, believe me, I'm still, very much, a work in progress.

I never have quite the same consistent answers about my eating habits, or exercise routine... because well, there is no consistent answer. I simply try to do whatever makes me feel healthy, so long as Mr. Meter approves... and I'm not sick of it. Mr. Meter, though, is going to have to learn to be a bit more flexible, sometimes. Or he'll end up decorating my wall. As you can see by this 14 day average, he can be a real drill Sargent, sometimes... even with those silly, googly eyes.

In order to survive, we need to change our seasons. We need to redecorate, to transform, to change the same four 'diabetes walls' we stare at, every day... because we need RELIEF. 

Sometimes, our souls just need a little rain.

Burnt Out on Judgment: The Not So Simple Motions of Diabetic Living...

This might seem silly... I know. I know I don't have to try hard, or go far, to ask my readers to imagine for a moment being a person with diabetes. (Naw... You don't say!) ☺

But still...! Imagine, for a moment that you're a person living with diabetes, and have lived with it for many, many years... Imagine it's been challenging. You've gone through many phases of burn out, and phases of challenge. It's been a deep struggle, for various reasons:

1. Managing this crap every day is a roller coaster, and well, it seldom likes to actually do what we expect it to do. Einstein once said that "doing the same thing over and over again and expecting different results" was the definition of insanity. I like to call it... Diabetes.
2. You have some white coat person always reminding you if you don't take care of yourself, you're going to die. And NOT in uncertain terms, either. 
1. You'll get retinopathy... 
2. You'll get nephropathy... 
3. You'll get neuropathy... 
4. All the opathies... 
5. You'll get your limbs amputated... 
6. You'll lose bladder function... 
7. You'll be impotent... 
8. You'll have congestive heart failure, or a stroke...
9. You'll go into DKA, or insulin shock...  
10. You'll DIE. 
3. You may not necessarily have many close friendships, in your immediate circle of acquaintances, that can actually understand you. 
4. You have some family members constantly reminding you of the things the white coat person was reminding you... 
5. You have friends, coworkers, and other relatives, wanting you to FORGET about what the white coats, and the other family members, keep reminding you, and then just go live life with them... "just live a little." (And it's always 'living' that's centered around food, or alcohol.)  
6. You have your own deep desires to want to just be NORMAL, or as close to normal as you can be... and "just live a little."
7. You've carried the heavy load of discipline, and care, however individualized your load might be, for a long, long time. You are very AWARE of how serious it is if you don't carry the load. 
8. You get tired...  You burn out. You drop the load.

Now... most of us understand this circle. We understand that it gets OLD carrying the load, and we get burnout. We stop... we go through the motions. Often, we even get eating disorders, etc. 

So we crusade long and hard for our folks, because, we don't want people to think we gave ourselves complications, when they happen. No one consciously says "I'm going to chug donuts! I want retinopathy!" -- Burnout IS a part of chronic illness. It is NOT a character flaw. It is not simply "people not doing their part," or not taking responsibility. It is simply... people being TIRED from taking on so much responsibility. 

By contrast, we may have well been doing 'our part,' and were just genetically predisposed to complications... But the world outside of us does not understand "genetically predisposed." The media doesn't tell ANYONE about "genetically predisposed" -- only about 'you can prevent and avoid complications, if you just take care of yourself.' Why? Because the media is not interested in shades of gray -- the media has a job, and that job is to gain viewership, and ratings. The only way you get viewership, readership, and ratings... is by generating controversy... And the only way you get controversy is by getting folks to think in the inflexible lanes of black and white. And when you scare people about the rising cost of diabetes (uncontrolled diabetes, mind you), and then show them articles about "My aunt Bonnie, who didn't take care of her diabetes, and was irresponsible, etc, etc..." people get MAD. Angry. Unsupportive. Unsympathetic. 

Does that make sense? I'm sure it does. 

Now, imagine a non-diabetic person... living their life as usual. They want to be normal, and keep living, just like anyone else... and as usual. They have the same family members, coworkers, and friends pressuring them to "just live a little." 

They go to their doctor, and hear:  

• "Meh, you could lose a couple of pounds, but you're fine."
• "You maaaaaay, or maaaaaaay not get diabetes down the long road... It's just not easy to say. But don't worry about it. You'll be fine. Just walk it off." 
• "Meh, you're blood sugar is a little high, but you're fine! There's no way you have any issues... Just walk it off..."
• "Nah, I don't think we need to test anything, you're fine... Just walk it off..." 

Now... If it is hard for us to get our minds wrapped around the realities and burdens of illness, when we HAVE illness... Imagine how hard it is for an illness-free person to get their minds wrapped around the POTENTIALS of illness, and some "boogieman" of illness, out there, somewhere, over the hill... that may come, or not come... but they can't really say for sure... It's just some hazy smoke and mirrors thing. Imagine being "genetically predisposed", but only if you trip! "Don't you ever TRIP!" (Of course, they don't ever mention the trip can also be almost anything, besides weight and diet...) 

Sure, hindsight is 20/20. I'd love to go back in a time machine, and slap the crap out of Liz, and tell her "hey, start carrying the load a little sooner!" (Not that it'd be of much help, with all my other health conditions, medications, and predispositions... They are, together, a much stronger trigger than lifestyle...) Some might say I was damned if I didn't, and damned if I did... But I'm not quite sure what I'd be avoiding, frankly... 

"Live sternly, as a diabetic, so that you don't become a diabetic." 

Seems a bit off putting... It might be hard to convince Liz. Especially if no one's serious about the boogieman... It's never around, and just some foggy illusion thing... And EVERYONE says you can get rid of it, if you do get it... (snark, snark) I mean, yeah, we should ALL do our best to be healthy, and everything... but Liz might want to enjoy a burden free life for a little longer -- at least, as long as she can. I mean, isn't that what we long for when we're burnt out? A bit of freedom? Choices? Splurging without going into some diabetic hell episode? Having a little more than a 1/2 cup of moderation?

Yeah, I thought so... What burnt out people want is not that different than what illness free people want. A little freedom, a little empathy, a little break, a little life.

So we should crusade long and hard for folks, because, people should not think we gave ourselves diseases, when they happen. Chronic illness is NOT easy to manage, but neither is it exactly so easy to avoid... No one consciously says "I'm going to chug donuts! I want diabetes!," and most people aren't binge eating disordered individuals... (And so what if some are... People have demons. People fight them as they can... or struggle, as they tire of their loads... Life is hard.) They are just people living... and illness IS a part of living. Illness doesn't really care if you gave it to yourself, or not. It is NOT a character flaw. It just is... It is simply... people going through the motions of LIVING... 

The Greatest Lesson You Will Ever Learn

I don't recall exactly how I got there...

But I think it was just one of those "I'm really unhappy with my body, so I'm just going to go on another diet," kind of moments. However it happened, I had been referred to a nutritionist, or dietitian, or whatever the heck she was, by my Primary Care Provider (PCP) at that time. (My PCP... a man who never cared to talk much about certain things. Including, telling me my blood sugar was high.) 

I sat there, waiting in an office... in the usual weirdness of waiting for one of these folks. Fake plastic foods lining wall to wall shelving, and giant tomes and texts which I am not entirely sure had ever been read. This office was the size of a small bathroom, sterile, and with dark wood paneling to boot. A large, round table, took up most of the room, while a cluttered desk sat at it's opposite. 

"So, what exactly is it that you want?" -- says the woman... doctor, who? I am not sure. She's wearing a white lab coat, and it's making me rather uncomfortable. I thought this woman was just going to help me find a diet plan... why is she being so curt? And why the heck is she wearing a lab coat? You don't need a lab coat to write a frigging diet plan!!! Rather shocked, I explain to Doctor Who that I want to lose weight, that I am not happy with my body, and it's time I got things figured out, with a little help. 

Doctor Who stops to take a very long, stern, look at me. She demands to know what my life is like, and what I do. Of course, at the time (2002), I was in employment limbo -- much like I am now. I lived with a large, religious family, active in the local college campus community, and I minded their kids in exchange for housing. I lived in their basement. Their dark, dank, gloomy, depression fit inducing, basement. I also worked a minimum wage job, with grueling physical labor, and even more tedious hours. I was at great odds with myself, and with my faith, and to top it off, the family and church I belonged to at that time were extremely controlling, and extremely judgmental. One of those types of churches that need to know and control every single aspect of your life, from what to study, to whom to marry. How I got to be in that state, however, is a story for another day.

"I am NOT giving you a diet. You don't need another diet," said Doctor Who, in her Indian accent... really without knowing much about me. "Then...? What am I supposed to do? I mean, I AM paying to be here, after all..."  Her features soften, only for a moment, just enough to tell me that I have an eating disorder.  "A what??" ... "Yes, an eating disorder. You don't need another diet, and I'm not going to give it to you." 

Stunned, I just sat there.  I'm nowhere near skinny enough to have an eating disorder; in fact, I'm quite overweight, even obese. Morbidly obese. (By the way, thanks for that, Polycystic Ovarian Syndrome.) 

She hastily draws up a chart ...  

Explains to me I am living in a vicious cycle, and gives me four rules.  

1. Eat only when you are physically hungry.
2. Eat ANYTHING you want.  Anything at all.
3. Eat only until you are satisfied, not full. 
4. DO NOT SKIP MEALS. 

She then asks that I buy the book Breaking Free from Compulsive Eating, by Geneen Roth, and sends me on my way, though not before telling me that "... but even that won't work, because you're too busy right now, to focus, and need to wait until you're at a better place to make some changes." 

Oh. My. God. Who the hell does Doctor Who think she is? I *payed* her to do what she went to college to do... GIVE ME A DIET PLAN.  And instead, she gives me a frigging book review, tells ME that *I* have an eating disorder, and spits me out of her office, just like that! How dare she?!?! &$^#^%$@!!

Of course... She was right.  She was a total bitch about it, but she was right.  

Through much tracking, and tracing, I eventually found the book... because of course, it wasn't an easy off-the-shelf kind of book, either. It was an old 80's book, and it sat on my shelf gathering dust for a good while before I decided to finally crack it open, sometimes just chancing upon segments, and paragraphs, before having the courage to actually read it cover to cover. 

Now, this is NOT one of those moments where I tell you I've lost a gazillion pounds (which, at times, I have...), and Oprah comes and finds me, and hosts me on her show... or Dr. Oz... or whatever other idiot flavor of the month happens to be. I am still fat. I still binge. I still get up, gather up the pieces of ME, and keep going.  

This is NOT the time when I tell you that that was the most inspirational book of my life; it wasn't. In fact, it's probably one of the cheesiest books I've ever read (and please, never read it while drinking anything... much less soda of any kind).  

But it is the time when I will tell you that I learned what was probably the MOST important lesson of my life... and what should probably be the most important lesson of YOUR life. 

NEVER ABANDON YOURSELF. 

It doesn't mean you are perfect, and will always follow the rules. It doesn't mean you are only relying on yourself. It doesn't mean you won't ever become depressed, nor sad... nor compulsive. It doesn't mean that you need to find 20,000 inspirational post-it notes for your bathroom, either.  

What it does mean... is that whatever you experience in life, or whatever it is you choose to do... BE THERE with yourself. Actively keep yourself company. Be conscious and aware. Acknowledge yourself. 

Acknowledge and OBSERVE from a non-judgmental place the rhythms and intricacies of your emotions... just observe them. No need to judge them. Turn off the TV, and step away from the electronic gadget.  

Do not run away into the occult recesses of your mind while you... ______________. (Enter favored compulsive behavior here, including, not taking care of one's Diabetes.) Acknowledge what it is you need, and seek, and GIVE it to yourself with the REAL DEAL. Not a substitute. 

Know that whatever it is we do, we do it for a reason... seek to LEARN those reasons. 

Allow yourself to be human, and just learn. Learn from the moment. Learn about YOU. Take life... one second at a time. Life will never be easier, or less complicated, like Dr. Who suggested, so just start TODAY. Start with one moment. One action. 

Consider the power of one snowflake... one snowflake every second can lead to a perfect Winter storm. This is YOUR storm.