Choices

On my first day of grad school, my pod alarmed in the middle of an orientation session and I had to rush home, still unsure if the bus I’d chosen was the right one to get me to my apartment. On the way, my iPhone 4 and I struggled with the spotty internet to email my advisor and let her know I wouldn’t be able to meet her – technical difficulties. That’s not really what I told her of course. I explained it all – because you can’t just explain a little bit of diabetes once you get going. It’s hard to just say “My blood sugar was low” or “My insulin pump malfunctioned.” I always feel like I sort of have to justify that statement with, “Oh and I have Type 1 diabetes. And I’m ok – I’ve just got to handle this.” The good-hearted people of the world want to know that you’re ok, which is touching. It can be really hard to give people who want to help and be there for you some reliable protocol to follow, because so much of diabetes is adapting to the moment. So much of it is being in-tune with your own body and responding in what might seem, to an outside audience, like a contradictory way from how you responded before. Sometimes I eat cake, sometimes I don’t. That doesn’t mean that in one situation I’m thinking about diabetes and in the other I’m not. It’s always there, presenting choices or at least weighing in on them.

This post is meandering because my thoughts are meandering right now. If there could be a central theme here, it’s choices and how they fit into our otherwise unpredictable lives. Diabetes reminds me that I make many choices in the day, from how I treat my body to how I communicate my identity, positionality and needs to others. It also reminds me that no matter how fixated we become on one choice or path or reality, our pod could always alarm right in the middle of it and we’d have to respond. This is another diabetes metaphor, but please don’t let that prohibit you from translating it to your own life if you are a person without diabetes (or not, maybe you don’t like metaphors). I’m just grappling with this – the contradiction between writing and reading our lives, both of which (I’m gently arguing), are quite necessary.

Everything in life I ever needed to know…

“I decided many years ago that a high blood sugar does not define me any more than a great blood sugar defines me. For 42 years I have been chasing the perfect blood sugar. It has never happened for more than a minute just the same as the really high ones do not last any longer.”

– Rick Phillips

I want to give a shout out to change. Year after year, change has stood by me. More than that, change even visits me day to day and moment to moment. So here’s to change: a truly dedicated friend.

Obviously, I also want to give a shout out to Rick Phillips, whose response to last week’s question is today’s featured quote. A big thanks to everyone who responded and added to our conversation around high-blood sugar blues and how to pick yourself up from them. Rick’s quote jumped out at me because of its utility for maintaining perspective as we manage (versus ‘control’) blood sugar and also as we manage (versus ‘control’) life. Last week I was talking to a fellow graduate student, job seeker and swimmer in the sea of uncertainty at a social for public healthers in my program. She mentioned that it’s taken her a year and a half to feel like she’s truly gotten her footing here and now it may be time to shift everything once again, perhaps even in a totally new place. I thought of Rick’s quote – how many ladders of learning and accomplishments and life experiences do we climb up, only to reach the end and realize we’ve moved not to a new plateau of constancy, but simply on to the next challenge? That sounds a little pessimistic I think, but it’s not intended to. Blood sugar management from the accept and let go perspective can sound a little pessimistic to – like, no matter how hard I try, even if I check my blood sugar and get that magic 90 mg/dl, it’s already changing, I can’t hold on to it. But! BUT! In truth, this is a comfort too. This wisdom of letting go is so helpful in diabetes and in life, because it directs us back to the process, not the product.

I think I’d like to make one of those posters like you see on the wall of dentist’s offices: ‘Everything in life I need to know I learned in kindergarten,’ except it would say: ‘Everything in life I need to know I learned from diabetes.’ That’s a little over-simplified though. In truth, not knowing has led me towards these conversations with friends and others that help me to break free from dichotomous thinking and see that there are ways of seeing and thinking about challenges that I have not even considered yet, which is itself a comforting thought.

So change, you may be a wildcard, the guest who comes to the party in sequins, carrying a jello-cake and two days early – but, you might as well come in.

¿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.

My New Favorite Diabetes “Free Food”

I want to start off by saying that I’ve never liked the term “free food,” whether that refers to an edible’s effect on diabetes management, weight, or anything else one might be concerned with. That disclaimer aside, I use the term to mean a food I can eat without immediately and involuntarily thinking about how it will eventually raise my blood glucose, even if only slightly. The list contains beverages such as water, tea, and coffee (although some people say caffeine has a noticeable effect on their bg, it does not seem to raise mine). I do not add anything to my coffee and put only a splash of unsweetened almond milk in my tea.

Which leads me to my newest craze, and revolution, inspired by a friend of mine who does not have diabetes, but who calls this his, “bedtime drink.”

Whole Foods Brand Unsweetened Almond Milk, heated.

It’s just that simple.

I heat it until it’s almost boiling, like as hot as I would drink tea. If it’s right before bed I have it plain. If it’s earlier in the day I’ll stir in a little bit of unsweetened cocoa (antioxidants!) and then sprinkle, carefully, a dash of cayenne on top.

It’s not a sweet drink, and the carbs are minimal: 2 – 3 grams max. My favorite thing to pair it with, depending on my blood sugar, is 2 blocks of any number of varieties of dark chocolate.

I don’t do the cocoa and cayenne at night because they keep me awake. Also, for people who are sensitive to spice, cayenne can be hard on the stomach. After working at an Indian restaurant for two years and learning to enjoy vindaloo sauce, I learned to love spicy.

Lest you be concerned that I’m promo’ing Whole Foods arbitrarily, this brand in particular is my jam because it does not contain carrageenan, which is an additive derived from seaweed that has been linked to cancer in some studies.

Please note (aka Disclaimer #2): I am not a dietician/nutritionist/or otherwise medical expert. My posts are not meant to advise, but rather to simply share my experiences. 

With a Minute to Spare

Chapter 2

So at 8:05 pm I’m sitting on the plane to Miami muttering, “Come on, come on,” under my breath, and hoping they start the engines soon. By 9:00 I felt like I had aged several years and my cortisol was jumping up and down like a jack russell terrier. I had one of those little in-flight tracker screens right in front of me, and although I enjoy many traditional flight hobbies like writing in my journal, doing crossword puzzles, and reading SkyMag, this time all I could bring myself to do, literally, for two hours, was watch that little plane icon move slowly through my home state (Georgia), and onwards towards the tip of Florida.

At 9:05 the estimated arrival time had jumped back from the original 10:15 (which remember would leave me with a total of 5 minutes to make my connecting flight) to 9:44 pm. I would have, calculating time for deboarding, at least 20 minutes of straight running time before the gate to my second flight closed. At this time, I did decide to update my journal. In it I wrote:

24 minutes to destino. Quick update, I’m on the plane. BG (blood glucose) is 320 mg/dl. Was so low in Raleigh that I couldn’t think. Didn’t take insulin for a long time. We are set to arrive @ 9:44 and then depart at 10:20. As long as no gate change I’ll be at F25 (only 20 gates away from where we arriving). I’m going to write an update at 10:40 pm saying I made it, and my BG will be perfect. Then I will fall into a nice sleep until 4 am, then write for an hour. Someday I’ll learn Portuguese.

This was my last journal entry for four days.

Back on the plane, as we declined in elevation towards our destination, I looked at the screen, then back at the overhead compartment, then at my purse, then at all the people around me, in a nervous loop. There were so many people in front of me, and I knew I had to get off of that plane. A flight attendant walked by. I asked her if she could help me. I said, “Hello there…I know this might be a weird request, but my connecting flight leaves at 10:20, and that lady up there, hers leaves pretty soon too, and if there’s any way we can get off this plane, like, first, or sooner, that’d be great.”

She agreed to make an announcement over the loudspeaker. She was very kind.

5 minutes later, as people rustled around and the captain updated us of our status repeatedly, a quiet announcement urging passengers to allow those with close connecting flights to depart first, was made. The attendant warned me that most likely, people would take little heed, especially those in first class.

And yet a door opened. Behind me, a couple on their way to an island off the coast of Florida, anticipating their vacation, had heard my anxious request. “You’ve got a close connector too?” One of the women asked. I sighed. “Yeah, it’s pretty close…” “Yeah ours got crunched with the delay. What’s yours?” she asked. I told her. “OH, that is close. That makes me feel pretty good about ours.” Despite this, she was very sympathetic. ”Here’s what you need to do,” she said. Follow us off of here and we’ll get you pointed towards the Sky Train. You’ve got to get on the Sky Train because where we are, you’re never gonna make it on foot all the way to your next gate. This airport is a giant.”

Now remember, our flight was arriving considerably early. It was 9:40, and we were descending towards a gentle landing. At 9:44 we touched down.

At 9:55 we were still waiting behind several other planes on a slow, slow pathway towards deboarding. Our huge machine idled in the queue. I began to feel flushed and frantic (noticing a theme?).

My friends from a few seats back knew that everything wasn’t going to go as smoothly as they’d originally presented. They amended the plan. “Ok, here’s what you’ve gotta do. As soon as we get up there, and they turn off the seatbelt sign, we’re gonna stand up and make an opening for you so you can get your backpack and get off of here. And then, don’t look back. Don’t wait for us, we’ll just slow you down. You gotta get off this plane and run like hell. You gotta get to gate 11 (9 gates away) and get on the Sky Train. I think you’ll have to go up some stairs…”

At that moment we docked.

The seatbelt sign went off.

My friends stood up, and I began to act.

I heaved my Osprey backpack from the overhead compartment and hiccupped down the aisle, meeting the line as it slowly moved off of the plane. I stepped onto the connecting bridge and could see the light of the airport at the other end, but I was still blocked by a throng of passengers. I tried to wait patiently because I don’t like pushing through crowds or running around other people who I could potentially crash into. So I slowly trudged along, until suddenly, in the Miami airport, at what was now 10:08 pm, I saw an opening, and I made a break for it.

My backpack was flapping on my back because I hadn’t buckled the waist strap and my purse was bouncing repeatedly into my stomach. If I had ever pushed myself this hard in high school track, I might have placed in a race. I had never run like this before. I also had never run before wearing a 35 lb. backpack. There was no one in the airport, no one out in front of me. Which is sort of a figure of speech because there were a few others, walking on the moving sidewalks which had been disabled because of how late it was. After about two minutes of running, my hair flying into my face, cheeks red, eyes wide, heaving breaths from the exertion, I see a business man and I think, he must know how this airport works. As I pass him on my right, I turn my head like a frenzied bull and with panic in my eyes I scream, “Where’s the Sky Train?!” “What?” he queries back. “THE SKY TRAIN?!!!”

I still don’t know where the Sky Train was. He failed my question a second time and I waved my hand at him in dismissal before continuing to sprint through the deserted airport.

Up ahead, one of those little cars was sitting horizontal in my path. As I approached it, I yelled to the conductor, “Please, sir, I’ve got to get to gate F25,” and instead of dodging it, I jumped on (not recommended behavior).

I learned my friend’s name, and where he was from, and that he had no faith that I would make my flight because moments before he had taken the last passenger who they were calling for over the loudspeaker to the very same gate.

I disagreed with him, but I was grateful for his kind presence and effort, nevertheless. We sped (at 5 mph) through the airport. My hair flew behind me, finally out of my mouth and eyes. I began to try to breathe again, although my lungs burned and my chest was tight. I was invigorated, I was going to make it. I had 1 minute before they would close the gate at 10:10 pm as we neared F25.

…To be continued.

Constant Resolution

As I alluded to in a recent entry, open conversation, not being silent, is still key right now. In the spirit of embodying my 2017 theme, I’m going to string together a few pearls of wisdom I’ve picked up from the various people who inspire me every day. Then I’ll talk briefly about diabetes, too.

My head is brimming lately with all these phrases and metaphors that my friends have shared with me as the wisdom that guides them around their busy lives. One of my friends, as we were driving down a street full of piles of leaves and Christmas decorations that had been taken halfway down, shared a quote by Martin Niemoller, a Holocaust protester and survivor, which I had heard many years ago but had forgotten until then. It’s important, and I don’t want to forget it again:

First they came for the Socialists, and I did not speak out—
Because I was not a Socialist.

Then they came for the Trade Unionists, and I did not speak out—
Because I was not a Trade Unionist.

Then they came for the Jews, and I did not speak out—
Because I was not a Jew.

Then they came for me—and there was no one left to speak for me.

So much of what I have to be grateful for in my life comes from the friendships, like that I have with this friend, with wise women and men around the world who are searching for purpose and striving to be all they can be every day. Another friend of mine, who I’ve recently reconnected with, reminded me that we are never through becoming ourselves. And yet another, in a parallel conversation earlier this month, shared a favorite guiding quote of hers, “the most important thing in your life is…your life.”

Translating all that to diabetes management, as is the constant struggle, leaves me with some interesting reflections as well. In 2016 I left the pump and moved back to insulin injections. This was a really positive change for me. Interestingly though, so was the pump when I started with it. Which reminds me that diabetes management, like life, is not a static endeavor. Our needs change and being able and willing to adapt is a sign of healthy coping, not an indicator that we are failing or were wrong before.

Now I’m enjoying more fruit and less wheat, more cooked vegetables and spices and hopefully, just a little less hot sauce and salty condiments. I’m borrowing some wisdom from both my Southern mother and Chinese medicine, that cooking foods, especially in winter, makes the nutrients more accessible to the body and of course easier to digest.

And finally, my 2017 health resolution, both because it directly improves my blood sugar and because it makes me friendlier, is to prioritize sleep. I rang in the New Year with this theme last night. But I’m also hoping that regular sleep will also help me effectively abandon it when I have the chance to work on my last, little, other resolution, which is always my resolution, to dance more.

So in sum, may we never be done listening to each other, learning about life and ourselves, and resolving.

 

A Matter of Perspective

I went to a yoga class this weekend at the gym/community center where I work as the coordinator of preventive health programs. The yoga teacher knew me as such, a coordinator of a program for people with diabetes, not as a person with diabetes. With Type 1, I was still under cover, even though my omnipod sticks out in my tight yoga pants and threatened to give me away.

After a few moments of opening meditation and one or two poses, she walked over to my mat and said, “Hi Katie, nice to see you here.” I was surprised she knew my name, but we had met before and we pass each other in the hallway: usually she walking zen-like to class and me in a half-run back and forth to the fax machine. She squatted down next to me as she spoke and asked me if there was anything going on with my body she should know about like past injuries, issues, or any concerns at all. I scanned my internal landscape silently, and then sort of shook my head and shrugged ‘Nope.’ Usually at a studio I will mention to the teacher that I have type 1 and they may see me eating glucose tablets or drinking juice in the middle of class, but at the time I felt pretty stable in my bg and had my tablets handy, so I just went with that everything was just fine. She looked at me as I shook my head no and began to shake her head yes. She replied almost before I had spoke, “Yeah, you’re a pretty healthy lady,” as if to acknowledge her asking was just a formality, that she could see my health in a force field around me. And I felt a wave of gratitude for this part of me, the healthy part, which is always there with me even when diabetes is throwing me for a loop. The part that exits simultaneously with the other parts that throw me into exhaustion, dehydration, and frustration. We are not just a sum of the whole, but we are who we are based on the perspectives we allow in. So I am remembering today that labeling me with a chronic disease is just medical pragmatism, not the only reality. Find what works for you.