Revisiting my new year’s resolution

I’m using the bonus hour that I acquired this morning when a low blood sugar woke me up to write this post. Last night I couldn’t fall asleep. I was pleased that my blood sugar was in the 80’s, having come up from a slight post-dinner low and stabilized at this most ‘normal’ of levels, but I had the nagging feeling that it wouldn’t last through the night.

See here is my big blood sugar-sleep dilemma: earlier in the week I’d had a bedtime snack close to bed and woken up with high blood sugar the next day. I was frustrated by this, but I had slept wonderfully. I find that the snack helps me fall asleep, but presents the challenge of usually requiring a little bit of insulin. Just the right amount though – too much and I’ll wake up low in the middle of the night (which is kind of dangerous you know), too little and I’ll wake up parched and drowsy the next morning (high bg).

So last night, I managed to avoid the bedtime snack. I’d brought up my low with a little bit of fruit right after dinner and then coasted. But being so close to 80 mg/dl made it hard to fall asleep and then I dropped over night.

Instead of sleeping this morning I’m doing research. I want to experiment with some of the food recommendations made by Adam Brown in this month’s issue of Diatribe. I think if I can find more foods that fill me up at dinner time without spiking my blood sugar, I’ll have less of a desire to snack later on.

There is always something great in Diatribe! I am amazed at how much I enjoy it and find useful diabetes wisdom every time I drop in. Check out the links above to see for yourself.

Finally, just in case you aren’t already in awe of sleep, I’ll leave you with this Radiolab podcast about its powers.

Applying for Marketplace Health Insurance

Last Saturday I graduated with my Master’s of Public Health! I’m so excited for everything that’s ahead of me, except losing health insurance coverage on May 31st.

A friend and I who help each other get through life’s hurdles, sat down to apply for marketplace coverage together. She just turned 26 and has had to go off of her parents’ health insurance. As for me, my coverage as a student research assistant only extends to the end of May. Because having health insurance is vital for all people, but especially those living with diabetes, I wanted to share my experience with the process.

Website screening tool: First I went to www.healthcare.gov and clicked the big green button that says “SEE IF I CAN ENROLL.”

Turns out after entering all of my info that losing coverage was a ‘qualifying event,’ so I was eligible.

Creating an account: At some point I had to create an account – which I did. The security questions for this process were really funny to me – I would suggest writing your answers down somewhere because they weren’t the easiest to come up with.

What if I don’t know?!?: The hardest part of using the screening tool and applying was estimating my income. I’m at a point where my income is in flux – my hours at work and the way I get paid are changing. I’m also hoping to find full-time employment soon and know that if I do, my annual income will be different than what I’m able to estimate now. Dealing with that uncertainty is hard, but in keeping with all recent blog posts, it’s just a part of life. In this context, the instructions make it clear that it’s important to update your account frequently if your income changes. There is also flexibility with how much of the premium tax credits you can use if you qualify, which can help those whose income might change.

Premium tax credits: Based on my current income, I qualified for a substantial premium tax credit which I could apply towards my premium when selecting a plan. I didn’t realize this before beginning the process, but you don’t have to use your whole tax credit each month, rather you can choose to use only part of it and have the rest applied as a credit at the end of the year when you file taxes. On the flip side, if you use it all and then your income goes up, you may have to pay back in some of it on your taxes. It wasn’t super easy to decide how to use this information, so I just elected to use enough of my credit to make my premium manageable each month.

Selecting a plan: This step involved a lot of reading and deliberating. The website helps to point you in the right direction by allowing you to enter your preferred doctors and prescriptions to see if they are covered under various plans, along with the level of health care you plan to use. For us people with diabetes, that’s a really hard one to estimate. Additionally, I was frustrated that no matter how I wrote ‘test strips’ or with what brand name I used, I could not get the system to register them under preferred prescriptions. Hopefully others will have better luck with this. Ultimately I chose a plan banking on at least one type of test strip being affordable. I’ll report back on my experience with this once coverage starts.

More documents: It seems like there are always more documents. I have to prove that my health insurance coverage is ending, so I have to send in a document/letter to this effect by the end of the month. Oh and I have to pay for the first month, which I can’t fault them for. What I did like about the process is that you could begin the application and revisit it and then select a plan and confirm enrollment before having to send in the supplementary documents or payment. This way, I was able to move forward and secure coverage that will begin June 1st, even while gathering my other resources.

Overall experience: Applying for marketplace health insurance coverage is not easy per se, but it is doable. My personal suggestion (based on my typical approach to things) is to get the process started, create an account, do the eligibility screening, and then know that you can find the information you need and log back in once you have it to complete things. If your situation is not very clear cut, I think it’d be really helpful to have a navigator (i.e. real person) to help you through the process. At our school there is an insurance office above our student health clinic and I’m assuming this is the case at many universities. During open enrollment, volunteer navigators are available to walk you through the process, and although I don’t know if that is true at all times of the year, I suspect real-person assistance is available and would be helpful. If you have experiences with this, please leave a comment with your thoughts!

How to beat the springtime blues

Springtime blues? “What’s that about?” you ask. After about four years of consistently feeling miserable for about a week every April, I think I’ve finally realized that for me, something about springtime wreaks havoc on my diabetes management.

I find myself suddenly feeling sluggish, cloudy and hungry.

My blood sugar levels go up and stay up, like they’re stuck on a higher plateau.

Insulin just doesn’t bring me down like it typically does and because I’m running higher, my appetite increases and I just want to eat…carbs.

And then all of a sudden the insulin will bring me down like a ton of bricks and I’ll be arrested by an intense low blood sugar.

So…I have some hypotheses. It does make sense to me that the same inflammatory response caused by seasonal allergies would not be so great for T1 diabetes, which by its nature is an inflammation of the immune response. My friends with T1D have turned me on to some research to suggest that springtime is a hard season for many people with various autoimmune conditions.

Spring is also a time of new beginnings, change, waking up from winter and everything suddenly gets so busy. In this space of having so much to do and so little time to do it (and feeling like my head is full of pollen), my typically stress and diabetes management technique of daily concerted exercise hasn’t been as attainable. So I’m here to share – with no guilt – that this week I got a massage.

This was actually my second of two 30 minute massages with Monique Kennedy, who I recommend highly if you’re in the triangle area. Check out her practice: Exhale Massage Therapy – where you can book directly online.

And the name really says it all – exhaling (a topic I’m excited to write more about soon) and its partner inhaling are so hard to prioritize and yet so very beneficial. Since the massage and the reminder to breathe deeply, to prioritize resting and recharging, my blood sugars have been just a little bit more ‘normal.’

I’d love to hear other people’s experiences with autoimmune conditions and spring time and about massage as part of a healthy life!

Calling all people with diabetes!

Community Discussion: High Blood Sugar (hyperglycemia)

How do you pick yourself back up emotionally when you have a high blood sugar reading that frustrates you? Please weigh in in the comment section below! I think we could generate some good wisdom amongst ourselves!

Oh, and if you don’t have diabetes, please share this link/blog with someone who does…I know you know someone who does. I’m really hoping to build this community and you are an important part of that effort!

¿Por qué bailar solo?

Hay mucho sobre que pudiera escribir, pero quiero empezar con una discusión sobre la palabra ‘prójimo.’ Esta palabra ha entrado mi mente y mi mundo mucho recientemente, y estoy pensando en lo que significa ser una buena prójima. Otra palabra que ha entrado es comunidad. Fui a una comunidad ayer adonde es evidente que hay esta idea de vivir, en las palabras de una residente, “de una manera interdependiente.” Es, dice ella, una alternativa de vivir tan independiente, sin reconocer que somos dependientes el uno del otro. Por qué es tan dificil en nuestra cultura (en todas las culturas?? Algunas más que otras??) a aceptar que no podemos hacer todo por nuestra cuenta. Por qué se da tan mucho miedo ser vulnerable y aceptar ayuda? Pienso que es una funciona de nuestras percepciones sobre la relaciona entre nosotros y los demás, o sea, entre nuestro mundo interior y mundo exterior. Es aquí adonde traeré diabetes entra la conversación. Está semana me caí por las escaleras. Le di un asusto a la mujer que estaba subiendo desde la otra dirección. Fue interesante que mis movimientos y la acción a mi cuerpo podría moverla también – que estábamos conectadas en esta manera. Luego, en mi clase de bailar con mi pierna doliendo mal, me di cuenta que mi azúcar fue muy bajo y que posiblemente era por eso que caí. El nivel de azúcar dentro de mi cuerpo influye mis movimientos en el mundo. Esta es una metáfora perfecta para la influencia que tenemos en nuestros aldrededores. Nuestros pensamientos, creencias, prejuicios, y historias personales tienen un impacto en el exterior sin nos guste o no. Somos conectados. Solo podemos operar en el mundo sin reconocer que dependemos de otros mientras tenemos poder, o sea, hasta que perdemos el control. Para mi, cuando me caí, perdí control. Fue una experiencia humillando, que me transformó en otro cuerpo temporalmente. Este viaje, pienso que es valioso, porque permite empatía. Esto, empatía, pienso que es el ingrediente clave (para mi) de ser una buena prójima. Obviamente, hay otra moral aquí también para mis amigos que tienen diabetes tipo 1 (o 2 realmente), que es, por favor, mide tus niveles de azúcar frequentemente y cuídate cuando tienen bajos. Ahora mi pierna se siente mucho mejor y estoy otra vez pensando en como podemos usar la palabra gratitud como un verbo. Tal vez, si estamos luchando por encontrar empatía, podemos pensar en todas las cosas en nuestras vidas por lo que deberíamos tener gratitud.

H2O

10 things you can do with water (that are great for diabetes):

Brush your teeth – People with diabetes are at an increased risk of periodontal disease and oral health issues

Drink until you’re hydrated – Dehydration can lead quickly to an emergency situation during ketoacidosis

Make hummus (soak chick peas, cook them, achieve desired consistency) – The fiber, protein, and other nutrients in hummus make it one of my favorite diabetes power foods

Wash your hands – When you have diabetes, infections can cause inflammation in the body that elevates blood sugar levels, which in turn makes it even harder to get well

Mop the floor – Clean floors are a vital part of happiness

Flush the toilet – Sanitation, obviously important

Wash your clothes – Although, I read on a tag of one of my ‘Toad&Co’ shirts that ‘clean is the new dirty’ and we should wash our clothes less often

Wash your dishes – Along with the next one, cooked meals are typically healthier than meals out. Keeping your kitchen free of foodborne bacteria is important to avoiding gastrointestinal illness

Clean your (non-starchy) veggies – My favorite diabetes superfood group!

Take your Vitamin D – there’s some promising research out about the importance of maintaining healthy Vitamin D levels for people with diabetes (and all people)  

Interestingly enough, this is also a list of 10 things you can’t do without water. In my town this past weekend we were under a state of emergency for over 24 hours because of over-fluoridation and a water main break (two separate incidences). I had a friend visiting for the weekend, so she and I went to stay at another friend’s house in a neighboring county. We all had a great slumber party and then the ban was lifted.

It worked out so well for me that it was particularly sobering to realize how blessed/privileged I am – in terms of this country and internationally. I was able to afford bottles, access them, and also have a nice place to stay because of my social network. Then too, thinking about the world, how bizarre that we declare a crisis and state of emergency after an hour of reduced water when in some countries people live every day with no expectation of running water in their homes. Why don’t we think about how lucky we are to have clean water that we can access almost anywhere by turning on a tap? If clean drinking water is something you don’t think about every day, chances are you’re privileged in comparison to many people in the world. Worldwide, more than 1 billion people still lack access to improved drinking water. And in many places, global warming and industry is causing water sources that entire communities depended on to dry up completely: Climate Change Claims a Lake, and an Identity (this is a great NY Times article about Lago Poopó in Bolivia).

So I know you may be wondering, what’s the call to action here? Well I’ve got two for you. The first one is to sign up for your town’s Public Health Reserve Corps (PHRC) or another similar organization that will alert you to volunteer opportunities during crises like the water shortage we experienced. The second is to challenge yourself to discover one thing that you take for granted in your day-to-day and learn about what life is like in regards to this element, whether it be water, clean air, reliable transportation, or something else, for people living in another part of our world. Please feel free to add your thoughts, experiences and/or calls to action in the comments below!