Life..’More than #diabetes’ Ups & Downs

Flowering Wattle

How much does diabetes dominate your life? It is a health condition which, because it is related to food and exercise, can seem like the most difficult health condition you could possibly have, doesn’t it? And because the symptoms are not always obvious or noticeable, it can seem that if you ignore it, it will just go away, or not be true.That you will ‘get away with it’, if you ignore it, or make a ‘token effort’. Even people with type 1 diabetes can at times feel that they can ‘stretch’ the ‘rules’, not take their insulin, or use insulin to allow themselves to ‘indulge’ in ‘favourite’ foods; or ‘allow’ themselves to ‘run high’ to avoid hypos. The insulin pump combined with the modern blood glucose meters, cgm’s, allows such fine control, approximates more closely than anything else the action of the pancreas in releasing insulin; yet in its very existence such biotechnology is a constant reminder of life with diabetes.

As the parent of a child diagnosed with type 1 diabetes, there were times when it seemed there would never be anything else that mattered in life, other than diabetes. When my daughter grew up & left our home in a tiny rural town to go to the City to study at University, things in some ways got easier; but in other ways, things got harder. I was a young Mum, and I was only 32 years old when my beautiful healthy girl was diagnosed. I was 37 when she left home. It was hard knowing she was 250 km away, and relying on others, who were not me, as her ‘backup’ person. Every night that we slept under the same roof, I got up to sit with her through her hypos. The click of a light switch, or the click of the toaster, would wake me. This continued through her teen years; her pregnancies; her own years mothering babies; travelling with her for Diabetes related professional reasons as colleague, & as her ‘back up person’ for her diabetes management, on trips overseas & interstate ; and on family holidays. Even now, if we are sleeping under the same roof, if I’m sleeping within hearing distance, something wakes me, and I can’t lie in bed knowing she’s out of bed & feeling bad.

I do have other things in my life: work, sport, friends, family: causes to do with the environment and the earth. I have grown tree seedlings for Trees for Life, collected for the Heart foundation, travelled. I’ve volunteered at Film Festivals, Arts Festivals, tutored at the U3A. But beating away like another heartbeat is my daughter’s diabetes. I work and volunteer in Diabetes. I practice Mindfulness. Being her parent will always be a part of who I am. Of course, it is much, much more intense for her. Every minute of every day and night, no respite. I do get to take breaks, she doesn’t.

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My life changed 15 years ago. My husband retired, and I got a job in the city, so we moved house. Over the past 15 years, my life has expanded to include assisting my mother in dealing with changes that came about in her life, first with my father’s diagnosis of dementia. In the beginning, I was working in a highly responsible & challenging job. My help was as practical as I could manage, also fitting in supporting both my daughters with pregnancies & babies, toddlers & growing children. With my father’s death, assisting Mum meant helping her manage her own health & living arrangements, & eventually her own dementia.

That time also came to include my own diagnosis of diabetes. Because of my daughter’s diabetes, I came to the diagnosis with a shorter period of ‘denial’ than some experience; and with very little anger. I do feel some negative emotions, of course; but I know that it’s possible to live a good life with diabetes. My fear of diabetes related complications is much less than my fear of dementia.

I hadn’t meant to write about difficult experiences in my life, but yes: they are also part of life, and many of them have nothing to do with diabetes. The past 15 years have included weddings, births, joys: wonderful family Christmases, when Mum played ‘Mother Christmas’ to our large family: visits from overseas relatives, contact through Social media with relatives, friends, strangers. Yes food is pleasure, but there are other pleasures. Exercise is pleasure. Doing things for others is pleasure. Growing things, writing, taking photos, playing with children, doing good work, talking with friends from all over the world, these are all pleasurable.

Life is Good. Life is a river, it flows. Life is truly a journey, with opportunities for rich experiences that include the difficult ones, and the easy ones: spontaneous ones and planned ones. Seize the moment, take opportunities when they arise. Life is more than diabetes: it includes things that are harder, and worse: and things that are easier, & better..Life is for the Living.

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Helen Wilde

carpe diem

Helen is a Senior Counsellor with Diabetes Counselling Online. She is also the parent of someone diagnosed with diabetes in 1979. She has lived with type 2 diabetes herself since 2002.

 

 

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The significance of d-routine for wellness

med

I had a friend visit last weekend. She, like me, is aged in her mid-40s, is a working Mum and has type 1 diabetes. She was telling me that she had started to suffer with anxiety or panic attacks and that her doctor had put her on medication for it. Not surprisingly her diabetes control was also not in a good place. For me it was somewhat of a shock to hear this of my extremely capable friend, but also was easy to imagine how it could happen when we reflect on just how stressful and overfull our lives have become. It also reminded me of the importance of having a routine, especially for those of us with diabetes, so that we don’t ‘juggle out’ diabetes as a ball in our busy lives. Diabetes really needs to be a very high priority for both mental and physical wellness, and yet it so often drops to a low one, dragging the rest of lives down with it.

As you know, I’m an Accredited Practising Dietitian, and my speciality is food/lifestyle and wellbeing, rather than psychology. In my blog today I wanted to remind people with diabetes about how having a routine every day can get your day off to the right start as well as helping your diabetes to be better controlled across the day, leaving you to focus on those other priorities in your life.

For myself I have created a routine that allows me that great start to the day, knowing that if you start well there’s a greater chance of continuing along that good line. As a dietitian I also am very aware of the evidence that tells us how important food is for mental health, hence the Australian Dietary Guidelines recommendations for a variety of fresh foods from the five food groups so that we get the nutrients we need for energy and for wellbeing, both physical and mental. The first key point in the guidelines reads:

“Good nutrition contributes significantly to maintaining healthy weight, quality of life,

good physical and mental health throughout life, resistance to infection,

and to protection against chronic disease and premature death.”

Australian Guide to healthy eating poster

Planning is an awesome strategy

My routine starts with ensuring I have enough time to fit it all in – Planning! Drawing on my blog from last week where I quoted Accredited Practising Dietitian Jemma O’Hanlon reminding us that “Failing to Plan = Planning to Fail”.

My thoughts for the next day start the night before, and I do that to ensure that I have a good eight hours sleep before the time I need to wake up, knowing that tiredness will not help me in *any* way. There is a lot of evidence around the importance of a good night’s sleep for wellbeing.

young girl sleep

I consider what time I’ll need to leave home to be where I’m going that next day. I know that my ‘d-routine’ takes me an hour and a half to complete, so I set my alarm to wake me an hour and a half before I have to leave, and off to sleep I go. Most days I plan to leave by 8am, meaning a 6.30am start. You’ll need to see how long your d-routine takes to work out your own hours.

My morning routine includes (not in order of importance, but how they occur):

1) Testing my BGL and having my medications

2) Eating a low-GI, high fibre breakfast with a serve of dairy

3) Checking my emails/facebook

4) Going for a 40 min walk/jog/lunge

5) Showering and dressing

6) Planning my snacks and lunch for the day

All six points are important for the success of my day, diabetically, mentally and physically.

No.1 – Testing my BGL and having medications – this one is a no-brainer for me. If I don’t know where I’m starting from with my BGL, how on earth can I know or control where I’m going with it? Same with the meds, there’s just no option not to have them. I’m often surprised to hear that people don’t take the medications they’re prescribed, and that’s why these two are the first on my list.

Glucose meter Insuline pen injection and lancetes

No.2 – Eating a low-GI, high fibre breakfast with a serve of dairy – we all should know the benefits of low-GI carbs as explained in my earlier blog, but when you know that your brain needs glucose to function properly again it’s a no brainer. Even if I’m not hungry, I eat my low-GI breakfast with grains, dairy and nuts to keep me energised for the morning.

Oaty heart

No.3 – Checking emails/facebook – As a person who thrives on being organised and needs to be for my business to function smoothly, I need to clear out my inbox each morning and deal with the quick responses, so I can know issues have been dealt with so they’re not on my conscience when my mind should be focussed elsewhere. If I had to leave one point out of my morning routine this would be it, but I can do it pretty quickly in most cases.

No.4 – Going for a 40 min walk/jog/lunge – I know that if I don’t fit this in to my morning routine I will regret it for many reasons! Exercise brings so many benefits to everyone, and especially to us with diabetes. There’s also good evidence to demonstrate that those with diabetes who exercise enjoy much greater glycemic control. Not only does it give me a chance to think through my day ahead so I’m better prepared, but my diabetes control is so much more stable on the days that I’ve exercised first which makes my day run more smoothly by minimising the highs and lows that happen if I’ve missed it. I also enjoy the sunshine on my skin that will make me vitamin D, and saying ‘good morning’ to other walkers. Definitely a bonus from a mental health viewpoint too! You can read more about exercise and diabetes here. I wouldn’t be without it!

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No.5 – Showering and dressing – Everyone does this one, so nothing special with diabetes here lol

No. 6 – Planning my snacks and lunch for the day – For me I need to know that I can have healthy low-GI (and gluten free as I’m a coeliac too) options available when I need them, so if pushed the least I will do is make a sandwich and take an apple and some nuts. It really only takes a couple of minutes and is well worth the small effort.

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You and Your Routine

Of course my routine will be different to your routine. The main point I’m trying to make is that if you can consider the important things to keep your diabetes on track, your mental health in as good a place as you can, and your physical wellbeing with the good food and exercise then the day in the your life should be easier to manage. Every day is a new day, and routine helps to keep you on track. Routines can change, and if you feel that yours needs an update, then now is a great time to do it!

Mental Health

In terms of mental health with diabetes, if you feel like you’re not coping then it’s advisable to speak to your doctor. Diabetes Counselling Online has recently published an e-book on Diabetes Burnout which may also be helpful, and we offer six free hours per year of e-counselling to Australians who have diabetes and their friends and family – just go here to register.

I would also recommend a visit to see a diabetes specialist Accredited Practising Dietitian, and an Exercise Physiologist to help you get your diet and exercise routines right for your wellbeing.

My friend and I are going to try a meditation class that we found locally too (hence the meditation pic at the top).

We’d love to hear how you try to keep your diabetes day together. Hoping you found this helpful.

Best wishes, Sally :)

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too.

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#shortcuts or the #longwayround? Which is best? Making decisions & weighing up #choices

Morialta Gorge butterfly

Yesterday I had an appointment at the Dentist. Groan. Yes, it was just a checkup & clean, but I did end up with a new filling as well. My dental appointment had been delayed by about 6 weeks, due to a month long virus that had also resulted in the cancelling of appointments with my optometrist, chiropractor, my flu shot, my mammogram, and my podiatrist. I’m still catching up! So it’s been a bit of a marathon of the rounds of all my health checks, most of which are diabetes related. But all (most) is well, my HbA1c results are good, as was my random bgl fasting test & my urine tests for kidney health, my feet are doing well, my eyes are unchanged. My blood pressure was up on the day I finally got my flu shot, maybe I’ll have to change medication for that. Sigh. My chiropractor has previously worked miracles on my back, shoulders, hips and is now focussed on my knees. I know I need his help to keep mobile for the sake of my diabetes management as well as heart, lungs etc. My dentist is also important in terms of my oral health, as being able to eat & enjoy the fibrous & ‘healthy’ foods also helps my diabetes management.

Largely because I have diabetes, this is a never ending journey of health checks. I feel fortunate to live in Australia with its great universal healthcare system and affordable health insurance, compared to some countries. I do feel sometimes as though I’ve been going ‘the long way round’ to arrive back where I was before all these checkups. It all seems so hard to fit in, & I’m not always motivated nor sure that my results will be positive. I know I’m lucky: some people are following up these same health care checks and getting not so good news. Sometimes it’s tempting to delay or postpone or ignore the need for getting tests done. It all gets so complicated, fitting appointments into our regular life. It’s tempting to take the ‘short cut’ & ignore it all, relying on the bgl meter & how we ‘feel’. Sometimes we’re scared of getting ‘bad news’. But at the same time we know that by getting the tests it means that we can get proper advice, and at least know the best path to take to improve or maintain our health.

So in the afternoon, feeling fine after my filling, I decided to take some exercise. Normally that’s a walk in my suburban neighbourhood, which does have some pleasant options & is something I can do easily, as everywhere I go is relatively flat. I can also do some local shopping, with all staple needs & some luxury items being walkable, even the post office & my pharmacy are walkable. Some days I will do several short walks. Yesterday was another glorious warm day in Adelaide, & I decided to pop up to the local Conservation Park, at Morialta.

I parked my car under some tall gum trees, & hopped out. Usually I walk on the flat, a slow steady imperceptible incline takes me on a delightful walk, crossing the creek several times, then to the waterfall at the end. Usually I see lots of birds, butterflies, and koalas.

Morialta Gorge butterfly
Golden Monarch

Most of the time I am out of mobile phone range, because of the walls of the Gorge, which is quite nice. My husband often tags along, but he climbs, heading for the Tops & walking a circular route around the ridges, crossing over the waterfall at the top, and meeting me back at the car. Yesterday he was feeling a little unwell, so I was alone.

As I hopped out of the car, ready to walk down to the creek trail, I glanced over my shoulder. I saw the beginning of the track my husband usually takes. I used to walk that track with him, but now I am too slow to keep up. I thought, ‘Oh, I might just walk partway up Hogan’s Track today’. So I started. The track is wide, & has been improved since I last walked it, but it’s still a physically demanding trail. The slope is quite steep in parts, and the sunny afternoon made me hot very quickly. I was intending to go partway, then head back for my usual flat walk. Somehow I just kept finding the motivation to keep going, with frequent stops, until I found myself at the top of the ridge. Here there are several options. I could head straight back down the broad track I had just come up. I could go to one of two lookouts. I could head up higher, to the next ridge, which provides good views of the city. I looked at the sky, and at the time on my mobile phone. I had about 30-45 minutes until the sun set. I knew I did not want to be heading down in the dark. So I took an option which was not the shortest, but which was manageable in the conditions and in the time frame. I headed along another ridge for Hogan’s Lookout, and a mad scramble down a ‘shortcut’, which would shave off about 300 metres of climbing, but I knew would be a more challenging descent. As I took the path leading to the lookout, I heard a soft grunt & a rustle. I felt a little surge of fear, you never know what creature might be about, and I’d seen no humans on my ascent. I looked off the narrow path, and there was a large echidna! Poor thing was clearly more afraid than I, and was trying to bury herself, face first, all fluffed up with her spines. I took a photo, spoke to her quietly, & headed on to the Lookout.

Hogan's Lookout trail
Echidna

As I neared the Lookout, I could see there was a great view, and the sun was starting to head to the horizon.

HHogan's Lookout

Another decision: which way down? I could retrace the Lookout trail, & head back down the wide track I’d come up. Or I could take the scramble trail, much steeper & narrower: shorter by about 300 meters, but would probably take longer, as I would need to be more cautious. I found the start of the trail, not easy, as it is infrequently travelled and the start is steep and somewhat overgrown. I could see the track of a bicycle, muddy wheeltracks. I thought, if someone has recently gone down on a bicycle, I should be able to make it on foot. So over the edge I plunged.

I was rewarded with great views, birds, butterflies, & an ankle & knee threatening descent. The sun was going down, & the level of difficulty was every bit as challenging as I’d thought it would be. There were so many traverses of this steep descent that I lost count. The rains had gouged out little gullies in the centre of the narrow track, which of course was littered with stones & rocks. Most of the way I had fantastic views, into the Gorge & over the plains, with the low sun casting long shadows, with Adelaide spread out before me. There were feral olive trees scattered amongst the eucalypts, & animal droppings indicating wallabies or kangaroos. I started to worry about how long it was taking, but then I recognised that I was almost on the final traverse, & popped around a corner to glimpse my own car, parked below me amongst trees.

Home stretch
Home stretch

By this time I was covered in a fine film of sweat. My knees were somewhat tender, but they always are, even if all I do is sit. I’m pretty sure that the exercise endorphins & the mindfulness practice were kicking in, because what I felt was elation. I’d challenged myself, both physically & mentally. I’d made good decisions. I’d achieved something that I’d though was no longer possible for me to do. I reached the last little slippery slope, popped back down onto the road, crossed over & followed the creek back to the car. As the sun set, I drove slowly home, feeling quietly happy, and very blessed. I had done something that I thought might be too hard, but by thinking & strategising I’d achieved it.

Helen Wilde

Helen is a Senior Counsellor with Diabetes Counselling Online. She has been the parent of someone with Type 1 diabetes since 1979, and has lived with type 2 diabetes herself since 2001.

 

Diabetes can't stop me!
Diabetes can’t stop me!

 

 

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After the #party’s over: #guilt #regret #acceptance

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So, the Moveable Feast of Eostre, the goddess of spring fertility, is upon us once again. It’s Easter. We have a full moon, rabbits & chickens, chocolate & sweet fruit buns with a cross baked into the top. For some religions, there are other, more sombre & deeply significant symbols associated with this part of our annual calendar. For most of us, there are 4 days off work, at a time of year when the moon is full, when the day & the night are almost of equal length, with the equinox falling just under 4 weeks before Eostre in 2014, on March 20th. The weather is generally pretty ‘liveable’, whatever hemisphere of this bounteous Earth we are living in.

The stage is set for a time of rest & relaxation, of time with family & friends, of contemplation, & of feasting. In our Northern hemisphere heritage & tradition, even though we are now living in the Southern hemisphere, the annual cycle away from the darkness & deprivation of winter means it’s time to make special purchases of foods that we normally reserve for special occasions: weddings, parties, birthdays, anniversaries. Some observe religious abstinence of some food for part of this time; but all spend at least part of this time feasting.

For about 38 years, our Easter has involved spending time with our extended family. In the early days, these Easter gatherings were held at our house in a small inland country town. We actually sent out invitations, & at first our brothers & sisters & our own parents came, bringing children, the occasional great grandparent, & the occasional dog. We needed caravans & tents for everyone to be able to sleep under cover, & occasionally the bathroom & septic tank struggled to cope. Luckily we were only a short walk from the Public utilities. The cousins bonded for life.

Later, once we acquired our scruffy little fibro beach shack, all the growing cousins brought friends; girlfriends, boyfriends. Meals were mostly eaten outside, huddled away from the sea breezes in a cold year, or gloriously somnolent in sunshine in a warm year. That’s the thing about Easter: it’s a Moveable Feast, so the weather can be like the end of summer; or it can be like the beginning of winter; or even both. We still needed a caravan or a tent some years, but bunks, sofa beds, mattresses on the floor, two showers & an outdoor hose, & two toilets helped a great deal. The septic tank needed regular emptying.

I remember a lot of laughter from those years. For most of those 38 years we were at the beach shack, & our time was taken up with sandcastles, swimming, searching rock pools for little crabs, midnight Jetty fishing excursions, sailing, rowing in a kayak or canoe. Food was abundant of course, as were leftovers. We played cards with gum nuts for stakes, Coon can, Pontoon, snap.

Andrew's tender
Andrew’s tender

Nowadays our eldest daughter brings her family & we spend about 5 days at the shack. This year, because of the school holidays & other plans our family holiday ended on Good Friday. Traffic on the road to Adelaide was building up, & so they left before lunch today.

Our party this year included a full eclipse of the Moon, two red moons in a row, sunsets & dawns that were peacefully beautiful. Oh & the beginnings of a mouse plague. We swam in the sea, laughed, played games, built sandcastles & lego cities. We spotted our resident gecko, still skittering about inside the shack. We put down mouse bait, & threw out one little corpse. We enjoyed the fun of a 5 year old who wakes bursting with energy at 6.30 a.m. & wants to play baby pelicans (learning to fly & land) baby galahs, or baby seagulls. We enjoyed the seriousness of a tall 15 year old, who wants to share his thoughts & opinions about a myriad of topics. Both children are bursting with the joy of life.

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Sure, we did enjoy some great, simple, homecooked meals. We didn’t buy takeaway. We didn’t eat chocolate. We didn’t have any chocolate with us. There are 3 people with diabetes in our party, & we aren’t that fussed about chocolate anymore. After the party’s over, what happens? There are the mechanics to be gone through: cleaning up, working out what to do with leftovers, perhaps extra sheets & towels to wash, if you’ve had house guests as we’ve had. But there is no time to waste on regret, guilt, or ‘shouldn’t haves’. The motto of ‘Acceptance‘, ‘going with the flow’, is the mantra that my daughter repeated many times over the past 5 days. ‘Don’t sweat the small stuff’ in life, whether it’s about food, children’s behaviour, TV programmes, the timing of how a day runs on holiday. It’s OK to change your mind, & also to accept that in many cases whatever decision you make is just fine. Managing diabetes is organised, stressful. Reducing stress can be as simple as letting go of the ‘need’ to be the one who manages, who seeks to ensure that everything is covered. It’s actually OK for things on holiday to not be tightly planned & organised.

Technically,our party is over for this year. Last night I was woken from sleep at 1 a.m. by the sound of young girls laughing out the front. Now I hear the sound of other people’s holiday long weekend just starting. People have arrived, having made a long drive from somewhere. My elderly neighbour on one side is from the Adelaide Hills, & he is having a Prawn feast with his extended family, including a new great grandchild. His elderly red dog is resting outside in the shade. On the other side, the young family of the second son is cooking up a Sausage sizzle. Their dog is a middleaged lab, all protective when he needs to be, & all tail waggingly friendly when he doesn’t. Everywhere I hear children playing, birds calling, wind, the sound of the sea on the shore. Out the front, two little boys aged about 9 are walking past, wearing shorts & fleecy jackets.

We have decided to stay on a little. I have been very unwell, & am still moving more slowly than usual.There is a lot to do. We have no need to rush back to the city, where our daily lives are. And it’s still so beautiful here. Our original plan was to head back today, but slowly our plan evolved into a different one. Acceptance includes being flexible, open to what life brings.

happiness comes from letting go of guilt
happiness comes from letting go of guilt

carpe diem

Helen

Helen Wilde is a Senior Counsellor with Diabetes Counselling Online. She has been the parent of a person with diabetes since 1979, and has lived with Type 2 diabetes herself since 2001.

 

 

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Helen talks diabetes burn out on Coast FM

Helen 1

You might like to listen to my interview on Coast FM recently all about diabetes :)

Helen

xx

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