The Insulin Chronicles

Notes from a 50+ Year Diabetes Survivor

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Chronic Disease, Empathy and Surly Traffic Cops

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“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. [Read more…] about Chronic Disease, Empathy and Surly Traffic Cops

Diabetes, Depression and Chasing Away the Dybbuk

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One night in the middle of my senior year of college when I could not get out of bed, and I could not taste my food, and I could not answer the phone, and I felt that there was something vile and rotten coursing through my blood, it suddenly occurred to me that perhaps there was a “dybbuk” dwelling within. According to Jewish folk wisdom a few centuries ago, the dybbuk was the dark, sick spirit that possessed people and caused all kinds of maladies. For a few minutes, I seriously entertained the possibility that a dybbuk prompted the inner darkness that descended upon me periodically. Then the realization that I was resorting to primitive superstition made me even more depressed, and I dropped the idea.

I got better, much better, over the years, but the dybbuk/black dog of depression never seemed very far away. And I could never fully account for it. Somehow my particular set of stories, and my particular capacity to overcome them, and what little I knew about biochemistry never came close to explaining it. Maybe it wasn’t a dybbuk, but there often seemed to be something from somewhere outside of myself that grabbed hold, or threatened to grab hold, something beyond my control and imagining.

Then, on a winter evening in 2012, when thinking about thinking about writing about diabetes, I found a New York Times article by Alice Dembner with an evocative lede: “Millions of people face a two- headed beast – diabetes and depression – that gnaws at them from the inside out.” It prompted me to hope there was a chance to understand the dybbuk –or whatever it was that grabbed hold of me–and maybe even find new ways to ensure that it never returned. [Read more…] about Diabetes, Depression and Chasing Away the Dybbuk

Gratitude For Feeling Crappy

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I often don’t feel well due to stress hormones, which act up partly because I have Type 1 diabetes. But I try to feel grateful when that happens. Huffington Post asked me to respond to a presentation made by psychologist Kelly McGonigal, called “How To Make Stress Your Friend.” Here it is. And here was my response: [Read more…] about Gratitude For Feeling Crappy

Did Trauma Cause My Diabetes?

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The following essay by yours truly was originally posted by Scott Strange @ Strangely Diabetic.  A friend and fellow traveler with Type 1 diabetes, Scott is an astute observer of  the medical scene and passionate patient advocate. His blog and tweets (@Strangely-T1) are  well-worth reading.

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What caused killer t-cells to attack the beta cells in my pancreas, preventing them from producing insulin, making my blood sugar skyrocket, and triggering my Type 1 diabetes? That was in 1962. No one has come up with a convincing explanation yet. Scientists aren’t even close to figuring out the interactions between the environment, genes, the immune system and who-knows-what-else that result in Type 1 (T1) or Type 2 (T2) diabetes. If you travel around the Internet, it appears that the entire world is one big “risk factor” for these conditions.

Suspects identified by researchers that might play a role in T1D include the smoked mutton consumed by Icelanders between Christmas and New Year’s, various viruses,  early childhood respiratory infections, whey, cow’s milk proteins, the timing of solid foods in infants,  psoriasis, low levels of Vitamin D, and many more. Risk factors for T2D, besides the well-known ones like obesity, could include not enough sleep and phthalates in soaps, lotions, plastics and toys.

But the culprit that interests me the most doesn’t get much attention in the research labs: trauma and major stress.  When I was a kid, the conventional  wisdom was that traumatic events –loss of a loved one, accidents– played an important role in diabetes onset.  This appeared to be substantiated by a number of population studies in the ensuing decades, but the evidence hasn’t impressed major players in diabetes research. In a long summary of biochemical and environmental risk factors for T1D,  the NIH barely touches upon the matter, gives it a few throwaway lines:

Although investigations of stress and IDDM [insulin dependent diabetes] have, in general, reported positive associations, most studies have been retrospective and suffered from methodological difficulties in assessing stress and measuring its frequency, intensity, and duration. Thus, prospective evaluations of the interaction among stress, the immune system, and the occurrence of autoimmune diseases are warranted.

Sorry, NIH, but I am convinced that a specific traumatic event played a major, albeit partial, role in triggering my diabetes.

In a blog post that was mainly about my mother and Sonya Sotomayor’s parents, I described the onset of the disease 51 years ago. It happened very soon after my grandfather died. In my grandmother’s apartment in Manhattan, I was so terrified by the mournful screams from my mother and grandmother when they embraced that I ran away and hid. Within two days, after an earache, sniffles, a sore throat and ravenous thirst, I was hauled to a hospital and suddenly became a kid with a scary disease. [Read more…] about Did Trauma Cause My Diabetes?