The stress test

Ah, Friday. Often lately, my weekends have been almost as busy as my weeks, but tonight I'm letting myself relax for a change. Maybe I feel like I can because I got a professional massage yesterday. I get these occasionally now; I actually really need them to get my back straightened out periodically, what with carrying all the extra kid stuff, in additional to my usual large purse (is it just me, or do others carry around a lot of diabetes-related stuff? I carry my meter and a small pack of extra pump supplies, insulin, and syringes, plus glucose and a glucagon kit, in my purse). Not to mention my daughter, who as I've mentioned is pretty big for her age. I feel like I'm always behind the eight ball in my strength to carry her. The masseuse said one side of my back is higher than the other; the side I carry everything on is higher, perhaps because it's more muscular, and probably also more tense!

I also really, really needed the massage to release stress - the kind that builds up so gradually over time that you don't even realize it until, suddenly, you collapse. Well, I knew I had stress in various areas of my life, but it's always hard to know when to do something about it - or what to do about it - before it overwhelms.

This got me to thinking about all the advice about stress and diabetes. You know, about how we need to limit the stress in our lives, because it can make blood sugar go up. But it's not like we go around choosing more or less stressful lives (unless you choose to be, say, a mine sweep). Stressful things happen in life. And yes, to some extent it's all about how you handle things, but sometimes it's impossible not to let things get to you (or anyway, impossible for me). And I always refused to shrink from doing interesting or challenging things in life just to keep my blood sugars in check.

For a long time, I used to deal with the daily anxieties of life by eating - usually carbs. Obviously, that's going to affect blood sugar. I tried exercise as an alternative release, and that really helped for a long time. But when I developed migraines, exercise often only made my blood sugar go higher. I had to cut back from aerobic exercise like running, to walking (if that). Now, walking is one of my stress busters, for sure. But I've added other things (besides eating), like talking (and, yes, writing); yoga; and the occasional massage. I'm shameless about asking for gift certificates for holidays and birthdays! Especially now that I'm a mom, I feel justified in doing all of these things even more often than before. I need to keep myself sane for my kid's sake as well as my own, and I'm just that much closer to the edge.

But I've noticed that the daily stresses don't directly affect my blood sugar at all. They might affect it indirectly, for example if I were to overeat, which I hardly get a chance to do now, even if I were inclined (not eating wheat makes it hard to overindulge in carbs). Stress might als make me less motivated to work on my numbers. But even sleep deprivation doesn't affect my sugars directly (that's one bullet dodged!). Good thing, as my daugher's been sick a lot lately and has reverted to wanting me with her at night. One night I held her, sitting in the chair, most of the night; the next night I went to bed early, only to wake up half way through and stay awake for hours thinking about all thing things I needed to do. So couterproductive, but insomina is not logical!

No, the real stresses that affect my diabetes are the short-term ones, like a near-accident (or an actual one). Or stage fright: Years ago, I performed in a community theater musical. It wasn't a huge affair, but I'm not much of a performer (I did it because a family member was directing). I had no more dinner than normal beforehand (maybe less than normal), yet right after the performance, my blood sugar shot up to 400. It went down below 200 about an hour later, and back to normal by two hours, without a drop of extra insulin.

I've even noticed that, on days I drive to work, my blood sugars go up higher in the hour or so afterward than on days I stay home. There's nothing like a nice drive on a Massachusetts highway to get your blood going, I guess! I actually account for that in my breakfasts on those days; I tend to eat more protein and less carb. It took me a really long time to figure this out, though, because of all the other variables: I thought I was just more active on days that I stay home, because I tend to be with my daughter. I also thought maybe it was the coffee I always drink. But even on days when I'm sitting on my duff working at home, it's better than when I commute and then sit on my duff working at the office; and the activity levels and coffee fix are the same in both cases.

So yes, stress does affect blood sugar, but not in the way that, I think, a lot of people would assume.

Have you noticed any unexpected ways that stress does - or doesn't -- affect your blood sugar?

Viral Vibes

Viruses come in billions of forms. Both my computer and I have been fighting off viruses this week. My husband's computer's power cord is on the fritz, too - so I don't know if this post will ever make it up!

Fortunately, my own personal virus is just a cold. Ah, daycare. At least my daughter is in family care, so there are only 5 other kids for her to exchange slobbery germs with. Still, as any parent knows, those kid germs move faster than anyone else's.

I haven't noticed my blood sugar being much affected by this cold, but stress seems to have been doing a good number on my numbers. Work is stressful these days - but I should be thankful to have work, right? But work could take up all my waking thoughts quite easily (you don't want to hear about that).

So could my daughter's changing moods and thoughts. She's going through what I think is standard for her age: high drama. I wouldn't call it the terrible twos, because much of the time it's positive. All her stuffed animals have come to life in her head, in just the past couple of weeks, it seems. Of course, she likes to have help animating them, and the scenarios tend to be rather repetitive (rather). But she gets the biggest kick out of the little girl mouse popping out the doors of her castle (made for other dolls) and saying "boo!" I mean, she giggles hysterically every time; then she says "do it again!" Yes, when I try to suggest a different game, sometimes a small fit ensues; but she can actually be persuaded most times. Is that common for a 25-month-old?

Yet when trouble comes up, it's Big Trouble: At daycare last week, after a too-short nap, when she saw a little boy (really the sweetest boy) sitting in the chair she often sits in to "read," she screamed and grabbed and tried to pull him out of the chair -- apparently by the neck. I know this sort of thing is common at this age; at least it wasn't hitting or biting). Both I and her daycare provider (Kim) talked to her about not hurting others, and Kim helpfully looked up ways to handle this stage, as she hasn't had any other girls this age before (she was a preschool teacher for a long time). Apparently, having her own special spot can help H head off such emotional collisions. She can go to it when she's had enough of cooperating and sharing. I just feel bad that I can't see the problem first-hand, it would be easier to figure out how to help. But we don't see this at home; she's the queen bee in her nest of toys.

Meanwhile, I'm still trying to get her the H1N1 shot (aren't most of us still?). Actually, I've been hearing that other states are doing clinics, whereas our pediatrician can't seem to get more than a handful of doses each week, and those are either snatched up before I can take a breath in the morning or are earmarked for the "high risk" kids. Because H is one month past her second birthday, she doesn't officially fit that category; but as her pediatrician admitted, viruses don't pay attention to such artificial cut-offs. So here we are. And of course, I am in the high-risk category, but adults can't get any H1N1 vaccine yet, at least in Massachusetts. I just want to get this done so I can stop searching for the vaccine every day, and stop worrying. So add that to the stress list.

But enough about viruses. I am looking forward to getting a continuous glucose monitor that syncs with my insulin pump (it'll tell the pump my blood sugar readings when I go to enter insulin), now that my insurance will cover it (the insertion sets, which must be changed every few days, will be expensive, though). I've had experience with a CGM before - during pregnancy - and I know it'll be incredibly helpful (particularly for that black box that is the night time). I hope it will be better than the previous generation of CGMs. I used a different brand during pregnancy, one that didn't sync with my pump. I don't want to name it because I think that brand has come a long way, too, from what I hear. But it would beep in the middle of the night a lot to signal a low when I wasn't low; though it always beeped when I really was low. I hear that with this new monitor, if you sync it with your finger-stick tests at the right times of day, it's really accurate, so you only have to do maybe two finger sticks each day. My calloused fingers would love that - though I've been thinking of taking advantage of those callouses by taking up Celtic harp playing (no kidding!).

I'm curious what you other moms out there are experiencing with this H1N1 thing. Are you as worried as I am? I'm also curious if any other type 1s have experience with the current-generation CGM from Medtronic.