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The Buddhist Diabetic: Practicing Non-Attachment

June 2, 2012

Two years ago I started practicing Buddhist meditation, and while the frequency of my meditation practices varies tremendously (like, say now, where if I get myself to sit still for ten minutes a week that’s something to write home about), there are certain lessons I have taken from the practice that resonate very deeply with me, and have changed the way I relate to the world. I think the reason I handled my diagnosis two years ago so gracefully was because, in part, I had just come off a ten-day silent retreat.

The biggest thing I have learned from meditating is the idea of ‘non-attachment’, or as some prefer to say, ‘this too shall pass.’ It’s the idea that we should be always aware of our reactions to things, and how they change: a happy feeling is wonderful, but is bound to change. A sad feeling can be challenging, but it is bound to change. If we grow too attached to happiness, we will suffer when it changes. When we are sad, we can remember that this too shall pass. Everything changes. Nothing stays the same. Basically.

This relates beautifully to diabetes. You know those weeks where you’re like, “sa-weet, I totally got this!” because all you have to do is breathe and your blood sugars seem to magically sort themselves out. We get those amazing numbers from our meter: 5.1 before a meal, 8.3 after a meal, 6.0 after a nice long run. We feel like rock stars. We feel like we’ve GOT this diabetes thing. Diabetes almost feels like a hobby, a skill we think we’re really good at it. We feel pleasure from the satisfaction of mastering something. Or at least I do.

Then it changes. What worked the day before doesn’t work today. Numbers become frustratingly high. Insulin seems to do sweet nothing. We shout profanities at our meter. Parts of our bodies beep a whole lot more often than we’d like them to. And we are reminded:  diabetes ain’t no fun skill we can master. It’s a disease, resulting from a broken body part, and it absolutely defies logic. And gravity. (Well, maybe not gravity, but I was hearing Rachel from Glee singing the Wicked song and I wanted to get lyrical on you reader. But who knows, maybe diabetes DOES defy gravity. It’s stupidly-effed-up enough to pull something like that off.)

It’s a really hard challenge to learn how to celebrate the victories in diabetes (yay, great A1C! Yay, great numbers in my meter!) without getting attached to the idea of some numbers being ‘good.’ Because there is nothing we can do: there will be days where, through no fault of our own, our numbers will be ‘bad.’

That’s what I was facing a few weeks back. My A1C was creeping up into the 8s. My numbers were being stupid. Like, totally stupid. I was needing way more insulin than ever before. I was developing an actual fear of eating carbs because of the shit-show that seemed to follow after every single meal. It came to a head when one evening, as my friends laid out a beautiful lasagna with freshly baked cheese pastries along side it, and then excitedly broadcasted that a beautiful watermelon awaited us for dessert, I felt so much panic and anxiety that I almost cried.

I was hating how much energy I was spending yelling at my insulin pump. Didn’t like that I’d anthropomorphized this little electronic device to the point where it clearly had become the locus of my diabetes in my mind. The source of all suffering. The symbol, and the sign, of my broken pancreas, and my diabetic identity.

A lot of other things were going on. I’d just marked my two-year diaversary, and with it had come up some surprising emotions. I reflected deeply on the feelings and sensations of that particular day, what it was like to get a phone call telling me to go straight to the ER, what the weather was like that spring day, what I tried to find out about diabetes those first few hours. I reflected on how unfair it was that, within hours, my poor little brain absorbed so much new information about managing diabetes that I didn’t get a moment to process how much my life had changed. Realizing how much diabetes consumes my thoughts still today, I began to feel angry a few weeks back that such a massive weight had been impounded upon me, and how much of my identity must have been put on the back-burner for these two years without my even realizing it, simply because of this preoccupying disease.

There was overwhelming love for the friends and family who journeyed with me through those first few months. There was fresh anger at some individuals who chose not to stay by me during that difficult inward time. Most of all there was anger, sadness, and grief at the fact that two years have gone by, and I haven’t had, nor will I ever get, a break.

Mostly, there was the growing awareness that my identity has been saturated by this disease. Now that it’s been two years, and it’s sinking in that it is not going away, diabetes is no longer my hobby, my focus of half-marathons, or my summer camp job. It’s not even something I’m good at anymore. It’s just a disease. This consuming, unfair disease that I’m tired of trying to spin into a positive.

It’s taken two years, but I’ve finally now begun to process the anger and grief surrounding my diagnosis. I’m seeing a counselor at school to work through this process, and to help figure out how to give diabetes a place within my identity that I am comfortable with. I’m drawing on support from people in my life to express these feelings. It’s helping.

Last Saturday morning, I woke up with an inexplicably high reading, even after raising my basals and giving myself a correction bolus in the middle of the night. And I’d had it. I was tired of trying to talk my stupid blood sugar down from the cliff.

So I ripped out my infusion set, rummaged through the fridge for an old vile, and drew myself 14 units of Lantus. I’d been meaning to go on a pump holiday for awhile anyway. I’d just finished a study at Toronto General that had had me on a CGM for three months, and I was getting kinda tired of so much stuff attached to me. The weather was warm and sunny, and I liked the idea of being pump-free for a few days. I planned all kinds of pump-unfriendly outfits, like pretty sundresses and tighter shirts, for the duration of my pump-holiday. Figured I’d stay on shots for the weekend, maybe push it to Monday or Tuesday.

Turns out though, my control this week has been better than it’s been in months. Lantus seems to be fitting beautifully with my lifestyle, allowing me more opportunities to snack throughout the day, and shaving off some of the insulin I need at mealtimes. And I seem to be doing fine with just single-unit increments of humalog in my shots, rather than, say, the carefully-measured 4.7 units delivered over 30 minutes that the pump affords. Pumps are famed for offering people with diabetes way more control, but I seem to be doing just fine this week doing things the old-fashioned way. And nothing’s attached to me, and nothing’s beeping. It’s like kneading bread dough by hand versus using an electric mixer. I’m enjoying the simplicity of it. It’s just a little bit more hands-on.

Taking off my pump has also been an important symbol for detaching myself from an identity as a diabetic. It has been incredible to let my body breathe, to be able to be naked, to have nothing attached to me that not only tells the world, but tells me, I have diabetes. I don’t have to tell clients when I first meet them, “hi I’m Sarah and I’m a type-1 diabetic and I’m wearing an insulin pump so it might beep at us sometime during our session but don’t worry I’m not sending a text I’m only giving myself insulin do you have any questions just thought I should tell you blah blah blah.”

My numbers have been a dream. Textbook-awesome. I bet my A1C is great right now.

And there you have it. In detaching from my pump, I’m becoming attached to good numbers. I’m enjoying feeling successful at my management a little more than I’m comfortable with. I’m having way too much fun thinking about whether to spread my Lantus over two shots or just one evening shot. I’m booyeah-ing my single-digit blood sugar readings just a little too often.

Because, inevitably, this too shall pass. Next week, the 12-14 units of Lantus might suddenly no longer cut it, and the only way I’ll find out is through a series of really crappy high readings. I’ll feel icky and tired. I’ll feel defeated. I’ll be mad at diabetes for changing on me, and will resent having this source of pride taken from me.

And that’s when I’m gonna have to remember. This ain’t no hobby. This is a crappy disease. And I’m allowed to be angry about it, and it’s probably healthy that I am. But also healthy that I recognize, unfair though it is, it’s in my best interest to look after it. Not cuz it’s fun. Just because it’s life.

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