Trying to Outwalk a Low Blood Sugar

I was a mile into my regular morning walk when the beeps started.

Dammit.

The beeps were coming from my Dexcom app on my phone and they were alerting me to a low blood sugar. Rather than correcting the low, though, or even opening up the app to dismiss the alarm, I just kept walking.

Outwalk the low blood sugar, Molly.

Outwalking a low blood sugar is easier said than done.

I really couldn’t understand why my blood sugar was low in the first place considering that I had no food in my system or insulin on board (other than my standard basal rate). Fasting workouts tend to virtually guarantee stable blood sugars for me, which is wonderful because otherwise exercise tends to make me crash. But what was different about this morning? I was utterly befuddled. My Dexcom alarm chimed a second time.

Outwalk the low blood sugar, Molly.

Even more confusing was my complete and utter determination to not treat the low blood sugar until I got home. I had glucose tablets on me, so it’s not like it was a matter of lacking a treatment. Rather, I think I was more focused on maintaining my fasted state for as long as possible, since I almost always do an exercise circuit (weight lifting, cardio training, HIIT intervals, etc.) when I return home from my morning walks. My low alarm rang a third time, just as loudly as it had before.

Outwalk the low blood sugar. You’re only 15 minutes from home.

I was deaf to my Dexcom’s persistent alarms for the next 15 minutes as I somewhat floundered down the road home, letting my impatient puppy tug me along. It’s almost like she knew that I was low and was trying to hurry me home, and I was 100% okay with that because my brain was starting to get fuzzy.

Outwalk the low blood sugar…

At long last, nearly half an hour after my first low alarm sounded, I was crossing the threshold of my front door and fishing my phone from my bag. I tapped through my notifications and cleared the low alert, noting that I was 66 mg/dL and definitely needed to eat something before continuing on with my morning routine. I sighed, set my sight on the kitchen (where a low blood sugar food stash awaited me), and resigned myself to the fact that I couldn’t outwalk the low blood sugar this time.

The Best Time for Me and My Diabetes to Exercise

I am a phony morning person.

By that I mean that I pretend that I like getting up early in the mornings, but truth be told…I hate it. Oh how I long for the days that I could sleep in as late as I wanted and shun my very few responsibilities…

Even though I clearly don’t love waking up early, there is one benefit to it that truly lasts all day long. And that is getting my workouts done within the first hour or so of my day.

Listen, I’m not a fitness freak. I don’t have a ripped bod. More often than not, I’m working out so I can eat and drink the things that I like without feeling as terrible about it (only light sarcasm used in that previous sentence). But I do like exercising and try to do so every single day because, well, it’s good for me and definitely helps me to produce better blood sugars.

Exercising is a thousand times harder than it needs to be, though, when my blood sugar crashes halfway through a routine – which happened a lot more than I wanted it to when I was working out in the afternoons or evenings.

Fed up with the lows, I changed up my routine and that’s when I discovered the beauty of fasting morning workouts.

I am definitely not as flexible as this cartoon lady.

I learned that if I work out soon after I wake up in the morning and wait until after I’m done to eat breakfast, then lows almost never happen. It’s like magic. I’m able to get through my exercise routine (which is usually a half hour circuit of some sort) without having to modify my basal rates whatsoever. Since I don’t have any insulin on board (because I haven’t eaten any food yet), I’m only working out with my basal rate running in the background, so there’s a much lower chance that my blood sugar will really fluctuate when I’m exercising. Of course, mornings that I wake up with a low or a high blood sugar are a little more challenging, seeing as I either have to bring it back up to a good level for working out or get some insulin pumping in my system, but I wake up most mornings with my blood sugar in a range that makes me feel comfortable working out in.

All the diabetes business aside, I gotta say…my other favorite part of working out first thing is that it’s over with and done for the day. Ba-da bing, ba-da boom. It’s not looming over my head for the remainder of the day, and that’s a really nice feeling.

A.M. exercise is A-O.K. to my diabetes and me.

How Raising a Puppy is Similar to Dealing with Diabetes, Part 2

Just about three years ago, I was helping my parents raise their puppy, Clarence. And naturally, with me being who I am, I found that raising him was a lot like dealing with diabetes – and wrote about it in this blog post.

Now that I’m a puppy parent, I revisited that post and found that there are even more similarities between the two.

For starters, one of the biggest parts of diabetes management is the constant monitoring involved in it. As it turns out, the same can be said about raising a puppy! Much like my blood sugar, I am watching her like a hawk during all waking hours. I’m prepared to pounce on her if she’s chewing up a puppy pad or squatting down to her business indoors, just like I’m prepared to act when my blood sugar is going higher or lower than I’d like.

Raising a puppy is only this cute and sweet about 2% of the time. (Okay, total exaggeration here, but I’m writing this after Violet decided to do her business in her playpen just after I had her outside.)

Also, as it turns out – shocker – having a puppy around is exhausting. My sleep has been interrupted several times over the last few weeks by Violet’s whimpers. Before, I used to only have to worry about a Dexcom alarm waking me in the middle of the night, but now I have to respond to her cries, too. Fortunately, having a puppy isn’t totally like having diabetes in this regard, because at least I can nap when she’s napping! (We all know that diabetes never sleeps…)

Another similarity, one that I don’t mind so much, is the frequent exercise that Violet needs. Just like my diabetes tends to be “better controlled” when I exercise each day, Violet also responds really well to playtime. The best part is that after a nice, long session of fetch or tug-of-war, she tends to zonk out afterwards, which I see as the puppy equivalent of having the coveted 100 mg/dL blood sugar.

However, there are tons of obvious differences between raising a puppy and managing diabetes. But the best, perhaps biggest one of all? Violet improves (well, when she doesn’t have an accident indoors) my overall mood and mental health. I know that her ability to do this will only increase over time as she matures. And I know that having her around will help me through the tough diabetes days that I’m bound to face in the future, and for that and so much more, I’m thankful for my little pup.

How a Broken Bone Affects my ‘Betes

I still can’t believe that I broke my wrist…again. At least I changed it up a little this time and broke my left one instead!

A broken bone is a broken bone, but my healing experience has been very different compared to last time.

For starters, when I broke my right wrist a couple of years ago, it was in the middle of winter (I slipped and fell on ice in the driveway). I was put into a cast that I wore for 4-6 weeks that felt like 4-6 months because of the challenges I faced. Between attempting to become ambidextrous as I built up strength in my left hand and taking a solo trip to Atlanta, Georgia to film a commercial for Dexcom, I did my best to work around my injury…even though I felt incredibly defeated in the face of the limitations it imposed; specifically, I felt that I couldn’t keep up with the exercise regimen I’d worked so hard to establish. I feared that I’d exacerbate the injury, so I didn’t even try to work around it.

This time around, it’s summer. The break happened after I tripped and fell down some stairs (klutz, much?). I’m wearing a brace for 3-6 weeks instead of a cast: My orthopedist said it’d be much more comfortable versus a cast, which can get seriously stinky and sweaty in the warm weather. And rather than stressing about how I’ll continue to exercise while also allowing myself to heal, I’ve made modifications that have kept my body, broken bone, and ‘betes happy.

How a Broken Bone Affects my 'Betes
Can anyone else spot the lone strand of fur, courtesy of my dog, stuck to my brace?!

I guess I learned from the last broken bone that it’s better to keep moving in some way, shape, or form than dwell too much on the injury itself. In other words, I’ve been trying hard to focus on the things I can still do while I’m wearing a brace as opposed to the things I cannot do. For example, my broken wrist can’t stop me from taking daily walks or, when I’m feeling more ambitious, going for an occasional run. It can’t stop me from making the shift to lower-body-focused workouts or core strengthening routines. I refuse to let this injury be the reason that I get sloppy with my nutrition or workout routines, and it certainly isn’t an excuse to become unmotivated in terms of my diabetes care. If anything, it might just be the reason that I tighten things up and make some much-needed improvements.

They say that when life gives you lemons, make lemonade…so I’m going to try, because a broken wrist won’t stop me from getting something good out of this less-than-ideal situation.

 

 

 

 

How to Hit Your Step (and Blood Sugar) Goals When You’re Stuck at Home

My diabetes has never liked it very much when I’ve stayed idle for too long.

Unfortunately, my diabetes and I don’t really have much of a choice these days other than to stay put – and I know that just about everyone else in the world is in the same boat.

So how do you hit your daily step goals when you can’t leave the house?

You get creative.

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With a little creativity, you can find tons of ways to stay active when you’re stuck at home – which will make your blood sugar and body happy.

And, in turn, your blood sugars will generally respond positively to any extra movement you get throughout the day…plus, with endorphins spiking (instead of bg levels), you can see a huge improvement in your mood. And who doesn’t need a mood booster right now?!

Here are the ways in which I’ve been getting 10,000 steps or more each day:

Taking spontaneous dance breaks. My mom and I are both working from home and sitting in front of our computers for long stretches of time Monday through Friday. To combat this, we’ve come up with a ridiculous but fun game called “DJ Dance Party”. It’s simple: Every couple of hours, one of us cues up music and we just dance around for the duration of the song. DJ Dance Party is a welcome reprieve from work, especially when it happens right after long conference calls!

Playing with pets. Our animals can get just as stir-crazy as we can, so by helping them combat boredom, we’re also doing ourselves a favor by getting off our butts. I play with my parents’ dog, Clarence, by chasing him around the house, throwing his toys at him, taking him for neighborhood walks, and kicking the soccer ball around in the backyard (weather permitting).

Dust off those old fitness videos. Do you have old Jane Fonda/Windsor Pilates/Jazzercise tapes or DVDs just laying around, untouched for years? Dig ’em out from wherever you’ve got them and give them a spin. It might feel silly, but then again you might also get a good laugh in addition to some exercise. I’ve done a few Zumba routines in the last couple of weeks because we have some old DVDs, and they’ve been surprisingly fun.

Hit up YouTube and other fitness platforms for free workouts. Personally, I pay for a subscription to Beachbody, which gives me access to countless workouts lead by professional personal trainers. I’ve used Beachbody workouts in lieu of going to the gym for about a year now and it has worked really well for me, but if I didn’t have the service, I know I could rely on YouTube – in fact, one search of the word “workout” on that platform brought up tons of results that vary in length and intensity. It’s a treasure trove!

Pace around when on conference calls. When I’m not attending a virtual meeting with a video chat component, I’m constantly walking around while I talk on the phone. And it honestly helps me become a more active participant in meetings, sometimes, because I don’t have the distraction of my computer monitors in front of me. I imagine this is the closest I’ll get to having a fancy-schmancy treadmill desk, but I don’t knock it because it works!

March in place while watching TV. Binge on all the TV shows and movies you want guilt-free and challenge yourself by marching in place in 15-minute intervals or at every commercial break. Steps rack up quickly this way, and it’s a go-to for me when I can’t get a walk in during the day.

So even though I’ve barely left the house, doing one, two, or a combination of these above exercises have guaranteed that I’ll meet my step goal each day. And they’ve also really come in handy after meals and long stretches of sitting, when my blood sugars are most prone to going up.

Staying at home has disrupted routines for most people, but it’s good to know that we can still control how much exercise we get in a day.

5 Things I’ve Learned about Exercising with Diabetes

It’s November 26th which means it’s day 26 of the Happy Diabetic Challenge! Today’s prompt is about diabetes and exercise. There’s so much I could say on the subject, so I decided to settle for a bit of a round-up post that explains what I’ve learned about exercising with diabetes over the years…

I exercise on a daily basis.

This statement is not a faux-humble brag, nor is it an exaggeration. Unless I’m sick, I work out in some form or fashion every single day. My workouts will vary in their intensity, but one thing is consistent: My diabetes plays a major role in how long, when, and what type of exercise I choose to do.

Since I grew up playing sports, I’ve had just about my entire lifetime with diabetes to figure out how to make it peacefully coexist – or, at least, merely coexist – with whatever exercise routine I’m completing. As a result, I’ve learned quite a few lessons along the way, and I’ve come to recognize several patterns that my diabetes follows when I exercise:

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My diabetes is practically BFFs with exercise.

1. My diabetes is happiest if I work out first thing in the morning. I never thought I’d be the type of person who works out before eating breakfast, but trial and error has taught me that this is the way to go in order to better manage my blood sugars during a workout. Fasting exercise has worked wonders on my blood sugars: I never have to worry about dealing with an insulin-on-board-inducing low blood sugar, nor do I have to be concerned about what the food I ate prior to my workout will do to my blood sugars while I’m exercising.

2. Different types of exercise affect me (and my blood sugars) in different ways. Many people probably relate to me when I say that weightlifting and high-intensity interval training (HIIT) often yield stable blood sugars during workouts but then trigger the need for more insulin hours later, whereas cardio (such as dancing, running, or circuit training) usually causes sudden drops in blood sugar levels. Of course, it depends on the timing, duration, and intensity of the workout, but it’s interesting to see how different types will require me to react in different ways in terms of my diabetes care.

3. Sometimes I need to suspend my insulin, sometimes I don’t. Again, whether or not I suspend my insulin – or even run a temp basal – depends heavily on when and how I exercise. If I’m doing my morning routine (which happens 75% of the time), then I don’t really do anything with my basal rates: I just keep them running normally. But if I’m taking a midday walk or decide to exercise in the evening, I often have to do something about my basal rate to avoid crashes or spikes. Insulin suspensions or temp basals are wait-and-see situations in those cases.

4. The hardest part about exercise and diabetes is that I can do the exact same routine every day and get different results. If I worked out at precisely the same time, for the same amount of time, and with the same sequence of movements every single day, then…my diabetes wouldn’t give a damn. Every day of life with diabetes is different because of the variables that inevitably cross my path. Things like mood, that time o’ the month, stress, diet, illness, and more can cause major changes in my blood sugar levels. It’s my job to react accordingly to those changes, but that doesn’t mean I always hit the mark on the first try. So with that in mind, it can sometimes be hard to accurately predict how my blood sugar will fare after every single exercise routine. Just thinking about it can be more exhausting than the workout itself.

5. My diabetes is my biggest motivator/fuels my desire to exercise. At the end of the day, I work out because of my diabetes, not because I’m trying to sculpt washboard abs (though I wouldn’t complain if that actually happened). My diabetes loves exercise: It results in an increase in insulin sensitivity and it helps tame my blood sugar levels overall. How could I not be motivated to work out every day with outcomes so tangible?

Yoga with Goats (and T1D)

It seems like a new fitness trend is “going viral” every week: between aerial silks, SoulCycle, and at-home fitness mirrors (in which a real trainer appears in your mirror and you get to watch yourself while they talk you through the workout – whoa FUTURISTIC right?), there is a plethora of ways to get physical that don’t involve standard, boring weights or treadmills.

I recently had the opportunity to try one of the most random, and possibly cutest, fitness craze…goat yoga. Yep. Yoga, but with goats.

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All downward dogs should be called downward goats when doing a goat yoga class.

It’s exactly what it sounds like. You move through a series of yoga poses, but there just happens to be adorable baby goats roaming around the class. They aren’t shy about making their presence known, either. When they aren’t bleating or searching for goat treats under your yoga mat, they’re actually JUMPING ON TOP OF YOU. It doesn’t matter if you’re in a tabletop pose (see my photo, above), downward dog, child’s pose…they’ll find a way to climb on you and turn you into their personal jungle gym.

It was a little disconcerting at first, and it was damn difficult to focus on flowing through yoga poses because you didn’t know if or when a goat would hop on your back or accidentally brush up against you with its horns.

And it was virtually IMPOSSIBLE when my blood sugar went low halfway through the class.

I knew that I was starting to feel off after I completed a short series of bird-dog crunches. I felt oddly exhausted after doing five on each side, so I went to go check my CGM data on my phone when I realized I didn’t have access to any, because I’d just inserted a new sensor that morning and the warm-up period wouldn’t be complete until the end of the goat yoga class.

Great timing on that one, Molly.

I decided to give it a few minutes before I took any corrective measures. So I just sat there, watching people struggle to get bendy with goats running amok. It was really pretty funny, but my sense of humor was shot, thanks to my low blood sugar.

I’m a little embarrassed to admit that the goat factor also prevented me from correcting my low right away, but…well, those things were germy. They’re farm animals, of course they will be messy and smelly. But they were literally peeing and pooping on our yoga mats, and precariously closely to our clothes/bodies. Forget feeling like I needed to sanitize my mat when the class was over – I felt like I needed to power wash MYSELF, at max intensity, just so I could feel totally clean again. So the prospect of checking my blood sugar in the middle of everything seemed absolutely unsanitary and virtually impossible.

But…like, I had to suck it up. After all, I didn’t want to do that thing that goats do, which is faint. Except they do it in a semi-cute way, and because they’re born with a condition that causes muscles to seize up when they’re startled. And there was no way I was about to faint due to a stinkin’ low blood sugar in front of a bunch of strangers and goats.

So I forced myself to navigate to the clean, protected patch of land that my backpack was perched on, dodging poop balls on the way over, and immediately grabbed my hand sanitizer so I could cleanse myself before reaching into my backpack and consuming a small box of yogurt-covered raisins. I still felt gross about it, but I did the right thing and took care of myself.

And I’m happy to report that by the end of the class, my blood sugar was on an upswing and not one goat had peed or pooed directly on me. Sweet success!

 

Starting Off on the Wrong Foot

“How are you today, ma’am?” The man behind the Dunkin’ Donuts counter smiled and looked at me expectantly, as I started back at him blankly.

I wasn’t sure how to answer. My mental state wasn’t great, that was for sure. I’d just come from a visit to a walk-in clinic, where I’d had X-rays of my foot taken to see whether or not it was fractured.

The previous 24 hours had been a bit of a whirlwind. I’d worked and gone to my first-ever kickboxing class, which was an awesome experience. I’d had dinner with my partner and started playing video games soon after as a way to unwind after the long day. That’s when pain in my foot flared up, suddenly and significantly.

Could I have injured it in the kickboxing class, without even knowing it? Was I overdoing it on exercising, in general? How and why did the pain just start up like that? Almost immediately, I plopped myself down onto the couch with an ice pack and extra cushions, hoping that I could stop the pain as quickly as it started.

No such luck. I went to bed early that night, but the pain was so severe that sleep was virtually impossible. I tossed and turned for hours, wondering what the hell was going on and coming up with a plan to get it checked out A.S.A.P.

That’s how I found myself at a walk-in clinic, a little over 12 hours after I first felt the pain. I was evaluated by a nurse practitioner who told me that “the likelihood of a fracture was low” (thank goodness) and that it was “probably tendinitis.” I was given instructions to rest, ice, and elevate my foot for the weekend, and take non-steroidal anti-inflammatory drugs (otherwise known as NSAIDs, like Ibuprofen or Aspirin) as needed.

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I’m trying to put my best foot forward as I deal with this injury.

That meant hours and hours of being sedentary.

That meant no exercise of any kind – I even had to keep walking at a minimum.

That meant my spirits were crushed.

I was glad that it wasn’t worse, and proud of myself for not waiting to seek medical treatment. But that didn’t mean I was thrilled with the outcome. Basically, I had to take the wait-and-see approach. Time will tell how long the pain lasts, and I can’t stand not knowing. I also can’t stand not being able to be active. Daily exercise is a key element to maintaining good blood sugars. Sitting around idle doesn’t do my diabetes any favors, but it’s not like I had any other choice.

I left the clinic, trying to process this information. This certainly wasn’t the way I wanted to kick off the long Memorial Day weekend. It definitely could have gotten off on a better foot. (Okay, okay, I’ll stop with the puns.) I found myself at a nearby Dunkin’ Donuts minutes later. I hobbled in, hoping that an iced coffee might lift my spirits somewhat.

I blinked, bringing myself back into the moment, and smiled wryly at the Dunkin’ cashier. “I’m okay,” I said to him. It wasn’t just a response to his question, it was also a reassurance to myself. I’m okay and I will be okay. I won’t let this get me down.

Hot Yoga: A New Win for my Diabetes

Normally, if you asked me if I would willingly go into a 105 degrees Fahrenheit room for 90 minutes for a workout, I’d say ohh HELL nawwww before you had the chance to finish asking your question.

I’m not someone who has a passion for exercising. I tolerate it. I try to do it daily for two very important reasons: 1) It keeps me in shape and 2) it helps me manage my blood sugars better. Otherwise, there’s very little about exercise that I actually enjoy. I’m not a fan of feeling out-of-breath for long periods of time. I have a love-hate relationship with the post-workout soreness that floods my body after a particularly intense session. And I definitely cannot stand sweating – on just about any given day, I’d rather be freezing cold and wearing layers of clothing than dripping in sweat.

All that said, though, I willingly participated in a fitness class called Bikram yoga…which is also known as hot yoga because you’re in a temperature-controlled room heated exactly to 105 degrees for the duration of the workout. For 90 minutes, you slowly move through 26 poses, and that’s that.

I wasn’t worried about the latter; it was the former that had me sweating (both literally and figuratively). I wondered whether I’d be able to tolerate the heat for a full hour and a half. I also had concerns about my diabetes devices – would I be sweating so much that they would fall off? Would they be able to stay safely in the room with me, or would the heat be too extreme for them? And how would my body and blood sugars respond to the hot yoga, anyways?

I knew the only way to get answers to my questions was to show up for class and find out for myself.

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Me, post-class, dripping in sweat in my car. Next time, I’m bringing a change of clothes.

And that’s exactly what I did. I went to a morning class with my stomach empty and my backpack full of diabetes supplies. My blood sugars tend to respond better to exercise when I don’t have any food in my system or insulin on board, so I made it a point to wait to eat my breakfast after yoga instead of before. But I still wasn’t entirely sure if or how my blood sugar might react to a brand new kind of workout, so I wanted to be armed with several different low snacks. I felt fairly confident about its stability, though, as I headed into the class sitting pretty at 110 mg/dL.

In addition to extra diabetes supplies, I also thought to bring with me some water that I’d filled and frozen the night before the class so I could stay hydrated throughout it with water that was sure to be extra refreshing in the heat.

Even though I had all this stuff with me, I chose to leave most of it in a cubby outside the studio, save for my CGM receiver, a tube of glucose tablets, and my water bottle. I didn’t want to take any chances with my cell phone, PDM, or glucometer and expose them to the heat – I have firsthand experience with an overheated cell phone, and while it does eventually cool back down its own, overheating my devices is not something I’d actively seek to do. I was taking a bit of a risk with the CGM receiver, but since I have the Dexcom app on my cell phone, it’s not like I’d be at a huge disadvantage if something were to happen to my receiver.

So with my gear in hand, I stepped foot into the yoga studio…and immediately started sweating. Yes, that quickly! It was a heavy, stifling, and moist heat – the exact kind that I hate the most. I started to question whether I had the endurance to even sit in this heat for 90 minutes, let alone move seamlessly through yoga poses in it. In the minutes before the class began, I sipped water slowly and told myself that above everything else, I needed to listen to my body throughout the class. I started to feel better as I reassured myself that it would be perfectly acceptable to walk out should I start to feel light-headed, low, queasy, or anything else abnormal.

Fortunately, though, an exit plan wasn’t needed as I made it through the full class! That’s not to say it wasn’t challenging or extremely sweaty – seriously, my body was so covered in sweat that it looked like I’d just come out of a swimming pool – but I proved to myself that I could do it. And the best part was that my blood sugar behaved beautifully: As a reminder, it was 110 mg/dL at 8:30 A.M. Class started at 9 and lasted until 10:30 A.M. I was home by 11 and when I checked my blood sugar there, I was at 118 mg/dL. I couldn’t have asked for better pre-, mid-, and post-workout blood sugar levels.

Was it scary to try this new, moderately intense exercise? Yes. Was I concerned about my diabetes before, during, and after the class? Yes. But was it all worth it? I’d say yes. I overcame my fears and was met by blood sugar success, making hot yoga a diabetes win in my book.