Sometimes…

Diabetes,

you hit me like a ton of bricks.

Right when I think I’ve got it down (being a pancreas),

you remind me…

I’m not.

Nope.

In fact I’m not even close.
Well I’m somewhat close.

Today I walked to work.  The snow has all but melted and the sunshine was hot on my back this 60 degree February day.

And getting back home as the sun was setting over the mountains I thought about how even, how stable, how consistently under 150 my blood sugar had been.

Somehow my memory had erased the hour long low that hit after I finished teaching a yoga class, blurring time like a sand sculpture, an orange, pretzels, half a cookie eaten…

And I felt like the boss of diabetes.

Until tonight – Strangely after cooking a balanced meal, which isn’t always my reality, these busy days.

Grass-fed ground beef, broccoli steamed, and a few slices of baked Japanese sweet potato and purple potato with butter.

I’ve had a real potato craving for the past few days – unusual for me.

And now, 239, I wonder….

How can I be so relentlessly optimistic to believe for a portion of everyday that my blood sugar will never again go out of range?

But I am that hopeful (blissfully delusional).

For a few precious moments everyday,

I believe that it might be the way it once was,

when I didn’t even have to think about it.

Asheville: City, Mountains and Sky

My writing and experience is heavily influenced by managing Type 1 diabetes, which I’ve been doing for the past 8 years.  My experiences, “Living fully with T1D in mind” will be the major current of this blog.  Having diabetes has changed my life in innumerable ways, and through meditating and processing and writing, I strive to capitalize on the joy and teachings that have come into my life through my journey with a chronic condition.  We all have some sort of chronic state we battle (or dance) with, even if it’s the force of our habits and history.  For me, joy and openness have been a product of acceptance and adaptability.  

WordPress is a new space for me.  I’ve previously been blogging at: http://sweetadventurer.tumblr.com/ and thought that I might recopy everything here.  Instead of doing that I’m just going to start fresh at this point, but reblog my past entries from time to time because our past informs our present! 

Asheville City, Mountains, and Sky

My favorite view from a downtown spot that never disappoints

Kayakin’ with Diabetes

October 2013

imageOmnipod on the water, a success.  As a paddler I try to be  more minimalistic than other times, which can be a challenge with diabetes.  But my boat is a Wavesport XXX, an old model from 99’, with no foot space, no cockpit, not much space period.  I fill the back with a throw rope, a big yellow sponge, and two pelican cases full of snacks and supplies.  In one case I keep a quick dry cloth for blood sugar checks, my ‘river meter,’ a novolog and lantus pen, 3 pen needles, 4 alcohol swabs (never know when somebody’s gonna scrape a knuckle), and some glucose tabs.  In the other I keep my glucagon kit, a granola bar, 2 disposable eye drops, and some other snack; today it was beef jerky.  I leave my pdm in the car, maybe in a cooler away from the freezer pack itself, because if you’re swimming, you want to worry about your boat, your paddle, and yourself, not your $1000 piece of durable medical equipment!

Then there are my water shoes attached with a carabener, a water bottle, and extra dry layers.  That leaves barely enough space for me.  Despite being strapped into a tiny container, half boat, half woman, there is something incredibly freeing about being one with the boat.  Couple that with finding the river’s line of least resistance and surging down a rapid – blissful and riveting.

Paddling is always a great reset for me, giving me that experience of being absorbed in the present by its very nature.  Holding that feeling all day and using my body to accomplish a goal helps me remember what it is like to be fully present, not puzzling or planning.  Diabetes sometimes can be a hard balance between planning ahead, reflecting back (often analyzing and criticizing), and going with the flow of the moment (with all of its unexpected holes, strainers, and whirlpools).  More and more I’m learning that both are necessary to be healthy, happy, and move forward.  For me a successful day on the river means advanced planning for blood sugar management so that I can focus my attention on the river and not on diabetes.

I use checklists.  It’s taken me a long time to realize that I just can’t keep everything I need to have organized in my head, much less my home, without real, printed-on-paper checklists.  When going out on the river I use the five finger test:  boat is your thumb, then each finger is helmet, life jacket, paddle, and skirt.  It doesn’t matter the order though because basically if you miss any one of those you’ve got to borrow or go back.  Now layer onto that all there is to keep up with diabetes on land: meter, test strips, insulin, extra pods, batteries, glucagon, glucose, alcohol swabs, etc.  Maybe you’re paddling the Nantahala, one of Western North Carolina’s icy beauties, so you need to have warm layers, a dry top, extra dry clothes in the car.  Perhaps you’re like me and you’re always voraciously hungry, especially after being a little cold and using your muscles all day.  That means snacks in the car for your return.  My favorite river snacks are beef or turkey jerky sticks, nut butter packets (try ‘Jason’s’ almond butter, peanut butter, and chocolate hazelnut butter in single serving packets), and celery, apple, and carrot for dipping.  Today I made a sandwich on ‘Farm and Sparrow’ bread from the local tailgate market spread with sunflower butter, layered with avocado slices, and splashed with balsamic vinegar.  I’m an exploratory eater.  Nothing to spoil and the river keeps it pretty cold anyway.  I like to eat relatively low-carb on the river but have back up carbs in case I go low.  I find that the less fast-acting insulin I can take the better to minimize the risk of lows.  That being said my basal needs seem to go up from both the cold water and the muscular exertion.  My big safety trick is keeping a honey zinger packet in the front pouch of my life jacket.  They can get pricey at $1.25 a piece, but the bulk packs are available at a lower cost from multiple sellers on Amazon.  I definitely have glucose tabs in my boat but the zingers are packaged in waterproof plastic (nothing worse than a soggy luna bar), easy to eat fast and you don’t even have to chew.  That’s helpful if you have to get your blood sugar up and can’t find a place to eddy out.  Of course trying to paddle, tear open a packet, and eat honey, is not ideal, but with diabetes you’ve always got to be prepared with the back-up that will let you do what you got to do, if you’re going to do it at all.

One of the last two check-boxes on the list is a great group of friends with some experienced paddlers in it, at least one or two.  And let them know you have diabetes.  Be that girl who introduces herself with, “I’m Katie (insert your name, don’t steal mine), I love to get outside, meet new people, and I have type 1 diabetes!!”  And give your glucagon kit to that seasoned paddler who has a dry bag.  Don’t keep it in your boat – because if you flip over and your boat is one place and you are another, well, what good is it going to do you then?

Final check-box: plunge in.  Check that sugar thirty minutes before you get on, check it two minutes before you get on.  Check over what you need to have with you all day in your boat, check it over again.   Flex those muscles, stretch the skirt with all your might over the cockpit, and launch into the rapids.  Now you’re a boater as much as your a diabetic.  We become whatever identity we embrace.

I am a boater. 

I am a diabetic. 

I am a planner.

I am an adventurer.

A friend I met on the river who organizes trips for a WNC paddlers meet-up group got me in touch with a friend of hers who is getting into paddling now that she is landlocked and her first love, scuba diving, isn’t easily accessible.  Her friend has lived with type 1 for forty two years.  Now that’s inspiring!  When we were getting to know each other over email she wrote me, “I love the water because it fills up what life drains from me.”  Type 1 diabetes can drain out quite a bit.  The background stress, the wondering, checking, assessing, judging, criticizing – all of that takes something from the rawness of our experience.  Like my new friend, the river rehydrates my soul as well.  I have found no faster way to feel the pulse of nature than to be taken in by the current of a wave train and merge with the force of the water.

A Backpack and a Paper Home

September 2011

Well, it’s been a long, busy road since my last post – taking me out of N.C. and into France. From there I traveled through Switzerland, into the edge of Austria, up into the corner of Germany and back again to my home base in the Loire Valley. Along the way I stopped in Zurich, Montreaux, Chamonix, and other parts of France. I carried my insulin in frio packs from hostel to hostel, sometimes finding a refrigerator and sometimes continuing to re-wet the pack every day or so to keep them cold. I ate an elaborate array of cheeses and pates in Paris, sausage and pretzel breads in Austria, and not much in Switzerland since everything was so expensive! It was a bread-filled time for me, lots of baguettes and butter, but also a lot of walking. Traveling for 2.5 months without a car necessitates a lot of time on your feet. And for a month of that I carried a 40 lb. backpack with me, full of medical supplies, clothes, hiking boots, and the essential memory recording equipment; a journal, camera, and two sketchpads. This was a solo adventure for me in many ways, even through the times that I was with friends or my french family. It was part of my journey towards feeling unrestrained, and yet in many ways I did feel constricted for parts of it. I realize in hindsight how that has opened up my life now; how like in yoga class after an intense twist your body is filled with oxygen and energy once you release the bind. I feel a new sense of direction and motivation after my trip that releases at unexpected moments.

Diabetically speaking, carrying my supplies was less of a hassle and challenge than I expected. I guess I’m getting better at it. When I traveled in Costa Rica during my Junior year of college, I had a lot of scary lows, a lot of fear over not having my supplies or finding myself unprepared and without access to what I needed, food or medical-wise. But even though I traveled for much of the time alone, staying in hostels where no one knew I was diabetic and even if I’d wanted to tell them I might have had to do it in German (French and Spanish I can do, but there are so many languages in Europe!), I don’t have any poignant memories of diabetes impeding what I wanted to do. Realizing that makes me want to shout with joy. I have become accepting of this condition to the point that I was surprised to suddenly recognize at some point that I had not been thinking about it. That is like stage three acceptance! (I have a feeling there are many more stages).

So I want to talk more about the trip, but my brain is already catapulting into the future with dreams and plans of my life as a nutritionist, diabetes educator, and food policy activist. Maybe I’ll never call diabetes a blessing in disguise, but it is really powerful for me to admit that having this condition has and still is shaping my passion, my drive, and my relationship with my body for the better. It is even shaping my career choices at this point, and I am so excited to be on the cusp of dealing with this global epidemic that is such an indicator of the pressing issues of our time. The rise in diabetes correlates with our disconnection and disharmony with the Earth, it follows poverty and economic inequality, it speaks to racial and economic separation, it illustrates how our lifestyles and priorities have so rapidly changed, largely affected by media and marketing.

Whoo, I feel I’m off on a tangent. I am experimenting with using this technology information share free-for-all as a way to be more connected, not less so, and I think blogging is an amazing way to empower the individual. Between managing a new job and diabetes it’s hard to find time to write, but writing is one way I manage my stress, and stress is the main culprit in my diabetes management. I kept a journal all through my trip and wrote in it nearly everyday – I think it served as a friend and comfort to me through my lonely times, of which there were many. Journaling for me is a way to jump into a self-expression that requires no explanation, no background, and no structure; no sense has to be made. It almost always grounds me when I am floating for some reason or the other, maybe it’s traveling, searching for a job and purpose, or uncertainty in my relationships. It is for me, and it is simple. In a world of complicated diabetes management that changes everyday, my journal is stable and always ready to listen. In a strange way it holds me accountable to myself as well. I have read back over past journals and realized that at some level I knew all along whether a situation was going to be healthy or sustainable for me, even if I have not always heeded that intuition. I’ve realized too that I have the power to view diabetes as a blessing and the lessons that it has brought to me as gifts, all through reassuring myself before I ever needed reassuring. It is powerful and amazing to honor yourself by recording whatever speaks to you in the moment.

Diabetic Backpacking Pack List

October 2011

SUPPLIES
Take an Original + a Back-up that you store somewhere different in your pack or in your partner’s
Glucagon kit (know how to use it and teach your hiking partners)
Meter + xtra batteries
Test Strips
Pen Needles (double what you’ll need)
Syringes (as many as you’d need if your pens malfunction)
2 forms of each insulin you use
Example: Novonordisk insulin pen
Novolog vial
Lantus Flexpen
Lantus Vials
What if your vials break! What if your pen breaks? Do you have backup? Do you have enough of a method of delivery (pen needles/syringes) to use just one form for your whole trip?
Hand Sanitizer
Hand Wipes
Lancets
Lancet Device
PELICAN CASE!So useful for all water susceptible devices and supplies. I keep my meter, test strips, a few pen needles, and an insulin pen of each type in my pelican case along with some hand wipes. One kit for all your diabetic needs during a break.
Frio Packs!Another wonderful invention that is especially useful on the trail. Frio packs have an inner layer of dry crystals that retain moisture and keep supplies cool. The packs can be re-wet in a cold mountain stream when they begin to warm up and dry out.

FOOD!

Essential food supplies will cover all of your carbohydrate needs if you are low. In addition you will need power food that you can snack on and enjoy that won’t be pure carbohydrate. Here are some tips:
Bring a lightweight mug and a spoon!
Straight-up carbs:
* A full plastic tube of honey – I take 12 oz. and have made it through half of this on just a one night trip. Be over prepared.
*granola bars
*dried fruit
*crackers*Fruitabu organic fruit roll-ups (taste good, no added sugar, organic fruit!)Real Food food:Breakfast Example:*Organic instant oatmeal packets (3 for two people) – add hot water – add freshly picked mountain blueberries – add walnut pieces
+ Coffee! = hot and delicious and slow to release carbohydrates
Lunch Example:
*Low-Carb spinach tortillas – I like “OLE Xtreme Wellness
+ powdered hummus (fantastic foods) just add water (the oil is superfluous)
+ fresh basil leaves+ Shelton’s Turkey Jerky
Note:  chew well, turkey jerky is not your usual sandwich meat.
Follow with one low-carb whole wheat tortilla spread with NUTELLA, sprinkled with cranberries and walnut pieces
Dinner Time!:
Darn’ Good Chili from Bear Creek or Bear Mountain, something along those lines
(just add hot water, stir and simmer
+ Dr. Kracker crackers in pumpkin seed cheddar flavor as edible spoons
* throw in a can of veggies, fresh herbs, or eat with carrot sticks for some fiber and nutrients
* munch on jerky for protein, or just enjoy plant protein from the beans

On one or two night trips simply rearranging a few ingredients has proved delicious and different enough to keep us pretty happy.

Miscellaneous Considerations:

*Bring a phone but keep it turned off so that you can check the time but not risk receiving a call if you hit an area with service.  What a bummer to hear a phone ring in the woods.
*Coffee
*Warm clothes, especially rain gear should always be in your pack.  The first trip of the summer we did was in June and by afternoon we were soaked and freezing despite leaving the city on an 85 degree day.
*Extra contacts and your glasses if you require them
*A headlamp! + xtra batteries
*nutella
*Water bottles (@ least two nalgenes each)
*Water filtration system (We carry a pump and laser purifier) + backup (either iodine tablets or xtra method)
*a Map (and know how to read it)
*Flame Orange Vest (if you’re going in hunting season)
*a lighter and matches
*coffee
*Sock Liners (no more blisters protect those feet!)
*bandaids + first-aid kit, benadryl, neosporin, alcohol wipes, etc.)
*biodegradable soap for poison ivy contact, dirty hands, etc
*t.p. and trowel
*plastic bags
*nutella
*Swiss Army Knife
*Camera!
*and all those other backpacking things you can find out about online or in an REI catalogue or from friends who go, like a sleeping bag, etc.
 – This is by no means a comprehensive list, it is just the things I’ve found particularly helpful/essential for me on the trail. I would say to make a written list of your diabetic supplies and pack that in advance, ensuring you have functioning supplies and backup.  Go over your list and go through a typical day in your head to make sure you don’t leave any supplies out.  Teach your partner/s about diabetes and your routine, as well as what changes to look for in your behavior that would indicate low or high blood sugar.  Teach them how to use a glucagon kit.  You should have a kit and your partner should have one in their pack.  Honey is a particularly valuable carb because it can be squeezed directly in your mouth if you encounter a severe low without the risk of choking.  Tell your partner/partners that if you are coming up from a barely conscious or unconscious low, to roll you on your side to avoid choking risk because vomiting is likely.  These things do not make for a very sexy talk, but the more you and your partners know the more you can enjoy your trip and not worry about your health.