guest post! – engage: exercise and diabetes – allison’s story

Throughout November, the diabetes community has been up to serious Good Things advocacy-wise for Diabetes Awareness Month. Many of my favourite things are initiatives like the Big Blue Test or Connected in Motion‘s World Diabetes Day Scavenger Hunt, that help create awareness while getting people–with and without–diabetes active at the same time.

To close off the month, Allison Nimlos offered to share some of her thoughts about exercise and type one diabetes–and how, despite the ever-constant and ever-changing variables that come into play when managing exercise with diabetes, it is worth it to persevere.

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After 19 years of living with type 1 diabetes, there are two things I know for sure about diabetes and exercise.

1) Exercise is essential for managing diabetes.

2) Exercise is a nightmare for managing diabetes.

Say what?!

No, this isn’t the Twilight Zone, but it is a fairly well-known fact that exercise is both amazing and horrible when it comes to managing type 1 diabetes. For type 2 diabetics, who rarely deal with low blood sugars, exercise is almost all good. But with type 1 diabetes, it gets quite complicated.

In managing type 1 diabetes, you’re basically a juggler. You’re juggling known factors, like insulin and food, but you’re also dealing with unknown factors, like hormones and stress, which can impact how your body responds to insulin. They aren’t anything you can control, so you just have to deal with things as they come. Exercise is sort of in between. Exercise is something you’re aware of — obviously, you know when you’re exercising — but the effects of exercising can vary from person to person, activity to activity, and even day to day!

Because of this, I’ve never been much into fitness. It’s actually easier, in some ways, not to be athletic because it’s one less variable to worry about. That doesn’t mean it’s good for you! Of course, it takes a lot of time and practice to figure out how your body responds to different exercise routines and what your blood sugar target levels should be. Diabetes is a very individual disease!

For instance, yesterday I ran a mile at the gym and ended my workout at a great blood sugar. Today, I ran another mile, and ended with a low blood sugar. Frustrating! But on the flipside, I also know that fitness helps me become less insulin resistant, which means my insulin works even better, my blood sugars in the long run will be lower and more stable, and my body will also be healthier in other ways. One of the major complications of diabetes is heart disease, so having a healthy heart and body through fitness is another excellent way to achieve that.

Here are some tips that I have for switching from being a non-exerciser to an exerciser when you have diabetes:

1) Stay observant. Diabetes changes depending on the variables, and it becomes a little easier to manage when you start paying attention to all the variables. From food and insulin, blood sugars before, during and after exercising, and even time of day, all those can impact your diabetes. Once you see what combinations are more successful, you can start trying to duplicate them.

2) Food isn’t the enemy. A lot of people don’t want to exercise because they are afraid of low blood sugars, and that means eating. But calories and carbohydrates can actually help you lose weight and be healthy. The right food is fuel! So eating does not necessarily mean you’re discounting your entire workout.

3) Be consistent. It takes practice, and a lot of people want to give up after the first workout because things aren’t perfect. But just like your first run or first time at yoga isn’t going to be great, your first time managing diabetes while exercising probably won’t be great either. You have stick with it, make adjustments, and even talk to your “coach” (doctor or diabetes educator) before you eventually get to the point where things will be easier.

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There are also many inspirational athletes with diabetes that constantly remind me not to let my diabetes get in the way. From Phil Southerland, who cycled across America, to Zippora Karz, who 
was a prima ballerina, to Will Cross, who climbed Mt. Everest, there’s no accomplishment that is out of reach for a person with diabetes. However, one thing I have learned time and again is the need for practice. It’s like training for a marathon. You don’t just go out there and run 26.2 miles. You have to start slow, practice, train, talk to people, and learn. Only then can you be successful! 

DSC_1755.JPGIt can be so difficult to adjust to something new. Not only is it physically difficult if you’re not used to running or cycling, but it can also be difficult to stay on top of your blood sugars, because your routine is completely changed. In the long run (no pun intended!), the benefits outweigh the negatives, and I’m personally more committed to fitness than ever. Plus, with the support of the Diabetes Online Community, my endocrinologist, my diabetes educator and, of course, my husband, I know that I can manage my diabetes and stay fit.

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Thanks Allison!  Allison blogs at With Faith and Grace, and is an active diabetes advocate, member of the diabetes online community (DOC) and writer for Diabetes Mine. Currently Allison is pursuing studies that will lead her towards nursing and becoming a Certified Diabetes Educator, creating for diabetes awareness at Blue Cupcake Press . . . all in addition to maintaining an active and balanced life with type 1 diabetes. You can find Allison on Twitter at @WithFaithGrace.

“a journey of empowerment, hope and love.” – jeff’s story on type 1 diabetes

Jeff Neitzel and I connected on Twitter within the last couple of months. Jeff and I have a shared love for taking our chronic disease journeys as they come and maintaining a [perhaps sometimes annoyingly-so] positive perspective on life with invisible illness. Most times when you ask Jeff how he is doing, the answer is atypical but one I love: “Shiny” :] (He’s also taken to my use of square bracket smileys, which makes me smile!).

Jeff graciously agreed to write a blog post about some defining moments in his Type 1 diabetes journey, and I am thankful for his willingness to share candidly some defining points from the travel map behind him in his type 1 diabetes journey of 28 years . . . and counting!

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Thank you very much, Kerri.  Your asking me to write this has helped me rediscover valuable memories that I might have otherwise forgotten.  I’m truly grateful.

Intro

For the record, I was diagnosed with Type 1 Diabetes on Tuesday, March 6, 1984 in Mooresville, IN, USA.  I was 13 years old at the time.  Fortunately, I have an older sister who diagnosed years before. So, my mother and I knew what was going on before we ever went to the doctor on that particular Tuesday.  If I may, let me tell you that I am a lucky man.  I doubt I’d be where I am today without the help of so many great people over the years.

My diabetes is a friend who has given me a lot over the years.  I truly count it as a blessing in disguise.  See, my diabetes and I are on a journey together.  In many ways, this is a journey without a predefined destination.  It is a journey of empowerment, hope, and love.

I guess you could say…  It’s not so much about the where I go but how I choose to get there.  The journey itself is the destination.  Are we there yet?  No, not yet.

Michigan

Now, I’ve said it before…  My diabetes life has been nothing short of a whirlwind.  The memories I have of my early diabetes days are pretty vague.  There are those events that are unforgettable though.  Here is one of them.

The only diabetes camps I remember going to were bicycle trip camps that were organized (in part) by Sam, my diabetes doctor.  They were both trips around Michigan with a ride across the Mackinac Bridge and a break day at Mackinac Island on one of them.

The riding and camping during these days was exciting, fun, and full of learning.  To this day, I still remember my most important take away from all this–and that is . . .

Don’t hide your diabetes.  It doesn’t have to be invisible.  Be proud of it because it’s part of you.  The visual take away in my mind is symbolized by all of us outside a shop on Mackinac Island checking our blood sugars, taking our shots, and all that other fun diabetes stuff.  Yes, people could see this bunch of kids with diabetes doing our thing and having fun while doing it.  Unfortunately, I don’t have any photos of this.  Alas, it is still a vivid and important point of diabetes empowerment for me.  I’ll carry it with me always.

Indiana and College

I don’t want to bore anybody with details of my first go at college stuff.  So, let’s just say that it was an interesting challenge not just for me but for my family as well.

There are a couple tidbits that are worth sharing in any case.  One is…  I wouldn’t recommend getting low in public, in your residence, or in your class(es).  My mom and my doctor had to make the college see the light on one occasion to stop them from kicking me out for getting low.

The other is…  In retrospect, I know now that I was dealing with depression at the moment in time when I jumped off the college ship.  See, I had a revelation back then that I wasn’t going to be around forever.  Rather than learning about the world from books, I decided it was time to leave and forge my own path in the world by just doing it.

It probably wasn’t the best decision in the grand scheme of things, but it was required for me at the time.  I’m a better person for it today.

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Boston and Beyond

Now, college was worthwhile for sure.  I’d return to complete my degree eventually.

My Boston years (from about 1994 to 2000) though…  They changed me absolutely in more ways than I can possibly convey here now.  Without going into the day-to-day of my life in Boston or the work I did there, I will say that it centering myself around this amazing city is one of the best decisions I’ve made in my life (to date that is).

The thing that was/is most valuable to me about Boston is the amazing friends I made while I was there.  Even though I’ve lost contact with many of them, there are a few people I still know from those days.

For the most part, Boston served as a jumping off point for my travelling via train, plane, bus, and bicycle.  This included trips to various parts of Europe, to Canada, and across the USA on at least two different occasions.


JANeitzel1-AmtrakDerail.jpgOne example I’d like to share is one of a train derailment.  Having ridden my bicycle from Boston, MA to Albany, NY (summer 1994), I then caught the Lake Shore Limited bound for Chicago.  Long story short, the train derailed near Batavia, NY on the way to Buffalo.  102 people were injured, but I wasn’t one of them.  Regardless, this was just another example to me of why it is so important to appreciate what we have in this world.  I’m not talking about material possessions either. I mean the power of the connections among people. I met so many fascinating people that day. People who were different from me but like me.  Knowing that we are all connected in one way or another despite our differences is so important to me.  That day just illustrated in a very powerful way.

So, where was diabetes during these travels?  It was right there with me every step of the way.  This whole span of my life was about much more than diabetes though.  It was about my love of people, geography, and cities.  Diabetes was there as my companion, not always the most cooperative companion mind you.  Still, diabetes made and still makes my adventure more fulfilling in more ways than I know how to say.

It simply allows me to appreciate more than I might otherwise be willing to appreciate if you get my meaning.  Things are just shinier for me when they’re good.  It’s the blessing in disguise thing ya know.

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In my mind, it’s all about the journey and connecting the dots of my life with those of others.  So far, I’ve gone from Indiana to Boston, Beyond, and back again.  I’m not there yet.  Diabetes will not stop me.  So, my journey continues.

Diabetes is a journey with many facets.  Those facets include the mental, the physical, and the spiritual for me.  It is a difficult journey for sure, and I’m not always so shiny.  That said, we (my diabetes and I) try to get up every single day and embrace the imperfection of it all.  Sure, we fail sometimes.  That’s life though in my estimation.

Anyway, we choose to keep on moving…  Are we there yet?  No, not yet.

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Jeff blogs at Betespora, an engaging chronicle of his “D-Quest”, reflections and some philosophizing thrown in for good measure–I can’t speak for others, but in my journey reading back, it constantly challenged me to question myself and my world . . . and DO something good! I haven’t been following Jeff’s blog for long, but it quickly became among my favourites out there.

Jeff has a degree in Information Systems and has special interest in Open Source programming working [and speaking in what I am convinced is a foreign language!] on the v6shell project :]. Jeff can also be found on Twitter at @betespora and @v6shell.

low monologuing – jamie’s story on type 1 diabetes

A question that gets thrown around frequently in the Diabetes Online Community [or DOC] is that of “What does a low blood sugar feel like?” My friend Jamie lives in the Toronto area, and has been living with type 1 diabetes for over twenty years. Jamie is also on the Chronic Roadtrip planning team, and we have had several amazing Skype and Twitter conversations on advocacy. Today, I’m thankful to have Jamie here sharing another bit of her creative diabetes advocacy (like her whiteboard at work, which I love!) as she shares yet another perspective on living with an invisible illness with a creatively written post! Thanks Jamie!

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You sit next to her on the train every day. She is a lovely woman who chats about her day, and you chat about yours.

She shares her hopes for a promotion. She talks about the sweater she almost bought but couldn’t bear to pay an outrageous fortune for it. She complains about the fight she had with her cell phone provider. She listens to you as you banter on about your workday.

Then she falls silent. She opens her purse and rummages through it. You close your eyes – it’s been a long day.

Then you feel a tap on your knee. You open your eyes and she’s looking a little flushed, and asks you if you happen to have any candy. You do, and hand her a crumpled bag of Skittles that has been lurking in the bottom of your purse. She looks relieved. She tears open the bag and eats them, then leans back in her seat and closes her eyes.

After some time passes, she perks up again and continues her banter about her daughter’s new job, and about the fact that her vacation is only “5 more sleeps”.

Pretty normal stuff. Right?

What you don’t hear is her internal conversation. To outsiders it would sound like a foreign language. It is a stream of consciousness, a constant underlying hum in her brain.

Am I high? No, it’s a low. Crap. Did remember to I stick my kit in my purse before I left? I don’t know. Can’t remember. I did. Ok. Test. Why do they make those stupid strips so tiny and they stick together. Did I bolus too much for that cookie? It was 3 hours after I had lunch. Maybe it was too soon to bolus. My pump said I didn’t have any IOB. Crap. I feel low – 3.1. Crap. I AM low. Where are my lifesavers? Stupid me. Stupid black hole in my purse. Why won’t my fingers work? Maybe she’s got something. She’s sleeping! Should I wake her? I’m soooo hot. Why don’t they turn on the air conditioning in here? I don’t know. YES!! Just tap her on the knee. She won’t mind, right? Thank goodness. Thank you! I wish I had a drink. I HATE cottonmouth.

This is the face of a person with Type 1 diabetes (aka Juvenile Diabetes, Diabetes Mellitus). This is the face of an invisible illness.

Type 1 diabetes requires constant management and frequent interaction. Blood sugar needs to be tested 8-10 times a day – sometimes more. Many inject insulin several times a day. Others use insulin pumps which pump insulin constantly, but it doesn’t end there. No matter which method, people with diabetes must count carbs for everything they eat, and get it right. They must add (or bolus) extra insulin – and get it right, for even a small error can cause a “low” or “high” blood sugar which must be dealt with by adding more insulin when blood sugars are higher than they should be, or have some “fast sugar” to counteract a low, which can lead to many physical symptoms – anything from sweating, confusion and even loss of consciousness.

These are some of the immediate issues that must be considered before any worries about complications we’ve all heard about, like kidney failure or blindness. Of course, people with diabetes worry about these things too, but it is so much more than that. The management is constant. The worrying is constant. The inside monologue is constant.

There are no breaks. The internal conversation does not rest. This is the hidden illness of diabetes.

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Jamie lives with her husband Larry, and is an advocate for both diabetes and accessibility awareness. In addition to three kitties and a dog, a member of the “furball” part of Jamie and Larry’s family is Keeta, Larry’s guide dog–accessibility for people who are blind is a big part of what Jamie advocates for!  Jamie enjoys reading blogs and collecting stories in InkStain’D, . You can find Jamie on twitter at @InkStain_D and her blog at Flying Furballs!

in case you missed it: an update to jay’s story

In case you missed it, an update to “A moment changes everything”: Jay’s Story was posted on Monday, so please check in to see how Jay is doing after his first year of living with diabetes!

As I articulated in the preface and post-script to that post, I am honoured to be able to share people’s stories of how they live, adjust and thrive with chronic disease. Jay and I have had many, many awesome conversations on the topic via e-mail before and after this post went live in January, and I am still blessed that he and all of the other guest bloggers who have shared their stories here, chose to take that step and share insight to their worlds.  To Jay and everybody else who has chosen to share their stories in this space: THANK YOU!

“a moment changes everything”: jay’s story

[Scroll down to the blue text to read Jay’s January 2013 update!]

When I signed up for Physical Activity: Promotion and Adherence last spring, I had no idea that the mysterious Staff-1* at the time would be well beyond ‘just another instructor’.

The mystery instructor turned into Jay Greenfeld, who through lecture and many e-mail conversations, has not only helped me work through various things, but also to think of things differently in regard to not only exercise, but life, and continue rolling on the journey of changing myself for the better.  Additionally, the class was the most tangible and enjoyable experience I’ve had yet in university (can I take it again?!).  [And no, it’s not just because he throws snacks out to people during class. Although that is freaking awesome. Except he doesn’t throw the apples. Related: highly enjoyed the discussions on Mean Girls, cereal and how nobody ever uses the stairs].

After our class discussion on exercise and chronic disease, I was moved to blog my exercise and asthma story and opened up the floor to others who choose to own their disease through exercise to share their stories (I’ve been passing some of those stories along to Jay, too, by the way!)

During the lecture, Jay shared the Sparknotes version of his story of being diagnosed with type one diabetes in August 2011, and how that fits into where he’s at in regard to exercise and life.  As Jay said in class “Yes, it does suck, and yes it is interesting” . . . to which I couldn’t agree more.

I’m amped to have Jay telling his story, with the shared hope between us that it may help somebody else in a similar situation.  Take it away, Jay!

jg3.jpgWe all hope to live fulfilling, memorable, and healthy lives. Leading healthy lives tends to be the most difficult for many. I was fortunate to be involved in athletics throughout my life starting at the age of 4. Although being born premature delayed the onset of the typical teenage growth spurt, I enjoyed the high level to which I was able to compete in Ice Hockey, Soccer, Tennis, and Swimming. After high school finished, I modified my participation in athletics to focus on coaching and used my personal time to exercise. While engaging in regular exercise, I chose to optimize my diet by eating balanced colorful meals. Professionally, I was fortunate to progress through an animated experiential academic journey that led me from the University of Winnipeg for college, New York University for my Masters, the University of Iowa for my Doctoral degree, and a 1-year internship at the University of South Florida as the final requirement for my degree in Counseling Psychology. I was blessed to apply my health and wellness strategies and stress management techniques to hundreds of University students and college athletes.

According to my friends I was the epitome of healthy living; abstaining from drugs and cigarettes throughout my life and maximizing each moment with the people I was fortunate to interact with. When questioned why I chose to live this energetic lifestyle (intentionally trying to motivate people of all ages to optimize their health), I responded: “Life can change in a moment and I want to ensure I have no regrets.” Those words were the very words I shared with a friend of mine mere moments after I finished the final requirement for my Doctoral degree. With my car packed it was time for me to drive from Tampa, FL to Winnipeg, MB and begin my formal career. I was set to teach health and wellness classes at the University of Winnipeg and work at a group practice doing psychotherapy for varying ages of the population.

It is important to note that my car was repaired after a significant accident in April 2011 that led to $7,000 damage, 24 hours in the ER, and $10,000 in medical bills (all covered by the other driver’s insurance). Four days later I flew to Iowa to defend my dissertation and celebrate my birthday with a few very important people in my life. Well, that was when things started to shift. I had to stop exercising to focus on the rehabilitation from the car accident and simultaneously started to lose weight for the first time in my life. I figured I was losing weight because I had to stop exercising, but when I lost 25 pounds between May 2011 and August 2011, I knew something was wrong. Nevertheless, I began the 2500 mile journey to Canada.

My last stop on my journey was visiting one of my closest friends in Des Moines and as we were eating dinner one night I said: “Something is happening to my body, but I don’t know what.” I continued the journey and had a delicious home cooked meal with a friend of mine and her mom in rural Iowa. It was a perfect ending, an exclamation point on my studies and moments in the U.S. with the most authentic conversation while feeling at home during this lunch. I realized one of the main reasons I decided to accept the job offers in Canada was because of family. So, I drove off into the sunset overlooking the breadth of corn fields that spanned the Hawkeye state. I left Iowa knowing I accomplished everything I wanted to do and was eager yet patient to return home to celebrate my sister’s 30th birthday with her.

Well if “a moment changes everything.” ….that moment happened once I crossed the border. For some reason between the border and my house (approximately 75 miles), I had to stop and use the facilities 3 times. I eventually arrived in Winnipeg and within 24 hours of rolling over the border, I was embraced by a wave of family members. I attended a wedding the next day and said to a friend of mine, “I am not well.” I called my uncles from the wedding and told them I needed some blood work because my energy was depleting as was my body weight. At this point I had lost 12% of my total body weight since April.

I met one of my uncles at the hospital at 8am the next morning and when he saw me he thought I was fading and he has no idea how I drove across the country looking the way I did. August 15, 2011 I had blood tests at 9:00 am, 10:00 am I had a meeting with the University of Winnipeg to review the syllabi I created for my courses, and came home at 10:30 to a voicemail: “Jay, you need to come back to the hospital, I have your blood test results. You have Type I Juvenile Diabetes.” I returned to the hospital and met with an endocrinologist and he told me that my blood sugars were higher than 36.0 mmol/L (close to 700 mg/dL). As the Diabetes Education Centre was teaching me how to use insulin, my legs and arms started to go numb, my vision became blurry, and my mouth and face were drying out along with the rest of my body with muscles protruding from my skin. I was going into shock and by 11:20 am I was carted off to the ER wearing nothing but a t-shirt, jeans and sunglasses as it was too painful to wear sandals. After the hospital staff spent 3 days rehydrating me I left and noticed that my car was hit from behind in the parking lot while in the ER. I returned to the hospital the next day because of boils on my head and face that were from a bacterial infection I developed from being in the hospital.

I have no idea how this diagnosis happened, but more so how long I was living with it AND how fortunate I am to be alive. As I was going into shock, thank goodness for the mindfulness breathing stuff I was doing in the ER otherwise who knows how much worse it would have got. So there it was– the moment my life changed forever. It is not life ending, just life modifying. Just because I will need to modify how I live (i.e., taking daily shots of insulin), I will not change my life or my perspective. I am fortunate that I have been leading a healthy lifestyle (with intentional eating and exercise) throughout my days which led the dietician to speculate that I was some sort of anomaly. After the brief dance with death I resumed physical therapy to repair my shoulder, back, and neck from the car accident, and made any attempt to get back to my “normal” life. In reality I was FAR from getting back to normal as I would come home from physical therapy with feelings of nausea and exhaustion.

I told my team of nurses and doctors, “Just tell me what I need to do and where my blood sugar levels need to be at and I will do it.” They gave me the information yet what they failed to mention was my blood sugars can be a little higher a couple hours after eating. Within weeks I was able to get my blood sugars between 3.5-5.5 mmol/L (64-100 mg/dL) and thought that is what they informed me would work. I began teaching and doing clinical work after Labor Day. Throughout my working days, I spoke with people at the hospital they provided encouragement for my numbers and amazement at how quickly I was able to have the numbers so close and so consistent. I took that encouragement and what I thought was progress and proceeded to live my life while most mornings and some days I had levels lower than 3.0 mmol/L (~75mg/dL).

So the days continued and I was having sugar lows 3-4 times/day leading me to feel faint, dizzy, and increases and decreases in body temperature. To compensate I had to treat each low with a lot of sugar and in addition to my meals I was eating the equivalent of 2.5 candy bars per day for 4 months. To help gain the original weight lost during the summer I was also given meal replacements as snacks. So, my body weight increased to 20 pounds higher than it had ever been in my life.

Let’s just say my first 100 days in Canada were not necessarily what I had hoped for (physiologically). Although work was extremely enjoyable in large part because of the people I am fortunate to collaborate with, life outside of work had been nonexistent due to the lovely August diagnosis. Although I felt I was making good progress with the blood sugars and such after attending 3 weddings in August– that was not the case which prevented me from going to Vancouver & Israel for the 4th and 5th weddings in 90 days. There had not been 1 day where I went without multiple lows. With the blood glucose meters available sometimes they are not 100% accurate and I was teaching in the afternoons with blood sugars closer to 3.0 mmol/L (less than 70mg/dL). Some of my lows (especially in the mornings) were borderline seizures and risk of a coma.

Unfortunately, the lows led me to feeling exhausted, blurred, and no energy to even think about doing anything after work. I reserved all of my energy for my students and clients and when I got home it was bedtime. I was passively moving through life in a fog, yet somehow able to function basically driving with the physiological gas tank on empty. Throughout the first 100+ days while living in Canada, I was the complete opposite of who I normally am and the antithesis of my book. I often limited my social phone calls to one per week due to the lack of energy to engage in a conversation where I am most present the way I want to be. If it wasn’t for email, text, and Facebook, I would most likely just not have the energy to be in touch with very many people. My social interaction outside of work focused on 11 hours of weekly physical therapy to repair my body and even that was an internal struggle to stay present, but I tried. I was hopeful that the physical therapy would help give me a sign of hope that something was progressing even if it required whatever little energy I had left.

Mentally and emotionally I was obviously frustrated at times, yet I did not isolate myself because I don’t like people or don’t want to see people. I just did not have the energy to do those things. I was not depressed or anxious about the current or future moments. I remained hopeful that things will continue to normalize as there are millions of people with this diagnosis. Physically, if it was not for physical therapy, I have NO IDEA where I would be. For the first time since April, I started to exercise at 25% four months after the diagnosis–a miracle really. Socially, with great difficulty, I made a few attempts to have the energy to connect with friends and people I care most about yet that has been limited and I remain optimistic it will improve. I had a few visitors come to town and tried to spend time with them after work. However, I was so disconnected from myself that although I felt my mind and heart were present in the conversations, my body was so distant that I was numb or void or any emotional and physical connection to . . . life.

By December 2011, I opted out of attending my graduation ceremony at the University of Iowa as I did not have the energy to even talk never mind fly. My skin was breaking out, my energy was depleted, my eyes were black and red, and at night my vision was often blurred and body helpless. I had learned I was taking too much insulin and HOW to adjust for that in a safe way. In August 2011 I was taking a total of 53 total units of insulin throughout each day and having 3-4 lows per day. The nurses adjusted my insulin slowly to 45 units per day. After a conversation with one of my first friends from pre-kindergarten in mid-December, I changed my total insulin intake to help increase the blood sugars and prevent the frequent lows. Currently, I am not taking any insulin and exercising at 70% until I return to my normal flexibility. The drastic shift in my insulin intake compounded by more routine exercise made significant changes in my ability to function at my pre-diagnosis levels. I also recognize and understand the “honeymoon” phase and know that I will return to taking insulin at some undetermined date. If it was not for that phone call with my friend and a shift in my primary endocrinologist, I have no idea if my energy would have returned as it may have been too late. As of the beginning of January I began to slowly resume normal cognitive, emotional, and physical functioning without experiencing the numbness, pain, and fog.

[Editor’s note: The following paragraphs are an update to Jay’s story, added August/October 2012 and January 2013I returned from a wedding in late January with strep throat and the flu. After recovering and ending my routine physical therapy, I began trigger point acupuncture on my shoulder, neck, and back, 3 times/week, which helped tremendously. I had also developed excruciating pain ion my lower left abdominal region which was later diagnosed as myofascial pain syndrome causing pain when I would walk and sit for longer periods of time.  I recovered from the upper body injuries by the end of February. Shortly thereafter as I intended to resume my normal exercise, I tore a muscle in my other shoulder. I returned to brief physical therapy for a couple weeks and began massage therapy 2 times/week for a month. By the end of March, I felt myself returning to normalcy. So, I resumed the slow, steady, and light exercise and by June I needed to start taking insulin again. The amount of insulin to carbohydrate ratio changed 4 times obviously leading to more lows, but with the experiences from the year, I understood how to work with it. Due to the Diabetes, injuries take longer to heal and it was not until August when I started to feel relief from all the injuries.

I then learned in September 2012 that the odd stomach pains that began during the summer of 2012 turned into frequent trips to the GI unit and they couldn’t find anything. So, I went with Eastern Medicine and they discovered a Candida overgrowth that leads to chronic fatigue, bloating, and cramps. So, the abdomen pain was lurking for months as was the excessive tiredness, because I had been living with a yeast infection since October 2011. The yeast overgrowth was better explained by taking too much antibiotics that were prescribed for the pain and various illnesses caused by my frequent appearances at the hospital. I then had to go on a detox diet to clean out the excessive yeast. So I was drinking nothing but these powdered shakes for 4 weeks to repair my stomach lining. The yeast had infected my body so much and certain foods I was eating made it worse leading to my organs (i.e., nervous system) shutting down in Sept/Oct 2012. I had lost 15 pounds in 2 weeks and apparently my small intestine was damaged, my stomach lining was torn, and my gastrointestinal tract basically stopped functioning. Through it all I stopped needing insulin and had to remove gluten and dairy from my diet in order to function.I started to see an Osteopath in November 2012 and he had told me after assessing my body that my organs were in a sort of earthquake from the car accident leading to damage on two spots of my spine and the reverse side– my bruised esophagus, and damaged small intestine, pancreas, and lower ab region.

By the beginning of December 2012, my blood sugars were finally balanced needing a maximum of 10 units of long lasting insulin (5 at night and 5 during the day), my injuries were healed, and my exercise was finally optimal.  I had flown to New Jersey to visit my sister, came home with the flu, and once I recovered, it was January 2013 when I felt myself, my body, and my world were truly healing. Finally, after 20 months, I can honestly say, it’s been quite the ride (and continues to be). Regardless of the routes I took to heal, it was more about what was best for me as I felt both Eastern and Western medicine contributed to my health improving. After seeing 8 different specialists for 12 different physical injuries, strep throat/flu four times, and the Diabetes diagnosis . . .  I am moving forward, because I refuse to give up.

jg1.jpgI love each one of my friends and family members, who have offered their support (especially those select few who have truly articulated themselves so beautifully). I apologize for the people in my life who I may have neglected or sent mixed messages to as I try to recover and I am taking each hour at a time. I am sad by some of the connections I have lost because of my inability to truly communicate my experience as it was happening. I have understood why certain friends and people in my life may have been offended by my lack of consistent communication (both verbal and nonverbal) and unfortunately I need to be focused on my health. Finally, I am beyond appreciative of the support I have received from my students as they have sent many emails sharing their experiences and thanking me for being so open about my reality with them during the semester. I have learned that we all have challenges in life and how we respond to these challenges is what will make all the difference. I openly accept my new reality until my different normal is settled and defined. I acknowledge that it could be a lot worse and it still sucks… let’s be serious, it sucks AND I will be ok. I still hold true to this quote:

“Attitude is more important than facts. It is more important than the past, than education, than money, than circumstances, than failures, than success, than what other people think, say or do. It is more important than appearance, giftedness, or skill. It will make or break a business…a home…a friendship…an organization. The remarkable thing is, you have a choice everyday of what your attitude will be. We cannot change our past…we cannot change the action of others. We cannot change the inevitable. The only thing we can change is our attitude. Life is 10% of what happens to us and 90% of how we react to it.” –Charles R. Swindoll

As I was fortunate to share with my students and have talked about this many times over wondering why bad things happen to good people and I am beginning to learn why. I think part of it is because most people won’t listen to bad people yet they often have their ear to the floor when good people speak. I seem to have led a healthy lifestyle. I have devoted my energy and efforts to helping people make healthy choices for themselves and hoping to inspire them to maximize their moments…. only to end up with some chronic illness. It reminds me of 3 things:

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1. Throughout life I chose to take risks and create adventures, travel and learn about this world, and truly live life to the fullest throughout my time just in case something came along that limited my activity… and here it is. I am only hopeful people are able to realize how lucky they are if they do have their health. It is very easy to take advantage of life before a physician tells them they need to make drastic changes. Why wait?

2. It also gives me a moment to reflect on who the important people are in my life why and how fortunate I am to have them help color my world.

3. I am confident that I will return to normalcy and this little bird will fly again regardless of how long it takes for me to “learn how to fly when I ain’t got wings.” I am inspired by the courage, resistance, and perseverance of so many who have been diagnosed with any form of chronic illness. I thank those in my life for their patience and understanding as I WILL reconnect with my mind, body, heart, and soul… one moment at a time.

I am thankful for the nurses, doctors, family, and friends affiliated with the medical field who have helped add insight and provide suggestions. I continue to realize, even though at times I was running into the wind, fighting the battle with cardboard while my feet were stuck in concrete, and wearing kryptonite around my neck, I am still the axis to my world.  I am the one who controls the speed and direction to which it turns and how each moment is defined.

Good things . . . come from the choices we make in life . . .

Jay M. Greenfeld, Ph.D.

Songs to accompany Jay’s reflection: A Moment Changes Everything – David Gray, Stand – Rascal Flatts, Little Bird – Kim Sozzi, Learning to Fly – Tom Petty & The Heartbreakers

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Thanks so much for sharing, Jay!  Love the music picks and the football picture!

I always feel hugely blessed being able to share stories of people I’ve met in “real life”, and I really appreciate Jay taking the time to share and be so open in class!  As I’ve said before . . . you just never know what a person is going through at a given time, and how well they can keep on rolling with life, and how resilient we can be . . . even when it feels like everything is up in the air, as is the reality with any invisible illness.  Had we not had the discussion that we did in class, I never would have known what was going on behind the scenes for Jay, and how valuable the connection can be from simply sharing these stories.

In addition to teaching university courses on health, exercise and wellbeing (and the whole list of things involved within those topics), Jay has a PhD in Counseling Psychology from the University of Iowa and is a practicing therapist.  He has special interest in exercise psychology, stress management and fitting exercise into the craziness of life, and how this affects people of all ages, primarily adolescents and university/college students. Jay is the author of My Choice, My Life: Realizing your ability to create balance in life (free shipping if you order here!), which is a fabulous resource and I totally recommend it!

Additionally, Jay seems to have an endless store of quotes in his brain, along with an amazing and seemingly relentless energy and passion for all he’s doing . . . and colouring outside the lines! [Stay tuned for more on the Good Things, also!]