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Hypoglycemia Chronicle 3: Why Did I Howl Like a Wolf?

I have lost touch with the world outside of my mind at least thirteen times because of diabetic hypoglycemia—low blood sugar–in the last 52 years. I dimly remember the loopy antics during some episodes before I lost consciousness, when I still had the capacity to listen to my own rants and mutterings as the glucose level went down.

But my wife is the only person who remembers one of the most noteworthy incidents. It was her first one, her maiden hypo-voyage. It prompted me to think about two related, intriguing mysteries of diabetes.

We were next to each other in bed, in the early morning. She woke up to find me sweating, pounding the bed with a fist. Perhaps she woke up because of the noise. Or perhaps there was already a primal connection between us, after four months of sleeping together, and her body was somehow synched up with mine.

As she tells it, she nudged me, asked if I was ok. Then she told me nicely to wake up. I mumbled nonsense and pounded a bit more. She screamed at me. No response.

At that point,she had already begun to recognize when my erratic behavior was caused by a drop in blood sugar. But this was a new one for her,this sweating and pounding and mumbling. Fortunately, she knew what to do. She rushed into the kitchen of my apartment in northern Manhattan and poured some juice into a glass. When she returned, I was sitting up on the edge of the bed,in a scary stupor. She tried to coax me to drink the juice. But when she brought the glass to my lips, I knocked it away and it fell to the floor.

Within a few seconds I tipped forward and she tried to block my fall, but we began to grapple with each other and tumbled down together, and she found herself wedged beneath me. For awhile, she was unable to move.

We were not married then, and we were not living together. The sweat-soaked body of her still-new man, the one she hoped was a keeper, pressed hard against her. She says she managed to wriggle free. I imagine her screaming, probably using her ex-dancer’s legs to lift my body up so she could slither away.

She ran out of the bedroom and called 911, using the phone in the living room. As she was giving the operator the details and pleading for help, I emerged from the bedroom and plunked myself down on the living room rug.

So here comes Diabetes Mystery #1: (more here)

Diabetes, Inner Chatter and the Monkey Mind

In a fine essay about Type 1 diabetes, Riva Greenberg conveys how much mental energy is necessary to “stay between the lines” –e.g., keep blood sugar within the narrow range displayed on her continuous glucose monitor:

If you met me…you would have no idea that half my mind space is not free, like yours. It’s busy doing what it needs to do to stay between the lines: guessing at the amount of carbohydrates in my meals, then checking my blood sugar to see how well I guessed. If not well, taking another injection or eating.

Or I’m preparing and drawing up my shot of insulin, also guessing at the dose, and remembering where on my body I took my last three injections so I don’t inject in the same place which can cause scar tissue.

Or I may be switching my syringes, checking my stock of pen needles, putting on a new sensor, ordering more supplies, and feeling my blood sugar plummet when I only meant to lower it a small amount. Then berating myself for over-compensating…

…That’s why the simplest I can put it is Type 1 diabetes is staying between the red and yellow lines all day and night, every day and every night.

Well said. What’s more, the incessant chatter that dominates the inner life of people with diabetes (PWDs) can feel like a terrible burden. Much of the time, nearly everyone has what some meditators call a “monkey mind,” which leaps constantly from one thought branch to another, one feeling to another. But if you are an insulin-dependent PWD, you have many extra branches for your monkey mind to grasp, and it is generating more noise, more instructions, more screeching, than the minds of non-diabetics. And you feel like you need those branches in order to get through the day. Greenburg conveys a distinct sense of being embattled, grim and weary because of this, which I’ve often shared.

One way to ease this burden, like every other burden, is to laugh. Chuck Eichten offers an uncannily accurate picture of a PWD’s inner babbling about food when things are not going smoothly on the metabolic front: (more here)

Why It’s So Hard –And So Important– To Eat Mindfully

I haven’t paused to taste and savor my food for at least 1.2 million minutes since 1975. That is a sobering stretch of tasteless time, which I calculated last week. I hope to use that number as a prod to remind myself to slow down and pay full attention to what I’m eating, instead of being distracted by the dream carnival inside of my mind.

When mindfulness—focused attention on the present moment—is applied to eating, there is evidence that it can reduce portion sizes and help people with diabetes to control blood sugar. Mindfulness is also an essential tool in the quest to understand the self and reality, my Buddhist teachers tell me. I know they’re right, but an equally important motivation for eating mindfully is the sense that I’m running out of time, I don’t know how much longer I have to enjoy feta cheese omelets with scallions.

Having returned to a regular meditation practice after letting it lapse for too long, I’ve eaten much more mindfully during the past year. It’s still insanely difficult, though. Why? No one had to tell our ancestors, “Idiots! Take the time to enjoy the gristle on that fire-roasted bear meat! Harry’s guarding the cave and there’s no need to worry about the snarling hyenas or anything else!” Yet I need to remind myself to remember to taste my food.

My diabetes might have something to do with that, according to Megrette Fletcher, nutritionist, certified diabetes educator and co-founder of the Center for Mindful Eating. “People with diabetes tend to think about food in terms of numbers and nutrients. They forget to get pleasure from it. They forget to ask themselves, `What does this piece of toast taste like’?” she told me. She tries to help her diabetic patients to “restore pleasure to the eating experience.”

Apparently, I’m not the only person with a useless pancreas who needs that help. In an email response to an earlier version of this post, Karol Breitholle, who has had Type 1 diabetes since 1961, noted: “I can relate. My husband is amazed that I look at food as a means of survival, not enjoyment.”

Of course, in an age that swarms with distractions, mindful eating is hard for everyone, not just people with diabetes. (more here)

Featured Story

Chronic Disease, Empathy and Surly Traffic Cops

“Don’t take anything personally,” Don Miguel Ruiz advises us in The Four Agreements, a memorable guide to Toltec philosophy. He gives one good reason:

All people live in their own dream, in their own mind; they are in a completely different world from the one we live in…Even when a situation seems so personal, even if others insult you directly, it has nothing to do with you. What they say, what they do, and the opinions they give are according to the agreements they have in their own minds…

It’s hard not to take it personally when other people are surly or otherwise unpleasant. But I need that ability in order to live and work in New York City, which sometimes seems like the international capital of casual crankiness and bad moods. Fortunately, I have been given a gift that makes it somewhat easier: my chronic disease, diabetes.

Don Ruiz is a wise man, but he missed something important about people. They say and do things not only because of the “dreams” –and words, and memories—thrumming in their minds. Their behavior is also prompted by what is happening in their bodies at any given moment. In fact, the dreams, words and memories thrumming in their minds are shaped, at least in part, by their bodies –and not just the “thinking” parts of their brains, but also their glands, organs, lymph nodes, bones, etc.

Even though it’s obvious that our own bodies affect our moods, it is easy to forget that this happens to other people, because we are lost in our dreams. So I try to use my diabetes to help me remember. Low blood sugar, for example, can make me cranky, silly, depressed or irrational—or all four. High blood sugar sometimes makes me lethargic and inattentive. (more here)

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Thinking with the Bodymind