The Insulin Chronicles

Notes from a 50+ Year Diabetes Survivor

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Hypoglycemia Chronicle #2: “Where’s Lillie?…Where’s Dan?”

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Yay, I’m here now, more than ever, and feel like I am living an actual life. But for long swaths of time, especially when the black dog visited, I did not feel wholly alive, watched myself and the rest of the world from very far away.

According to the psychiatric manuals, I had a combination, of “derealization” and “depersonalization,” coping mechanisms people use to distance themselves from despair or anxiety.

That is one of the reasons I hesitated to dive into permanent relationships and to have kids. I didn’t want to be a psychological fraud, an emotional huckster who would be forced to feign not just love, but the sense of being alive and present, to those who needed me. Before I met my wife-to-be 27 years ago, Dr. S, one of my better shrinks, pointed out that there was obviously someone real, an actual Dan Fleshler, who felt moral compunction about pretending to be real. “Where does that come from?” he asked. “Who’s feeling that? Where’s Dan?” [Read more…] about Hypoglycemia Chronicle #2: “Where’s Lillie?…Where’s Dan?”

Why I Don’t Taste My Food and Neither Do You

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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 believe they’re right, but an equally important motivation for focused attention is the singular delight of feta cheese omelets with scallions rolling around the tongue. [Read more…] about Why I Don’t Taste My Food and Neither Do You

Diabetes, Inner Chatter and the Monkey Mind

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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: [Read more…] about Diabetes, Inner Chatter and the Monkey Mind

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