What does diabetes keep you from doing?

Someone once told me that my height makes me ineligible to become a flight attendant. Something about reaching the overhead bin (which, make no mistake, I can do--it just isn't always the most graceful of processes). I was somewhat shocked to hear that this was actually a thing so I looked it up and saw that although different airlines vary in their minimum height requirement, it looked like I would just make the clearance for most of them. I can tell you that I do not actually wish to fly the skies in a professional capacity, but the idea that I would not be allowed to seemed really unfair, and I think there's a parallel here with diabetes. Is there anything you think you can't do because you have diabetes (besides make insulin)? One of the most common things I hear people express worry about is playing sports. The fear of going low is very real, especially for those who have had traumatic experiences with lows. And while it is true that engaging in physical activity does require some extra effort in the diabetes department, it is also true is that we have the tools and the knowledge to prepare and plan for a strenuous (or light!) workout. Sure, there may be a few things to "work out" at first (haha)--for example, when your blood sugar spikes when you first start exercising but then drops soon after. This can be infuriating and confusing, especially when you're trying to do something good for your body and it seems to be going in another direction! Talk to your diabetes nurse educator about why these things happen, how to prevent them and what to do if something does occur. Also, check out Team ConnecT1D's page to connect with other T1 and T3 (or people who love a T1D) athletes. Join Team ConnecT1D for JDRF's Beat the Bridge or check out Ragner, a relay race along the beautiful Northwest Passage.

It can definitely be overwhelming to think about, whether it's exercising or coping with living life with a chronic illness in general. If you find yourself feeling anxious or struggling to get out of a thought pattern that keeps you from doing what you want to do, consider making an appointment to come see me. I help people rediscover hope. 

Mindfulness: It's Science!

Mindfulness is quite the buzz word these days, and not necessarily in a good way. Many of us hear “mindfulness” and picture a lady in stretchy pants sitting criss-cross-applesauce on top of a mountain. Not that it’s a bad thing to do any of those things, but I think it’s tempting to dismiss something that seems to be everywhere and, as far as we can gather from the word itself, entails sitting quietly and thinking about feelings and stuff. The thing is though, the concept of mindfulness is popular for a reason. There is a wealth of scientific research that shows that it does have a lot of benefits, particularly for people living with a chronic illness. 

The workshop was led in 2016 by Dr. Jody Stanislaw, who received her doctorate degree in Naturopathic Medicine in 2007 from Bastyr University. She has had Type 1 herself for 35 years, and she's partnering with ConnecT1D to put on two free workshops for their Speaker Series. I've met with her personally, and she's awesome. Check out the flyer for more details and registration info.

Me, too

Let’s say you made a pact with your friend that you would each go to the gym three times this week. Things got busy (the cat swallowed a washcloth and had to go to the vet, and there may or may not have been a small fire in your garage), and you went zero times. You’re dreading the phone call where you must report that you didn’t quite make it, but as soon as you say hello, your friend blurts out, “Ack! Stuff came up and I didn’t go at all!” What feeling comes up for you when you hear her admission? For many of us, the feeling is one of relief. We feel just a little bit less bad when we find out we’re not the only ones who didn’t reach our goal because we know that someone else had trouble too. The connection around a shared experience—whether it is struggle or triumph—is a powerful one and should not be underestimated because 1) it alleviates guilt (which is a big time energy-zapper) and 2) it adds a valuable member to your support team with whom you can be accountable. Doing the accountability job yourself can be tricky, as opposed to having a supportive person who call you out on and help you with your stuff because they have been in that very same position. Working towards a goal with someone who is/has worked on or achieved that same goal can be incredibly encouraging because they know it can be tough, but they are living proof that you can do it. Or at the very least, they can walk beside you and say, “I feel that way too, and we can figure it out together.”

If this kind of support sounds appealing, please check out the upcoming drop-in group for young women ages 14-25 with T1D.

Hemoglobin A1C: what's all the fuss about?

Most people who have diabetes have probably heard the term “hemoglobin A1C” (or HbA1C). Our doctors say it’s important and our parents tend to get pretty worked up about it, but here’s my question: do you know what a HbA1c is? And why it matters? No need to be embarrassed if you don’t because many people have somewhere between a vague idea to none at all.

First, what is it? According to the Mayo Clinic, your A1C result reflects your average blood sugar level for the past 2-3 months. Specifically, the A1C measures what percentage of your hemoglobin—a protein in red blood cells that carries oxygen—is coated in sugar (glycated). Many doctors use the A1C to monitor your diabetes treatment plan because the A1C is supposed to reflect how you’re doing overall. Check out the chart to see how the A1C level corresponds to the average blood sugar in milligrams per deciliter (mg/dL). 

For those who do not have diabetes, your A1C level target is below 5.7 percent. 5.7 to 6.4 indicates prediabetes, and 6.5 and above means (you guessed it!) diabetes.

Some important things to note here: Not once in this post have I used the term “test”. Thinking about diabetes in terms of a test that you pass or fail is not helpful because it can quickly bring blame and shame into the mix (and let’s face it—we’ve already got enough of that in the diabetes world). The A1C provides information. It is an indicator of whether one’s diabetes is being managed safely or unsafely. It is also important to note that there is no “one size fits all” here. For instance, one person may have a higher A1C target due to hypo-unawareness (or when a person does receive the warning signs that many of us do for when their blood sugars are dropping). Your doctor will tell you the best range for you. If he or she does not, ask! I recently heard an analogy comparing an A1C number to the amount of money in a bank account. What would you do if you walked into a bank, asked the teller how much money you have in your account, and heard, “Don’t worry, you’re fine”? The same goes for your A1C. Owning your diabetes means knowing the specifics of what’s going on in your body and understanding what is needed in order to feel healthy. The A1C lets you know if you are in a safe or unsafe place with your diabetes. Remember, this is not a judgment. Blood sugars go wacky for all kinds of reasons (being sick, stressed, depressed or just burnt out) and the A1C is information that can give you and your health care team a better idea of what needs to be addressed so that you can feel your best. If your A1C is higher than you'd like it to be but you've having trouble doing what you need to do or feeling stuck in negative thought patterns, consider reaching out. I help people rediscover hope and work through that stuckness towards a healthier, more joyful life.

“Don’t let where you want to go keep you from being where you are.”

“Don’t let where you want to go keep you from being where you are.” I heard this the other day, and it's kind of an interesting sentence (though somewhat confusing at first). So many of us are future-oriented thinkers—we look forward to the way things will be because we are not at peace with what is going on now. I think this is often the case for people with diabetes. We are told that we should be doing a better job, and we internalize this. We take on this belief. Look at blood sugars for example, and not just the number itself (“good” or “bad”) but how often we check (do it more!). It seems like we can always improve ourselves if we would only work harder, which leads us out of the present (where we feel inadequate) and into the future. The future is yet to be determined! We can still succeed! we tell ourselves. The problem here is that in this moment, we put off taking action. Why? Because the present is informed by our past “failures” (which often seem to be easier to spot than our successes!) It’s easy for us to stay in that same pattern, so we escape to the future, where we will magically be different. This is what keeps us stuck—living in the future and forgetting the now, where we are taking no action. So what can we do?

First, take action right now. So if you want to check your blood sugars more often, check right now. If you wish to be healthier, do something! It can be small, like doing 10 chair push ups (it’s the first exercise). Create a platform to jump off of—give yourself evidence that you can break the pattern. Second, celebrate that action! Build momentum upon your success. You checked! That’s awesome! It may seem silly at first but we find what we’re looking for. If your brain has built a well-worn neural pathway whereby you are constantly looking for mistakes, you’ll find mistakes. But if we look for success, we’ll find those, and our neural pathways will change! Sometimes we do get down and we need some help. If you feel stuck in old though patterns and are looking for help from someone who understands, please don’t hesitate to get in touch.

Diabetes & Identity

I went to Florida this past week for a conference. I didn’t know anyone there, and it got me thinking about identity. When you go somewhere new and interact with people you’ve never met before, you have the freedom to be whoever you want to be. This got me thinking about when diabetes or chronic illness comes into play and we are allowed the opportunity to “redefine” ourselves. When do you tell someone you have diabetes?  Maybe you don’t usually tell anyone. Why is that? Many people feel ashamed (and I’ll go into the shame that is so strongly attached to diabetes another time). Others are worried they will be scrutinized for what they eat or seen as “different”. If you do say something, why do you think you do speak about it? Is it for your own safety (for example, so that they know what to do if you experience symptoms), or perhaps because you feel like it explains who you are? And what comes up for you when you do tell someone? Maybe nothing. You might not even think it’s a big deal. Some of us are very uncomfortable with anyone knowing, particularly within the context of romantic relationships, while others wear diabetes as a badge of honor. Some of us feel like victims and want others to recognize our plight. We want people to see our strength, and diabetes is an example of something difficult that we live with every day. Often, it just depends on the day! How does your chronic illness affect the way you think about yourself? There is no judgment, or right or wrong answer in however you feel—seriously. I’ve just found it to be helpful to know so that I can stay balanced—so that I don’t lose myself in it but I don’t neglect it either. How important is your chronic illness to your identity?

Running low on mental energy

I recently attended an event about chronic illness and there was a woman on a panel who has severe rheumatoid arthritis (RA). She was about 28 years old and told me about the extensive thought process she had to go through before attending various events, including the one we were at that day. Although our diseases are very different, it got me thinking about my own diabetes, and the mental checklist I need to go through before I leave the house. It's as though I have a newborn baby with me at all times, and I never get to put her down. She's unpredictable, often demanding and heavy--especially when I have to lug around a giant bag with all those supplies and anticipate her needs. BG (blood glucose) monitoring kit? Check. Back up pump supplies (insulin, at least 2 insertion changes and reservoirs), and glucose tablets. Check, check, check, check, check and check. This task becomes even more complicated if I’m being fancy and carrying a small purse! Where is all this stuff supposed to go?! Not to mention that many of the guys I know with diabetes often carry backpacks, so what would they do if they were trying to be fancy?! I’d like to see James Bond haul all this stuff around in that tuxedo he wears. My point is, diabetes, as well as many other chronic conditions, often require additional mental energy. Over the years, we learn “diabetes life hacks” to make these things a little easier. For example, I carry juice and extra pump supplies in my car and I have multiple tubes of glucose tablets in each bag/purse so that I do not need to continually switch them as I rotate fashion accessories.  I also keep a list by the door of the things I need to have with me when I leave the house (PICKIT: Pump, Insulin, Cell phone, Kit, ID and Tabs). Another thing that has been very helpful is having a network of people who have diabetes and could loan you glucose tablets or other important things should you find yourself in a tight spot. But constantly being prepared can be tiresome. One of the most helpful thing has been to pay attention to when I’m feeling overwhelmed and to “keep tabs” on where I’m at with the diabetes tasks. Some days I feel fine and have no problem. Others I feel burdened and bogged down. Just noticing these things helps because they’re flags that let you know you might need a little bit of extra support that day. When you express this and ask for the things you need, you avoid blow-outs because that frustration is going to creep up one way or another, and it’s often better to say what it is that’s actually bothering you as opposed to getting in a fight with a loved one because they asked if you’ve checked your blood sugar. Sometimes my partner will ask me if I’m low and it won’t bother me but other days, it will. This is a sign that 1) he’s right and I’m actually low—arg! or 2) my tolerance level for diabetes is going low and I need some support—whether that’s a hug or an offer to carry my glucose tablets in his pocket so I don’t have to put them in my tiny purse. 

What's in a number?

This weekend I went to the Behavioral Diabetes Institute’s conference for health care providers entitled “Promoting Behavior Change in Diabetes”. It was fantastic. There were so many important topics discussed but the one I’ll bring up now is the idea that blood sugars are not “good” or “bad”. As we attempt to take the shame and blame out of diabetes, we are seeing that viewing these numbers as information upon which to act is simply a more effective way of managing diabetes. For many people with diabetes, the emotional burden and guilt around “testing” blood sugars is debilitating because it is easy to intertwine self worth with those numbers. Therefore when these numbers are “bad”, we are bad. We are taught early on that so much is riding on these numbers! Doctors, parents and loved ones are constantly asking about them—and it’s good that they want to know. They care! But being “tested” 6-7 times per day and having that result mean you are a “good” or “bad” person—that if you are outside of a certain range, you are failing, well, who is eager to hear that? No wonder kids lie about these things to their parents. I still don’t always feel comfortable showing my number to everyone at the table because I know I might get jumped on and sometimes I don’t feel like explaining the back story (which I can’t even figure out sometimes! I ate the exact same thing yesterday and I’m up 100 points?! Agh! Why?!)

So what can we do? Let’s use the word “check” instead of “test” when it comes to blood sugars. Let’s see it as information—nothing more, nothing less. Say it with me: “I am not my number.” Second, let’s separate out who we are from our disease. It’s a part of us, for sure, but there’s a lot of other really cool stuff about us that can be easy to forget. (For example, I am a huge fan of cats.)  Chronic illness can be incredibly difficult—both physically and emotionally, and sometimes we need someone to help us remember and strengthen who we are apart from our disease. I help people rediscover hope. Call me at 206-858-0247.

Look Who's Coming to Dinner

I was going to a dinner party the other night and I was not looking forward to it. There was traffic on the way over which is by no means my favorite, but that aside, I had been looking forward to this particular evening all week. The people my partner and I were meeting up with were his childhood friends, and I enjoyed spending time with them. This sudden attitude shift can be an indicator that my diabetes (or T1D) is doing something funky, so when we arrived at their home, I checked my blood sugar. It was 476. (For those of you who are not familiar with T1D, a common target range for blood sugar is between 80-180). After a quick bolus (which is a way to administer insulin to cover blood sugar and/or food intake), my very supportive and patient partner asked if he could do anything to help. I shook my head. I needed a few minutes to collect myself, and I told him to go ahead inside. I sat there, tears in my eyes, and asked myself what I really needed. The answer was simple but its effect was profound—I needed understanding. It’s easy for me to isolate in those moments when my diabetes messes with my mood, and as loving as my partner is, I didn’t feel like explaining what I was going through. I got out my phone and pulled up a group text I’d started with two of my dearest friends who also happen to have diabetes. I said what I was feeling (an intense, seemingly irrational and almost crippling sense of irritation), how much I hated having diabetes in that moment, and do you know what? They got right in there with me. No one was trying to pull me out of my frustration—they simply sat it in with me, and it felt amazing. They responded with the perfect mix of commiseration, compassion, humor and unity, as only a fellow T1D can do. Five minutes later I got out of the car and went inside feeling more peaceful, less alone, and dare I say it, ready for a good time. My blood sugar was still high, but I felt grounded in the connection I had made with people who truly understood my struggle and said “we’re in this together”. Chronic illness can be incredibly difficult—both physically and emotionally, and sometimes we need someone to help us remember and strengthen who we are apart from our disease.

I help people rediscover hope. Call me at 206-858-0247.

Winter 2016 Support Group for Teen Girls with T1D

When I look back at my years as a teen with T1D, it is clear to me that the periods when I took good care of myself were too few and far between. Trying to navigate regular teenage problems like fitting in, peer pressure, dating, and keeping up with the demands of school in the midst of fluctuating blood sugars was a struggle. Like a regular teenager, the extent to which I would listen to my parents was often minimal. Friends usually yield the greatest influence during adolescence, but none of mine had T1D and I spent a lot of time feeling frustrated, angry, guilty and helpless. 

My personal experience coupled with my understanding of adolescence and development, enhanced by my masters degree in Marriage and Family Therapy from SPU, are behind the creation of this group, the goal of which is to provide teen girls between 14-17 years old with the support and skills she needs to feel less isolated, more empowered and better equipped to cope with the increasing demands of self-management and diabetes. Group members will be given the opportunity to be honest in a safe, moderated environment where they can relate to and learn from each other because of their unique experience with T1D. The six sessions will take place Tuesdays from 7:00pm-8:15pm between January 19 and February 23, 2016.This is a six-week commitment for teen girls between the ages of 14-17 years old. Space is limited and inquiries must be submitted before December 31, 2015.  The cost is $250. Please call 206-858-0247 or email cassady@cassadykintner.com for more information about how to sign up.

Saturday, August 15, 2015: Giving Dating a Shot

The first workshop, “Giving Dating a Shot: Diabetes & Relationships”, kicks off the 3-part Diabetes & Relationships series on Saturday, August 15th from 1-2:30pm at the Phinney Ridge Community Center. We’ll address some of the emotional and physical issues specific to people with T1D who are either not sure if they’re ready to start dating or are actively spending time with potential partners. Topics like how and when to talk about T1D, the importance of your perspective, and how to own your diabetes, and why it might actually make you awesome will be discussed. 

This workshop is for people with T1D over the age of 18 and will be held at the Phinney Ridge Community Center, located at 6532 Phinney Ave N, Seattle, WA 98103. Please email Cassady@cassadykintner.com with any questions.

Workshop Resources

See you there!

Get your ticket.

Diabetes & Relationships Workshop Series

In 2015, Cassady Kintner and ConnecT1D teamed up to present a series of free workshops on how to handle diabetes-related issues in relationships. Here's a recap:

Much like the forgotten glucagon pen in the back of your refrigerator, the topic of type 1 diabetes and its effects on relationships is incredibly important but rarely addressed before panic sets in. Don’t wait until you’re sweaty and confused to learn how to address these critical issues with others! From ponderings such as whipping out a needle on a first date, to navigating heated fights with a significant other (and not because you are low), to keeping it real between the sheets (despite all the test strips that somehow end up lodged in the bedframe), we’ve got you covered. Come learn, laugh, share concerns and get advice about diabetes’ various effects on relationships that you (and surprisingly many others with T1D) might not otherwise feel comfortable discussing.

All workshops are for people with T1D over the age of 18. Workshops are held on Saturdays from 1-2:30pm at the Phinney Ridge Community Center, located at 6532 Phinney Ave N, Seattle, WA 98103.

August 15: Giving Dating a Shot: Diabetes & Relationships

September 26: Sharing the Sweet Life: Diabetes for Couples

November 7: Menage A Trois: Inviting Diabetes Into the Bedroom

Click here to get your tickets. 

Monthly T1D Support Group at the Polyclinic

Having type 1 diabetes is difficult. But do you know what's relatively easy? Finding things in common with other people who know exactly what it's like to struggle with a demanding chronic illness--especially when they're all in the same place at the same time. 

Who: People with T1D
What: Supporting each other
Where: Polyclinic Madison Center, 8th floor conference room
When: 2nd Wednesday of every month at 6pm
Why: Because it stinks to be alone with a chronic illness when there are so many awesome people out there who understand
How: Moped, bus, jet-pack, car (free parking available in surface lot across the street)
No registration required. Get more info about future topics at https://polyclinic.com/type-1-diabetes-support-group.