Under Pressure

I love both Freddie Mercury and David Bowie, so I’m starting the new year off with a nod to both in this post’s title. I haven’t written in a while and there have been several reasons why.

First off, I had been training since last June for my very first marathon in October. My goal was to run my first before I turned 50. (Which is another blog post yet to come – 50 years old and 40 years of T1D.) I was feeling really good and was only 4 weeks away from race day – had already logged more miles than I can count and had gotten up to 20 miles on my long runs. I was ready! Running that many miles is not easy for anybody. It takes dedication, eats up a lot of your time, stamina, endurance, etc., etc.  Running a marathon with Type 1 diabetes is even harder: you get all the preparation and body hardships as anyone else, but then you have to figure insulin dosing, temp basals, how many carbs for how many miles, what to do when you’re high, but you want to run that day, or what to do when you wake up low before a 15-mile run. Neil Peart of Rush once compared his drumming to mentally doing calculus while running a marathon – I’m paraphrasing because I don’t remember the precise quote (I’m sure someone out there can set me straight though), but it does occur to me that is exactly what Type 1 diabetics who run do!

Alas, that goal was not to be. I was 15 miles into my last long run before tapering down for race preparation and my foot slid, my ankle rolled, and I instantly broke a metatarsal. I was beyond pissed at myself and utterly destroyed. I had worked so hard for this, and it was just not going to happen. So, I put on a brave face and said it was okay, I’ll start training again as soon as I can. It wasn’t okay though. My body betrayed me yet again like it has been doing for the past 40 years and that was really pretty depressing.

My diabetes control took a beating right about then, too. I literally went from full-bore exercise several times a week to nothing in one fell swoop. So, the lack of exercise changed my carb ratios and basal rates dramatically. The stress and depression from that loss messed with my

 

blood sugars too. If you’re reading this, and not a T1, please note that this happens. Stress is awful on diabetes and it can be a vicious cycle. Stress begets high blood sugars, which beget stress, which begets high blood sugars – I’m sure you see the pattern.

Then my boyfriend and I found a house we wanted to buy. We had been looking since the summer, had already been qualified for a mortgage together, so were ready to make an offer, but had not found anything we really liked. We had just decided to give up for the winter and start again in the spring when we found a house we both fell in love with. It was a difficult purchase for various reasons that we had no control over, which of course was very stressful and we’ve already seen the stress plus diabetes equation at work. Just before we put an offer in, we had also booked a week-long trip to London to celebrate my 50th birthday, something we probably would not have done if we had known we’d be buying a house! So, we closed on the house the day before we flew to London, flew back a week later, packed like crazy people, and moved in the following weekend – a week before Christmas no less with my mom and kids coming to stay with us as well! More stress! Moving is one of the most stressful events people go through. The holidays are too! And winter in New England was fast approaching! So much to do! The house had plumbing issues also – stuff that needed immediate attention. Thankfully, we found a great local guy who got us up and running quickly, but moving equals stress too and everything always costs more than you think it will. Money equals stress. We had a perfect storm of stress inducers flying at both of us!

So, how does a diabetic deal with stress? I’m sure everyone is different, but I, personally, hit a breaking point where the stress and my (usually from stress) high blood sugars collide and I wind up in a heap of tears feeling like what’s the point in trying to manage T1 if nothing you do makes a difference anyway. That’s counterproductive of course, as it adds to the stress, which adds to the blood sugar response, which throws me back in that awful stress/blood sugar cycle.

I’ve got a wonderful guy who amazingly has always known how to handle these things with me, particularly where my diabetes is concerned. I don’t know how he does it. A supportive partner really is a wonderful thing and cannot be understated. I do feel the need to add, because I’ve experienced it myself before with family and others and I’ve witnessed it in motion, that telling us to “just calm down” really has the absolute opposite effect. Now we get to feel stressed about being a burden or causing problems for other people as well! More stress! That equation comes into play yet again: stress + diabetes = high blood sugars = more stress. It’s partly a purely physical reaction – just like anyone else in a stressed situation, our bodies gear up for battle and release adrenaline for a fight or flight response. Unfortunately, that hormone release is to facilitate getting glucose to your muscles so that you can either fight or flee. Well, the glucose doesn’t get to our muscles without an assist – injecting insulin. So, we’re left with high blood sugar in response to stress. It’s a delicate balance because once the adrenaline subsides, that hormonal response is gone too and our blood sugars can drop like a rock now. Forty years in and I still have not figured out how to effectively deal with this, because there is no equation to follow here to “fix” it. Unfortunately, one day the same situation would need just a 150% temporary basal all day, while another day will require upping my bolus amounts and several basal changes. Every person responds differently too.

And now we’re in the new year and we’ve settled into the house we love, our Christmas present to each other this year, and things have calmed down. I had another blow to my running recently though – my foot is not quite ready to get back out there yet. So another couple more months and yet more x-rays and we’ll see where I’m at. I’ll get back there though of course. It’s something I need to do. I’ll continue to deal with any stress that comes my way too. I can’t say I’m thrilled about another delay, but I will deal with it and I have no choice but to deal with the blood sugar roller coaster that may happen as a result. It’s just what we do.

 

 

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Stacey Rose
Stacey Rose is a type 1 diabetic mom of 3 (one of whom also has type 1). She is writer, runner, and music lover. She lives in Massachusetts and travels to LA frequently.

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