Why Online Communities Aren’t Always the Best Source of T1D Support

Before I jump into this post, let me make this unequivocally clear: The DOC (Diabetes Online Community) has been an incredible source of support, advice, and education to me ever since I discovered it (roughly seven or eight years ago). This post isn’t necessarily about the DOC; rather, it was inspired by a recent experience I had with a totally different online community. But what I’m about to say here can be applied to just about any kind of virtual support group in existence…

In addition to the DOC, I consider myself a member of a few other online communities. One of them is focused on fitness. (I’m not going to specifically name the group here, mainly because I’d like to maintain its privacy as well as the privacy of its members.)

Anyways, said group was formed to provide members with a place to post about their respective fitness journeys. Members are encouraged to post daily about their workout routines, nutrition plans, and any emotions that might arise as they work toward building a healthy lifestyle. It’s common for members to interact with one another and show support when someone is struggling, as well as applaud victories big and small as they’re met. Unsurprisingly, negativity and criticism aren’t welcome in this group, as it can be detrimental to the goals that each member has for himself/herself.

Thanks for the love!

In keeping with the spirit of the group, I posted a photo a few weeks back of myself (making a grumpy face) after a particularly challenging cardio workout session. In the caption, I wrote: “Excuse my pissed off expression…I had to cut cardio fix short because my blood sugar was getting too low. Only worked out for about 20 minutes this morning. I really wanted the full one cuz I treated myself with food just a tad too much yesterday…but I don’t totally regret it because it reminded me that I just don’t feel good when I snack unnecessarily. I’m always struggling to remember to only eat when I’m hungry or if my blood sugar is low, not because I’m bored or emotional. I know one day I’ll fully accept this and practice it!”

I wasn’t seeking sympathy or anything, I was just being honest with the other members of the group and channeling a bit of my frustration. Regardless, a few people did comment on the post with some reassuring words, like “you’ve got this”, “thank you for sharing”, and “one day at a time”, which I appreciated.

But what I did not appreciate was the comment thread that followed and involved myself and two other group members (my thoughts as I initially responded to this chain are denoted by asterisks):

Group Member #1: Oh no, be careful! Do u usually run low?
Me *Not wanting to dive into a long explanation*: I’m pretty well controlled for the most part, but exercise can make me go low sometimes! 
Group Member #1: do u have diabetes?
Me: yes, type 1 diabetes for 21 years now
Group Member #1: oh wow! Be careful!! Do u carry glucose tabs with you?
Me *Rolling my eyes as I respond, and adding a “haha” to keep it light*: of course! Haha I’ve had T1D for a very long time so managing it is second nature.
Group Member #1: okay good! Just making sure. Sorry, this was the pharmacist in me asking (an annoyingly cute monkey-with-hands-over-eyes emojis PLUS smiley face emoji followed this comment)
Group Member #2: The nurse in me wondered the same. 🙂
Group Member #1, responding to Group Member #2: haha! (followed by a stupid heart emoji)

What exactly is my issue with this thread? It starts with the “be careful”. It was probably an innocuous comment on the poster’s end, but I thought that me telling her that I’ve had diabetes for 21 years might signal that I know a thing or two when it comes to managing it. It also mildly irked me that she was qualifying her comments to me by saying that she was a pharmacist. That’s great and all, but that doesn’t make her an expert by any stretch of the imagination on diabetes…same thing to the girl who also chimed in by saying she was a nurse.

Now, you might be thinking that I’m overreacting to this whole thing – and part of me agrees, I’m sure that both girls just had pure intentions and wanted to offer support in their own ways – but if that’s the case, then this is a perfect example of how things can get misconstrued in an online setting. My interpretation of this thread is that both girls were trying to tell me that their expertise in their respective fields meant that they knew a good bit about diabetes, and rather than come off as supportive, the comments felt like show-offish (like, oh, look at me and how much I know!) and as if they thought I couldn’t take proper care of myself. Again, my interpretation may or may not be true, but it’s fact that we all need to be careful when choosing our words in situations like this. Even better, when something isn’t totally clear, we can choose to say nothing rather than chime in with a comment that might come off wrong or sounds misguided.

With that in mind, I now get why some people say that online support just isn’t for them. Personally, though I appreciate and like being part of online communities, this experience did teach me a lesson about being careful with my interactions in these spaces, and that I should always try to remember…it’s impossible to gauge tone/emotion in the comments section, and coming across as a know-it-all isn’t a good look on anyone.

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For Feet’s Sake!

First and foremost, let me apologize: I’m sorry for all of the cheesy puns that are about to follow.

Now that’s off my chest, let me put my best foot forward and write about feet.

People with diabetes are told to pay extra special attention to their feet. There’s a few things to look out for, such as circulation and nerve issues. So recently, when an old foot injury flared up, I knew trouble was afoot and I better do my best to heel it.

A couple years ago, I broke a very tiny bone (roughly the size of a corn kernel) in my foot called the sesamoid bone. It was classified as a stress fracture, so I wore a bootie and did non-weight-bearing exercises for six weeks while it heeled. I also decided to take a break from high-heel shoes and cushion my sneakers with gel inserts, which wound up being an important step in recovery. Before long, my foot was feelin’ fine and my soul was joyous.

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Fast-forward to the present day, and the injury seemed to be waltzing its way back into my foot. For feet’s sake, I thought it was a thing of the past! Luckily, I’d kept my gel inserts from the first time around and started wearing them again. I didn’t want to toe the line with this foot pain – I addressed it and monitored it closely, and will continue to do so.

For now, my foot is toe-tally better. I’m reminding myself that it’s important to pay attention to my body’s signals and handle them accordingly. Foot health is absolutely not something to mess around with, and like everything else related to diabetes, I’ve got to hop to it and take good care of my feet. Can you digit?

The One Good Thing about a CGM Hiatus

All was quiet. A little too quiet…

No beeps. No buzzes. No alarms.

And the silence was refreshing. I didn’t like being without my CGM for a week, but there’s no doubt about the one positive effect that its absence had on me: It gave me a much-needed mental break from an audible aspect of diabetes.

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Diabetes can be LOUD sometimes. Especially in hypo repeat mode.

It was a blissful reprieve from my diabetes literally screaming at me like a needy baby. A week-long vacation from my CGM hollering at the top of its lungs “HEY YOUR BLOOD SUGAR IS HIGH DO SOMETHING ABOUT IT” or “WAKE UP YOUR BLOOD SUGAR IS LOW YOU BETTER TREAT IT RIGHT NOW.”

It’s rare that I can describe diabetes as peaceful; in this case, it was, and the experience will make me consider putting diabetes on mute a little more often.

 

Why I Decided to do a 3-Day Cleanse (and How it Impacted my Blood Sugars)

No carbs. No dairy. No meat. No processed foods. Strictly vegetables, fruits, and shakes for the next three days. 72 hours – I could do it, right?

Last week, I completed a 3-Day Cleanse. My goal was that it would help me feel a little bit refreshed after a couple weeks of nonstop gluttony. I figured it’d help reset my system and make me feel less bloated and tired. I didn’t want to do a typical “cleanse” though, the kind that forces you to stop eating any and all food and stick with juices. That’s why I did this particular program – I would be eating real foods on a regular basis throughout all three days. The bonus was that it would be foods I’m familiar with and are generally low carb, which could only mean good things for my blood sugar.

My routine for all three days would follow this format: Wake up, drink a glass of water, blend a shake together with one serving size of fruit. I’d have a cup of herbal tea one hour after breakfast, and one hour after that, I’d have a fiber-filled drink. Lunch would consist of another shake, one serving of vegetables, one serving of fruit, and one spoonful of hummus. I’d have an afternoon snack of baby carrots and one spoonful of almond butter with another cup of herbal tea an hour after consuming the snack. Dinner would be one last shake, one cup of vegetable broth, and a spinach salad with olive oil and lemon juice drizzled on top. I could have a final cup of herbal tea any time in the evening.

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I didn’t expect to learn as much as I did throughout the program, but those three days taught me a lot about how the things I put into my body impact not just my blood sugar, but my state of mind. Here’s what happened during my cleanse:

  • Day 1 – This day was by far the easiest to complete. Despite dialing back the amounts and types of foods I was consuming, I didn’t feel hungry at all – everything sated me. I was really enjoying watching my Dexcom CGM graph because it barely budged. I stayed right around 90-110 mg/dL for most of the day, probably because I was eating minimal carbs. Fewer carbs means less room for error, and this concept was definitely cemented into my mind by the end of the cleanse. I went to bed with a slight headache at the end of day 1, but a smile on my face. This would be a breeze!
  • Day 2 – My CGM sensor went kaput by mid-morning, and I was PISSED about it. I wanted the ability to continue tracking my blood sugars on this cleanse, and suddenly it was no longer available to me (because oh-so-conveniently, it was my last sensor in stock). Fuming over my CGM situation, I started feeling slight pangs of hunger shortly after having my fiber drink. I ate lunch as soon as I could after that, and spent much of the rest of the afternoon fighting a headache and dreading going home to see – not eat – my mom’s delicious home cooking. On the brighter side of things, my digestion seemed to be improving already and I felt a bit less bloated.
  • Day 3 – I went from “Oh, this cleanse will be a breeze!” to “OMG THESE ARE THE LONGEST THREE DAYS OF MY LIFE GIMME REAL FOOD AGAIN BEFORE I HAVE A MELTDOWN” in less than 48 hours. That’s gotta be a new record. I distracted myself as much as I could from my misery by burying myself in my work, which helped to a degree. But I couldn’t fight the lightheaded sensation that seemed to grip my entire body. I was confused by that – I though only eating real, plant-based foods would eliminate crummy feelings. Maybe I was experiencing a sort of withdrawal as my body got used to this new diet? I can’t confirm that, but I suspect that after a few more days, I likely would’ve felt much better…or hungrier. I’ll leave it to speculation because there is no way I’m doing this again any time soon. But MAN, am I proud of myself for completing the cleanse without cheating, not even once.

So if I felt THAT miserable toward the end of the cleanse, then why am I glad that I did it? Mainly, I’m astonished at how much easier it was to maintain my diabetes and “desirable” blood sugar levels in that three-day time period. Even without my CGM, I was still getting great results. It reinforced something that I already knew: that the body will react accordingly to the quantity and quality of foods that are used to nourish it. It made me realize that perhaps I should toy with cutting down my daily carb intake and upping my veggie/fruit/protein consumption to find out whether that positively impacts my blood sugar in the way that I think it will. This doesn’t mean I’m starting a low-carb or keto diet; rather, I’m simply going to follow a more thoughtful one.

To sum it up, this three-day cleanse/torture act/lesson (whatever you want to call it) helped make my understanding and appreciation of food much stronger, which makes it worth it in my book.

 

Why Word Choice Matters to a Person with Diabetes

Read the following five sentences. Can you tell what’s wrong with them?

  1. She’s a diabetic.
  2. He’s testing his blood sugar right now.
  3. Her diabetes is out of control!
  4. Isn’t that a really bad blood sugar?
  5. He suffers from diabetes.

Have you figured it out?

The language in those five sentences is extremely negative. “Bad,” “out of control,” and “suffers” are obviously gloomy and cynical words to use when referring to diabetes – you don’t need to be a wordsmith make that connection immediately. But what’s wrong with “diabetic” or “testing”? It’s the connotations around those words. Calling someone with diabetes a “diabetic” is labeling them with the disease and removing the actual person from the equation. Saying that a person with diabetes is “testing” their blood sugar makes it sound so…clinical. It also implies that the person could pass or fail the so-called test, adding pressure and guilt to the situation.

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Choose your words wisely.

In my real-world, full-time job, I’m an editor, so it gives me great pleasure to amend those above sentences into more positive, empowering language:

  1. She has diabetes.
  2. He’s checking his blood sugar right now.
  3. She’s having a tough time managing her diabetes.
  4. How do you handle high or low blood sugar?
  5. He lives with diabetes. (Or even better: He THRIVES with diabetes.)

Ah, much better. Never underestimate the power of words.

Favorite Things Friday: Mini Boxes of Yogurt-Covered Raisins

One Friday per month, I’ll write about my favorite diabetes products. These items make the cut because they’re functional, fashionable, or fun – but usually, all three at once!

Mini boxes of yogurt-covered raisins is an oddly specific kind of food, but they’ve literally saved my life (and my mom’s) hundreds of times.

I’m almost certain that I introduced these raisins into our low supply kit because I was looking for something that 1) was portable 2) had 10-15 grams of carbs 3) could be quick and easy to consume and 4) wasn’t glucose tablets (I get sick of them). I must’ve been browsing through the aisles of the grocery store when I found a bag containing 10 mini boxes of raisins. Clocking in at exactly 10 grams of carbs per box, they seemed to fit the bill nicely. I brought them on a trip to Disney World soon after buying my first bag, and that sealed the deal for me. They proved to be super convenient throughout the trip and helped prevent me from over-correcting my lows, which was huge for me.

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A box of raisins adjacent to my OmniPod PDM. I can easily fit several boxes of raisins into my purse, along with my other diabetes supplies.

Since that trip, the raisins have become a go-to low treatment for me and my mom, who agrees that they work just as well as glucose tablets. They’re much tastier than glucose tablets, and qualify as a healthier way to treat a low. As tempting as it might be to treat with Skittles or Starbursts, I struggle to control my intake of the candy when dealing with a particularly icky low. The raisins are already perfectly portioned, so that eliminates the can’t-stop-won’t-stop (eat ALL the foods!) feeling that can make dealing with low blood sugars difficult.

The raisins are excellent on the go, too. I can pop a box of them in the car, at my office desk, in the gym, or at church. I’ve even whipped them out at bars, and my friends get a bit of a chuckle when I down them like a shot of alcohol. But honestly, they’re so discreet and go down so easily that most of the time, people don’t even notice that I’m eating them. And if people aren’t noticing yet another part of my otherwise very prominent diabetes care kit, then that suits me just fine!

Four Factors that Impacted my Diabetes in Las Vegas

Recently, I returned from a trip to Las Vegas with my best friends in the universe. It was awesome to take a vacation with them, especially in a place that’s virtually a playground for adults.

Before I went on the trip, I knew to expect some sort of disruption with my diabetes care and management routine. I did as much as I could to prepare myself for every potential scenario, from packing extra snacks and supplies, to asking the DOC how I should account for a sudden change in time.

While my preparation really did help, I still encountered the unexpected when it came to my diabetes on the trip. Four factors in particular come to mind…

  1. The heat – At first glance, this is a no-brainer. I’ve been to many hot climates on vacation, so it isn’t news to me that intense sun can make blood sugar go low quickly. We were literally in the middle of the desert, so I knew it would be important for me to watch my numbers closely, as well as keep myself hydrated. But I think the fear of going low all the time was a little too strong, which meant that I was running a bit higher than I’d normally like for most of the vacation. My paranoia about drinking plenty of water, though, was not a joke. I pride myself on being good about staying hydrated, but I struggled to keep up with the dry desert heat. I can’t help but wonder: If I’d been better about drinking water, would it have benefited me during some of the stickier high blood sugars? Speculation can only get me so far now; however, all signs are pointing to probably yes.
  2. The strip – The Las Vegas strip is less than five miles in length, but the whole stretch of it, marked by hotels, stores, casinos, and ginormous flashing lights, feels incredibly long. Nevertheless, my friends and I naively believed that we could skip taking taxis and walk all over the place. For the most part, we could, but it was definitely dicey when we walked nearly a mile and a half from the Cosmopolitan to the Rio one evening. It influenced my blood sugar in a positive way – the exercise brought my levels down to a nice and stable place – but that didn’t mean it wasn’t scary to walk practically on the highway at nighttime.
  3. The alcohol – I’m well aware of the fact that different kinds of alcohol can have different affects on blood sugar. To minimize blood sugar swings, I stuck with the less-sugary options as much as I could (i.e., opting to order a rum or whiskey with diet coke), only getting fancier drinks when I was consuming fewer carbs at mealtime. For the most part, this strategy worked well and proved to me that a little extra thought can go a long way when it comes to deciding how to treat yourself. But it also reminded me why I don’t have weekends like this often – it’s exhausting enough to take care of myself on a daily basis without alcohol being a factor. Throw it into the mix and I’m watching my blood sugar so carefully that my CGM’s battery is drained in half the time it normally takes to zap it.
  4. The pizza – The scientific answer to the reason why pizza is tough on blood sugar involves the glycemic index and some fairly complex calculations…boring! All you really need to know is that it takes a long time for pizza to have an affect on blood sugar due to its high fat-to-carb ratio. As a result, it tends to be a “treat” food for me that I only indulge in every once in a while. But when in Vegas…you have as much of it as possible. Pizza was one of the quickest and easiest food options for me and my girlfriends throughout our trip, so we ate it multiple times. I don’t regret a single cheesy, delicious bite…but I am slightly remorseful for not doing a better job bolusing for it. The first time we had pizza, I didn’t give myself enough insulin. The second time, I gave myself too much and went low, though that may have happened because I didn’t finish both slices like I thought it would. The bottom line? I didn’t realize that pizza would be a dietary staple on this vacation, and I’ll probably refrain from eating so much of it on future vacations.
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A slice a day does not quite keep blood sugar at bay. But it’s tasty as hell.

Despite the diabetes curveballs I encountered, I enjoyed my trip to the fabulous Las Vegas. I managed the challenges as best as I could without letting them interfere too much with what I wanted to do. Plus, it helped that my best friends were with me the entire time. I have to give them credit for making the most of my diabetes difficulties, too. For instance, I felt badly about sidelining them in the Bellagio on our last night there due to a low blood sugar that crept up on me after walking (the strip!) and over-bolusing (the pizza!), but they really rolled with the punches and made the most of it. In fact, I’m pretty sure they experienced their favorite people-watching moments while we sat and waited for my sugar to come up (I got a kick out of the weird people coming in and out of the lobby, too, but was slightly more focused on raising my number).

Thank you, Kortney and Roshani, for accompanying me on an incredible girls’ trip and for being my best friends in the world. Maybe Las Vegas 2020 needs to happen – now that we know to expect, perhaps my diabetes will be a more cooperative travel companion the next time around!