Category Archives: Diabetes

Confront, Understand, Internalize, Master and Triumph; A Step by step perspective in dealing with Type 1 Diabetes

I have introduced in prior writings a five step process that I have used in assessing and developing systems and procedures and the associated training protocols. I would like to expand on that here and also offer a few different perspectives from which to understand it. My primary objective is to communicate the reality of the challenge that faces those of us who have Type 1 Diabetes and to put forward a perspective and a process to achieve positive results.

The 5 steps are:

Step 1:  Objective

Identify and state primary objective. What is it you want to accomplish or manifest? What does the outcome look like? It should be, in the end, a written statement that is specific, time bounded and measurable.

Step 2:  Functions/Ingredients

The second step is to identify and prioritize the ingredients or functions involved in accomplishing the objective. This step is a brainstorming exercise followed by a ranking from most important to least important. What are the components involved? Which ones are more important?

Step 3:  Systems and Procedures

In this step it is time to create a system that most effectively accomplishes the functions we identified in step 2. This is the creative step. How do I want to go about this? How do I integrate the tasks so that I am doing it in an effective way? What procedures do I want to put in place?

Step 4:  Implementation

Step 4 is the implementation step. We work the system that we created. Training is involved here as well as action steps. What do I need to do? How do I do it? What should be my practice?

Step 5:  Managing Outcomes

As a result of employing steps 1 through 4 we will have achieved outcomes. Step 5 is about managing these outcomes. How do we measure them? Am I getting the results I want? How do I enjoy the results I get? What are these results telling me?

The 5 steps are a step-by-step process but it is by no means linear. Instead it is more cyclical. Once we have reached step 5 and assessed our outcomes then it is time to go back and re-commit to the primary goals, explore for unseen or now more important functions or ingredients that we may have missed, alter systems and procedures, and evaluate our implementation strategies.

This 5 step process was born from what I have learned over the years as a systems developer and trainer. One of the most profound things I came in contact with is something called the Growth Cycle. The 5 step process mirrors the growth cycle. What is interesting, at least to me, is that many of my studies in metaphysics, religion and spirituality have similar tenets running through all of them. They all in one way or another refer to the cycle of growth from the seed level to the manifestation level. Christianity and Judaism reference the Tree of Life and the Tree of Knowledge. The Buddha sat under a tree and contemplated the roots of suffering. Continue reading Confront, Understand, Internalize, Master and Triumph; A Step by step perspective in dealing with Type 1 Diabetes

Soul Garden

A year ago I went through a month long yoga teacher training program. It was an intense program with about 70 students. Toward the end of the month we were getting to know each other fairly well and the teachers put us through a process that was pretty amazing. I thought of it today and want to share the process and some of the insights.

I have been struggling lately with my mood. It has been going up and down kind a like my blood sugars. As usual, the persistent questions of why and what keep entering my mind. Why are we here? Why do I have to deal with this disease? Why do I feel so bad? What is my purpose? What should I do?

The Soul Garden process went like this. We all partnered up. One partner represented the soul and one was the heart. we all formed a big circle… To begin, the hearts (about 35 of us) went in the middle of the circle and got into a yoga pose or any pose and held it. After a few moments the souls were instructed to go into the middle and find a way to physically support the hearts’ poses. We stayed in this formation for a minute or so. Then, while the souls maintained their pose…the hearts were instructed to move out of the circle and then go back in to support the souls’ poses. We alternated this several times.

What we experienced was what it felt like to be supported, what it felt like to support. what it felt like to be unsupported, what it felt like to stretch to support and many other things. It was very emotional for many people. I was reminded at the time how fortunate I have been to have people around me who have supported me. My father, my mother, my brother, my sisters, friends and others. I was also reminded of how much capacity I have to support.

As a Type 1 diabetic there are certain things I have not been able to do. On a more subtle level, having diabetes has forced a defenition of who I am in a certain way. I know some of you may not understand this. I imagine it would be hard to understand if you have not experienced a major chronic illness. I am unable to be or do some things that I could otherwise be or do. On the flip side, it means I can be or do things that I otherwise could not do.

I am grateful and appreciative of all those who have supported me. I am constantly searching for ways to support you and others so that I can mantain and grow the Soul Garden.

Diabetes and Depression

As someone who has lived with type 1 diabetes for over 31 years now I can tell you that depression peaks its ugly head in every once and awhile. I have gone through a couple episodes of deep depression. It got so bad about 12 years ago that I decided to take antidepressants to get out of it. I got out. It took about 6 months. I stayed on the drugs for another year and then I got off of them. It took about 3 months to get off of them. You can’t just stop taking them. I firmly believe that, if at all possible, one should not be on antidepressants. If you need them then take them. When you get out of the rut then find a way to get off of them. I know this runs counter to the thinking of many medical professionals. I don’t care. I don’t have much faith or trust in what doctors have to say unless it is an emergency. My Endocronoligist is there to write my prescriptions, order my blood tests and to collect $50 from me every 4 months…that is it. Living with diabetes effectively means that you take responsibility for what is going on. Don’t give any of that responsibility to the docs. They will want some of it as most of them have major ego issues and think they are better then most others. But don’t give it to them. Don’t do it.

Mood swings are just part of the baggage that goes along with dealing with the disease. It is an insidious disease. There is no let up. It is 24/7 unless of course you choose to block it out. Therefore, it is understandable when you feel down, There are physiological reasons that you get down as well. I don’t feel good about things when my blood sugar has been high and I don’t feel good when I am rebounding from a low. The best prescription to ward off depression is to workout. It is all about the work out actually. Become an athlete. Walk hard, run hard, do yoga everyday. Attack the workout. Good Luck..

Meditation Seminar Donation

There is no charge for the Vipassana Training I participated in September. However, they do take donations. There are no employees of the center except for a 5 person management team that receives stipends. All of the support and work is done by volunteers…..Servers. This is another way of giving back. In fact, the teacher, Goenke, says that serving is more important than monetary donations. I did not donate right away. I wanted to wait and let the experience incubate. Following is my letter to the center offering my donation. It elaborates quite a bit on my challenge of balancing blood sugars with the rigors of the training…..
September 23, 2007

Dear Dhamma Dhara

Enclosed is my donation. Everyone comes to your trainings with different challenges and for different reasons. I am 45 years old and was diagnosed with Juvenile (Type 1) diabetes when I was 14. Most people who “get” diabetes get Type 2 diabetes also called Late Onset. In fact, in the U.S. there are approximately 20 million Type 2’s and 1 million Type 1’s. Type 1 diabetics are different in that they do not produce any insulin whatsoever and must inject insulin to survive. Type 2’s experience elevated blood sugar levels because of being overweight, having diminished insulin production, insulin resistance and other factors. They can often realize normal blood sugars by losing weight, diet adjustment or pills that assist the body in utilizing the insulin they produce.

Insulin is a hormone produced by the pancreas. It is part of the digestive process and a good metaphor for this process is that it is the key that unlocks the doors to the cells to allow the glucose in the blood stream to feed the cells. So, when someone is diagnosed with Type 1 diabetes this door remains shut and the cells are not fed, the glucose remains in the blood stream and the body reacts to elevated blood sugars and the fact that the cells are starving by breaking down the liver and expelling excess glucose through the kidneys. The “game” of managing the disease is really a balancing act (Awareness and Equanimity). The goal is to maintain as close to normal blood sugar levels as possible. This is done by injecting insulin, knowing how many carbohydrate and fat grams one is ingesting and taking into consideration past, current and future activity levels. There are several other factors to consider such as stress, emotional responses and passing illnesses such as the common cold. In order to balance effectively one must figure out a basal level of insulin that the body requires to maintain a normal state, a carbohydrate to insulin number and an insulin sensitivity level. In order to ensure that blood sugar levels are in a target range one must continually test blood sugar levels by pricking the finger for drops of blood and using a glucose monitor. Of course, a blood sugar reading is a snapshot. It does not tell you if the blood sugar level is trending up or down. The only way to know this is to check often. There are continuous blood glucose monitors in the beta stage but they are not that reliable right now and are not very comfortable.

I currently use an insulin pump to administer my insulin. It is the best method out there right now. The alternative is to inject with a syringe 4-7 times per day. I test my blood sugar between 8-15 times per day depending on my food intake, how I am feeling and my activity level. Living with diabetes has been a challenge for me. The “sensations” that one experiences with fluctuating blood sugar levels is in itself a a challenge not to mention the associated physical demands and the emotional hurdles. In the past five years I have done some deep work on connecting with the root cause of the disease. Interestingly, I have identified the disease as a kind of addiction (cravings and aversions).

About 3 years ago I arranged a business buyout from my two partners in a business we had built over the previous 7 years. One of my business partners is my brother and the other a very close friend. Since that time the business has developed a not-for-profit entity and my partners asked if I would reach out to other people with diabetes and share my experience and also deliver immediate financial funds as needed.

That was a long introduction but I thought it important to create a context for the purpose of this letter which is my donation. I participated in the 10 day program starting September 5, 2007 as a new student. I heard of your training from my Aunt and Mother who heard about it from a fellow yoga student who had gone through the training. My Aunt went in June and my mother did it 2 weeks prior to me. They went to the Texas location. I chose to go to Massachusetts because I knew how beautiful it would be during early fall. I read the “Art of Living” and was intrigued. My brother also read the book and strongly suggested I go. I probably would not have gone unless I was pushed by my brother. I am very reactive even though I have been working hard on my self.

Please excuse me for not making my donation on Saturday or Sunday. I wanted to make it a solid and valuable donation. Goenka said during one of the discourses that serving was as important if not more important than donating money. I wanted to let my experience incubate and I wanted it to be non-reactive and include service.

My major concern going into the training was my blood sugar control. My diet would change drastically and I would not have immediate access to the foods I normally use in my balancing act I perform in trying to stay in a desired range. Having diabetes is a major sankhara. And what tremendous insights I got on the matter as a result of surviving the ten day training! While I was there I had to make quick adjustments to my insulin dosage. I tested my blood sugar almost every two hours in order to monitor the physical changes. I reduced my Total Daily Dosage by almost 50% from about 50 units of insulin to 27. Even more profound was that I had to reduce my basal rate by almost 40%. The basal rate is the amount of insulin I get every hour delivered every three minutes. This number is the amount of insulin my body requires to maintain a steady level. I reduced it from .8 to .550 within the first day and a half. What makes it even more of a significant thing is that I normally engage in a high level of physical activity. Physical activity lowers insulin requirements because it burns glucose. During the ten days the only physical activity I engaged in were some short walks after a meal.

While I would not say that I enjoyed the training I would say I experienced tremendous insight and wisdom in a direct and personal way. My “issues” surrounding the contracting of diabetes in my life are perhaps unique to me, perhaps not. Nevertheless, what I learned and what I experienced will help others with the disease. Specifically, it will help those who have Type 1 diabetes who want to experience a path toward liberation. It is a disease of much craving and aversion. And these cravings and aversions can easily multiply with lack of understanding (ignorance). In my experience in reaching out to others with the disease I am surprised at the lack of knowledge and basic skills necessary to maintain good blood sugar control. Both Awareness and Equanimity are required to achieve the kind of balance one must achieve in order to be successful (less suffering, more happiness). As a training developer and facilitator myself I recognize that knowledge and skills are but only part of the whole picture in the training process. Most important is an understanding of the context one is engaged in and the primary objective (goal). Clear understanding and acceptance of context and goal leads to proper mindset or attitude; Right effort, awareness and concentration.

I was blessed with an Assistant Teacher – Robert Crandall and Course Manager – Eric who almost immediately upon my arrival ensured I was going to have what I needed to make it through the training. I was given just enough. I had a little extra food at dinner……Some beans, tofu, vegetables, rice. Eating just fruit would not have been enough. I needed a few carbohydrates to get through the night. I was also given a thermos of orange juice at night in case I went too low. I must tell you the orange juice was so important. So thank you Robert and Eric and the person who brought my orange juice and everyone else who made it possible for me to be there. My appreciation at the time brought me to tears (It was early on in the training so I was still a bit vulnerable…I am sure you understand).

So, my donation is in two parts; Monetary and service oriented.

I have enclosed a check for $____. Please accept this offering and apply it in whatever way you deem most beneficial to achieving your desired results.

I would like to be a resource for you in accommodating those who have Type 1 diabetes. I would like to offer myself as an example of someone who made it through the training with the disease and I would be willing to communicate with and offer assistance to anyone who wanted to speak with me whether student or center representative.

There are a few bullet points to be aware of with a Type 1.

The person should have relatively good control over their blood sugars. Someone coming in who is out of control will have an extremely difficult time. My thinking is that those coming to your training will have an adequate level of mastery over their disease but I could also see people having trouble wanting to participate. Good control can be measured in a few ways and it will be almost impossible for you to make an accurate assessment without blood lab reports. This is probably not feasible or workable but asking them would be a minimum requirement, I would think.

Only fruit at the 5pm meal is not enough. Theoretically, I probably could have done it but it would have been too drastic an effort combined with the other challenges presented. The person with Type 1 diabetes needs about 20 grams of carbohydrates and some protein at 5pm. A lot of diabetics are use to taking a snack before bed. I did not need it. I was allowed to have a few protein bars with carbs in my room. I really did not need them but I am glad I had them. The thermos of orange juice at night was critical.

There are Glucose Tablets available at the drug store. Every Type 1 should have a bottle of these tablets. The acute concern of having diabetes is going too low. Usually one feels it when going low but not all the time. These tablets are perfect for lows. They act fast and dissolve in the mouth. There is no reason for someone to bring food in the mediation hall. I heard someone eating and it was very disturbing. One can have these tablets available and there will be no disturbance
Testing blood sugars is critical. I check a minimum of 10 times per day. Any Type 1 in good control should be checking at least 10 times per day. I was checking more in the training because of the changes that were going on and my own general obsessive compulsive nature.

Robert encouraged me to get some exercise by walking. Great suggestion. Walking after the meals was very beneficial to me.

I want to re-emphasize that my experience is with Type 1 not Type 2. Type 2 is different but many of the points are applicable.
Michael

Polarity; An important perspective in understanding balance

As we have talked before, the objective in the game of conquering diabetes is to achieve blood sugar readings in a pre-determined desired range. It is a balancing act. Let’s step back for just a minute and look at the world around us. Anything that exists in our universe is seeking balance. Anything “out of balance” is considered, at best, not meeting potential or dysfunctional and, at worst, broken or dead. If one looks deeper at these “things” one starts to see that the way our universe(nature) achieves balance as by having two opposing(polar) forces at play. The atom itself has an electron and a proton. Two opposing forces that make the atom an atom. In electricity there is the positive pole and the negative pole. A circuit is created when these opposing forces interact in a balancing act that creates light in a light bulb via the resistor. There is good and bad, white and black, dark and light, male and female, republicans and democrats(lol) …..Yin and Yang…..
There are two polar forces working in the balancng of Type 1 diabetes. They are Insulin dosage and Carb/Fat gram ingestion. There are other influencing factors but these are the two main ones because of the absence of normally secreted insulin in the Type 1 diabetic. Greater certainty in achieving success in getting bg readings in the desired range is accomplished by reducing insulin dosage to the most minimum number through healthy eating, checking blood sugars atleast 10x per day, excercise, stress reduction and increasing overall health condition.