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