Monday, December 14, 2009

When Conflict Catches You By Surprise

In all honesty, things have been going pretty well with both my husband and with his diabetes. He recently had a check-up with his Endo, and even though he was afraid otherwise (due to high-levels of stress at his job and subsequent blood sugar highs every day) his A1c was great, all numbers fine. Phew. I was proud of him and his effort, because I know, and recognize how much work it takes him to make those numbers happen and keep himself in check. Kudos to him.

So how does it happen that you're going along, all is well, your spousal "diabetes-anxiety" is kept in check, you're happy with how things are... and then BAM!, diabetes-related issues once again raise their ugly head and create conflict in your relationship. I thought, after 12+ years of dealing with this that I would be an expert at not "letting it get to me"... but once again I am humbled by the power of the diabetes' effect on our lives and my reactivity to it.

So here's the story - see if any of this sounds "familiar" to you?: my husband went out on a Saturday evening to have a beer or two with his soccer buddies, a very important one of whom was leaving to move to Bali, so this was his goodbye. My husband left early - around 6pm - saying that he would be home "in a couple of hours". No problem, off he goes, all is well.

Here is the challenge - it was a Saturday. Every Saturday morning my husband goes and plays soccer for 2-3 hours, which is fantastic for both his mental and physical health. Since he's from Barcelona, Spain, this few hours is his "religion", and I don't mess with it! The challenge is that such a burst of physical endurance sets him up for blood sugar lows all weekend - but we're used to this, he's been playing for more than 10 years with this same group of guys, and he's very good at controlling the lows. However, they are something that we've come to expect ... particularly a few hours after he gets home on Saturday, Saturday evening, and then again Sunday mid-morning. He combats it by lowering his basal rate of insulin (he's on the Medtronic pump), bolusing less, and keeping a close eye on his numbers by checking often. I'm not as "vigilant" as I used to be around these lows, but I still carry some anxiety about it, particularly since the only real significant low episodes he's had (a couple as low as 29!! but most bad ones in the 40s and 50s) have been after he's played soccer.

So, back to Saturday night - Tony goes out, and my expectation is that he'll be home before 9pm sometime. So 9pm rolls by, 10pm rolls by ... I try to call him on his cell phone, but he doesn't answer ... and by now I'm starting to get that pit of "worry" in my stomach, the one I hate, the one I try to "talk out of myself" by rationalizing what he is probably fine, can't hear the phone, etc. By 11pm, and after the second voicemail I leave, I am starting to get very fearful, my diabetes-anxiety has kicked in full gear. It didn't help that it was crashing and storming outside (something that we don't get very often here in San Diego!), and in my head I was creating all kinds of stories for myself: that he had a low, that he got into an accident on the way home, that the beer mixed with not enough food mixed with soccer could have created a low that clouded his judgment and he drove when he shouldn't have ... oh, the stories go on.

Needless to say that by when Tony called me at 11:10pm saying "did you call me?", it wasn't pretty. It is incredible how quickly anxiety turns to anger when you know that person is fine. And when the key turned in the lock 1/2 hour later?...well, I'll save that for another post.

I'm lucky to say that my husband and I really don't have much conflict in our relationship. But this event, my reaction to it, and the consequent "discussion" that Tony and I had, really showed me how critical communication is when you live with someone with type 1. What it all came down to was this: had Tony called me at some point in the evening to let me know that he wasn't going to be only "a couple of hours", but in fact was going to stay longer, all of this would have been averted. The fact that I didn't know, that I was left to worry about all of the possibilities, was what was unfair. It highlighted to me a couple of things, and I wonder if these would be the same for you all:
  • It reminded me that living with type 1 is a partnership formed of mutual trust and mutual respect. I do my part by being attentive to Tony's needs around diabetes, by being supportive, by watching what I cook, what I shop for and bring into the house, by the choices we make every day. Tony's part (other than proactively trying to manage his diabetes the best he can, which is huge) is to check-in with me when he is out, especially if he is gone longer than expected. It is amazing how a quick "hey there" can ease my mind, and help me put my diabetes-anxiety back in its place. His being sensitive to this shows a great deal of respect for me and my feelings.

  • It reminded me how important it is to communicate to Tony my needs around his diabetes. I forget sometimes that I have them too! In this case, I had never really shared how important it is for me to have that check-in with him, especially in certain cases like him being out on a stormy night, a Saturday night where he was prone to lows, in a loud environment where he couldn't hear his phone. Had I communicated that to him ahead of time, in a "less heated" discussion, I think the message would have been better received. In the end Tony did listen, but it took us a while before either of us were open to hearing each others' needs. I think we could have done this much more painlessly had we done it ahead of time.
But you know what? Lesson learned! Even for those of us who feel we "have it all under control" that diabetes-related conflict can still rear its ugly head when you least expect it. I think the key is maintaining respect for each other by being proactive about it - communicate your needs with your partner, and listen to theirs. And do it before you're in the "middle of it"... for both your sakes!

Friday, September 18, 2009

Fact of Life #5: Denial (No, not theirs, yours!)

People talk a lot about "denial" when they talk about diabetes... about how the PWD in their life doesn't take care of themselves, how they pretend the diabetes doesn't exist, how they do whatever they want around their disease... and so on, and so on. We've heard it - and talked about it, with friends, family, doctors - many times before.

But how many times have we actually stopped to look at the flip side of that... at the fact that we as spouses, partners, loved ones of the PWD may actually be living with a form of denial all our own?

I think it is true of anyone who lives with and loves a person with diabetes, that there are many moments of
wishing that the diabetes didn't exist or was gone magically (poof!) one day. For me it is a matter of wishing I could take it all away from my husband, so that he could go back to those carefree days where he wouldn't have to think about, worry about, or deal with those diabetes ups and downs on an hourly basis. Of course I don't share this feeling with him (until now, that is!), because unfortunately - as we all know - just wishing the diabetes was gone doesn't make it so... or make it productive, so I just push that notion back under the rug from whence it came.

But I wonder sometimes if that desire to have the diabetes "gone" creates a unique type of denial for me as a spouse ... something I would term the "No-Big-Deal-ness" that I find myself feeling or communicating to other people around my husband's diabetes.

As a spouse, I think that a certain level of "denial" of the disease is healthy ... in order to keep the diabetes in its place and not allow it to rule, or define, our lives. However, I've also come to realize that there are times that I find myself in that different kind of denial... the one where even though I recognize (of course) that the diabetes is there, that it is not going anywhere, that it is a fact of our lives, I still find myself thinking "it's not so bad ... and because it isn't bad now, it never will be. Ever, ever, ever."

I know I am one of the lucky ones - my husband has had type 1 now for 12 years, with no complications and only a handful of serious low episodes. He is very proactive in his care - wears a pump, checks his numbers many times a day, counts his carbs, sees his doctors and has his A1c checked regularly - and I am always awed and grateful for how well he does all of this.

In a way I think his good management of the diabetes has facilitated my unique form of denial ... not to put any blame on him of course (who wouldn't want a spouse who takes care of business?!), but I almost feel like the fact that his diabetes has remained largely "invisible" has allowed me to lull myself into that "no big deal" denial.

For others whose partner's may not be taking as good care with their diabetes, and may in fact be in denial of their own disease, it may be a realization that you too are somehow a "partner in crime", abetting your partner's denial with your own participation in, or encouragement of, things that are less than optimal for your loved one's daily management... that regular trip to the ice cream store? Getting upset with your partner with the disruption that checking blood sugars or treating the diabetes makes in your daily routine? Making it difficult for them, and for you?

Regardless of how we got here, I'm starting to think that this type of "no big deal" denial isn't a great place for us to be.

People have shared with me that one of the worst experiences for them as a spouse of someone with type 1, is finding themselves "unaware" and unprepared for a diabetes-related event. For some it has been the onset of a complication where there didn't used to be one - for others, the first call to the paramedics for a low that couldn't be reversed. And for others who have spouses who have lived with diabetes for many years, it is the worsening of an already existing complication to the point where it truly begins to become a part of their daily lives in a way that cannot be denied.

How do we prepare ourselves and open up the "can of worms" of feelings around our partner's diabetes that our current denial - our it's "no-big-deal-ness" - protects us from? How do we come to terms with our loved one's disease and give it a place in our lives... a place that respects it for what it is, yet empowers us to stay in control of our emotions and reactions to it?

Here is my take on it - I encourage you to comment and give me yours:
  1. Be realistic - Get the information you need to know what you're dealing with. Where is your partner's diabetes at? What challenges do they have right now? Learn as much as you can, both from your loved one as well as from others in your diabetes network, and let that frame what you think (and what you feel) about where the diabetes is and is likely to go in the near future. In this case, what you don't know can hurt you (and your partner), so now's the time to get real. It's the only way that you can be on the same page with your partner.

  2. Get angry or sad if you need to - Once you know what you're dealing with, it's natural to feel sad or angry or both if the information is not what you were hoping for. You may run the gamut of emotions - from fear, to loss, to anger at your partner, to relief if the news is better than you expected. Regardless of what it is, I think it is critical to really stop and feel the feelings you have around this. You may or may not choose to share them with your partner - however, it is important to find someone to talk about it with, to get it out in the open. Empower yourself by acknowledging and addressing your feelings head-on. Burying your head under the rug never helped anyone!

  3. Accept it - This is a biggie, and it takes time. The goal is to get to a place where you feel "okay" with the truth of your spouse's diabetes, and you know your role and are comfortable with it. You don't feel the need to downplay (or dramatize) the diabetes, but are realistic with where it is and where it is going. You recognize the possibilities (good and bad) in the future, and have thought about how they might affect you (and how you might respond). You've come to a place where the diabetes just is in your life, and you're okay with that.

  4. Partner Up and Move on - I think that more than just accepting our loved one's diabetes, we need to feel the ability to partner with them and move past it. This may mean figuring out a way to have the disease in your life, but not having it BE your life.... having those life strategies and "plan B's" that you can implement if things go south, and not being unalterably shocked or affected if diabetes-related events surprise you. It means having some resilience, together as a couple facing the disease and moving forward. Living well with the diabetes ... both of you.

Sunday, September 6, 2009

Fact of Life #4: Diabetes Never Takes a Vacation!

Well, we're back from a wonderful 3 week trip to Spain... Since my husband Tony is from Barcelona, we went over to visit family and to enjoy the Balearic Islands a little bit. For the most part, it was idyllic ... sun, the sea, warm air, salt, the food, the people... glorious. And it would have been completely glorious, that is, if diabetes hadn't decided to "bud in" once again, and remind us that - indeed - diabetes never takes a vacation.

But I'm getting ahead of myself... let me share with you all a wee bit of our vacation story, and see if any of you can relate. Firstly (and this was a big deal) it was our first time flying overseas with not just ONE child in tow, but with TWO ... our son is 6 and our daughter is 18 months... and for those of you with kids, you know how it does up the chaos/exhaustion a wee bit. Especially when you are juggling carry-on bags, toys/snacks, diapers, diabetes supplies and trying to keep your children entertained, your partner's numbers in check, and yourself sane for the 2-3 planes (and 2-3 security checkpoints) and 20+ hours of travel.

When we finally landed bleary-eyed in Barcelona, the first exciting thing that happened is that my husband Tony realized (with horror) that the toiletries bag he had packed in our carry-on bag that contained all of his carefully prepared insulin cartridges for his pump, as well as all of his vials of humalog/syringes, had vanished somewhere on one of the planes between San Diego and Barcelona. We immediately tried to work with Delta Airlines baggage services to figure out where it might be (not an easy task in Spain with two tired kids crying), and whether somebody had picked it up from where we guessed was underneath one of our seats (that's the last time we buy a black toiletries bag that gets camouflaged on the floor in the chaos of trying to get kids off the plane and make a tight connection!). It never did materialize... because who thinks to put a Delta tag on a toiletries bag that is supposed to be inside your carry-on??

So there we were, in Barcelona with no insulin for Tony other than what was in his current pump cartridge ... so we had about one day to get more. Luckily for us, Tony is a Spanish citizen and so was able to go to a medical clinic in Barcelona, see a doctor, and get a prescription for more insulin (thank god for socialized medicine!). But it still took a day out of the trip to make all this happen... I didn't mention that Tony's glasses were also in that toiletries case, so he had to decide whether he could wear his only pair of contacts 24/7, or get new glasses made. Chalk up another day for that.

But luckily, we had everything in place for our short trip over to the Balearic Island of Menorca (next to Mallorca, for those of you who know the islands). We were looking forward to a hassle-free time, keeping diabetes in its place... being more active, swimming, snorkeling, etc.... and it was like this, until the next exciting thing happened about 4 days into our stay: Tony's insulin pump stopped working! One day, boom!, 7pm on a Thursday evening, he didn't have any insulin delivery. So here we are, on an island in the Mediterranean, trying to figure out what to do, with a weekend approaching. We were also staying in a town where we didn't have a phone, and while there was a phone booth in the plaza, we still had to drive to the next town over to buy a calling card to be able to make calls to the U.S. Yes, things are more difficult over there... but most of the time you can roll with it! When it is urgent matters however, things seem a wee bit more, shall we say, trying. So after trying to figure out our game plan, we spent many hours on the phone first with Medtronic U.S. (who couldn't send us a new pump directly to the island due to Customs issues with durable medical devices), and then with Meditronic Spain in Madrid, where we were told it wasn't as simple as sending us a new pump, since the European equipment is different and the pump had to have a serial number that corresponded with Tony's doctor's original prescription for liability reasons. They also determined that the pump malfunctioned mostly likely due to the heat and humidity that we were experiencing in Spain (that I can agree with - there wasn't one minute that we didn't have that sheen of sweat on us). Okay, so there we were.

In the end we were able to get a new pump sent to us in the island by having Medtronic U.S. ship a new pump to the Madrid office of Medtronic internally (to limit the days it would sit in customs), who then shipped it on to us. All in all it took about 6 days ... In the meantime, Tony only had fast-acting Humalog with him, and for the first few days had to get up multiple times during the night (every 2 hours or so) to test his sugars and inject what he needed. We called his diabetes educator here in San Diego from a payphone, and we determined that if we could get ahold of some Lantus in Menorca, Tony could use that in combination with the Humalog until the pump arrived. With luck (and on our second try), we found a sympathetic pharmacist at one of the local pharmacies who sold us the Lantus without a prescription. We were so grateful - one thing was easy! - however, we had to buy the whole box of insulin pens (6 I think) so ended up paying 76euros for this (about $110 USD). But we whipped out our VISA card with glee! We were just so happy to have this one small victory.

Thankfully the new pump arrived unscathed and worked great. But the experience, and the amount of hours/days of our vacation lost to trying to deal with diabetes-related issues, remained in our heads. One of the reasons why I wanted to share this all with you, is that there were some significant "lessons learned" from this trip - even for us, who consider ourselves fairly well-travelled, diabetes-saavy, organized people! I hope some of you can benefit from what we learned - here they are:

Lessons Learned:

1. Never lose sight of the "important" stuff in transit: I couldn't believe that of all the things that we were juggling on the plane, the one thing that slipped our grasp was the most important (who cares about that portable DVD-player, really?!). Keep your eyes on the vital supplies - take inventory of them before you get caught in the crush of people trying to get off the plane - and if possible, store them in separate bags so that if one gets lost you still have a backup.

2. Make sure you have a back-up prescription from your doctor in the US for all vital stuff: It would have made life easier (and saved us half a day in doctor's appointments) if we had thought to bring a doctor's prescription from the U.S. for any required supplies (insulin - both Humalog and Lantus, test strips, syringes, etc.) whether we thought we'd need them or not.

3. Be organized! Before travelling create a "travel checklist" (that you can refer to any time you need to take a trip) to make sure you have all of the supplies you need with you, and then some. Always pack more than you think you'll need! Also, make sure you have all the important phone numbers with you (your doctor or diabetes educator in the US, their fax number, your pump tech support, etc.), and be prepared to make calls once you are at your destination (i.e., buy calling cards [multiple cards help, those minutes always run out faster than you think ... especially if you're waiting on hold], or rented cell phones, etc.)

4. Have a "Plan B" in case things go wrong and you need to go to your contingency plan: For us it was remembering how to give shots and use Lantus (hence the call to the diabetes educator), and figuring out how to bridge the gap until the new pump arrived. It would have been much less stressful if we had thought this through ahead of time and gotten all of the information we needed.

5. Know how your insurance works in whatever country you are going to: We had the luxury of being in a place where my husband had access to local healthcare. If we hadn't, it would have been much more difficult to go to the clinic. Make sure you know how you could access health services in any country you are visiting, and how your insurance would function if that was necessary. At minimum, know how to file a claim after the fact for any expenses you incur while travelling (like our $110 Lantus).

6. Know how the health / hospital system works in whatever country you are travelling to ... and remember, they are most likely very different from yours! A little bit of research in this area will save you a LOT of headache. Just doing your due diligence will help you in the event that you actually need to access the local healthcare - and it will help you know what to expect. Don't expect diabetes care to be the same as it is in the U.S. - in my experience, even in a country like Spain, diabetes mentality is a good 10-15 years behind the times.

7. Have the "in-country" phone numbers of any medical equipment you require: For us, it would have been smart for us to know the numbers of the Spanish office of Medtronic in Madrid, in case we needed them. Knowing what we know now about how customs work with medical equipment, I would definitely have those numbers handy in case you need to contact / work with people in the country you are in.

8. Find out what the overseas names are for products you use: For example, in Europe Humalog = Novorapid ... and it would have been good for us to know these things before we tried to talk with pharmacists and medical professionals about getting prescriptions for these.

9. Don't expect that airlines have a *clue* what a diabetes meal should consist of, so plan ahead for food on international flights: This one has just become a major pet peeve of mine! We thought ordering Tony "diabetic meals" for the international portion of the trip would be a good thing, but after the second meal where his breakfast tray consisted of a white bagel, whole sugar jam, a banana and orange juice, along with a note that read "this diabetic meal prepared especially for you by Delta Airlines" (I kid you not!!), we realized that we really are the only ones who know what/how a person with diabetes should eat... especially for a flight where you are sedentary for 10-18 hours. Bring your own food, you'll be glad you did!

10. Don't let it get to you!! Do what you need to do, but don't let diabetes mishaps define or ruin your vacation: This one is really true - yes, diabetes issues are awful when you are trying to have a good time on your trip, but they only interfere as much as you let them. I am extremely grateful that Tony kept his chin up and didn't let all of this get him (and us) down. He did what he needed to do, to the best of his ability. My reaction was to partner with him and support him as he made all of the phone calls, visited the pharmacies, and kept track of how his numbers were going ... I also made the conscious choice (there really was no choice to make) to stay positive and to cheer the good things that happened... the little wins that got us closer to getting him back on track. What were a few days lost on our trip, when it was his health and safety at stake? It sure put everything in perspective... and it all worked out. In the end.

Thursday, August 13, 2009

"Fact of Life" #3: You've Got to be a Team Player

Diabetes is not something that any of us signs up for. Not our spouse/loved one, not us. This can be particularly true for those of us whose partner developed the disease during our relationship, and it comes as a complete surprise. However, even if we went into the relationship knowing that our partner had diabetes, I think at some point the intricacies and daily grind of it get to be too much... and we think "how can I continue doing this?"...

Now, a disclaimer: I write this knowing how much harder it is for my husband with type 1 than it is for me. I need to say that! He has the hourly balancing act on his plate 24/7, whereas I get to forget about the diabetes for long periods of time throughout the day. I wish he had that luxury.

The funny thing about living with someone with type 1, is that over time I've realized how critical it is to approach the diabetes as a "team sport". If I think that we're both on the same side with wanting to do things right, then it becomes easier to understand and support my husband. I am less at odds with any of his choices / ways of coping. It is absolutely true that diabetes affects everyone around it ... it is a "family disease" ... and so with that in mind, I've figured out ways for me to not only show my support for my husband, but also take my place as his team-mate, and to hopefully remove a tiny bit of the daily burden off of his shoulders.

Here are some of the ways that I have found useful to act in that team capacity:
  • Make healthy choices when shopping - Since I am the one mostly responsible for the food shopping and cooking in my house, I try very hard not to bring those things into the house that will be tempting for my husband (and for me!). Those wonderful croissants, chips, white breads, dessert items... the vast majority of the time I leave them in exchange for healthier, complex carb items, fruits, fresh vegetables, proteins... things that I know are better for all of us. We don't need that other stuff! Because I know that if it is in the house, it will get eaten... so I try hard not to bring it in.

  • Be a "co-pilot" in the car - Since my husband prefers to drive (and I like him to as well, takes the stress off of me!) whenever we take road-trips I make sure that we are well-stocked in the front seat of the car with anything we might need for lows while driving. I stay alert, stay engaged with my husband to ensure that if he doesn't pick up on those subtle hints of a low while we're driving, I do. It is probably the only time that I ask him to check his numbers before we leave the driveway (then I can check it off my co-pilot check-list ... "numbers normal, check! we're good to go..."). Stay supportive, but don't freak out. Offer to drive if he needs time to keep his sugars in a safe zone.

  • Allow them to make their own choices, but try not to tempt - This kind of follows along with point #1, but if there is an opportunity for something out of the ordinary... a special dessert, etc... I always try to let my husband choose how much he'll indulge in any given thing. He's an adult, he can make his own choices... he knows his body and his insulin better than I ever will. I do however try not to create too many opportunities where he'll have to make that choice over and over! If it's occasional, I stay out of it... and let him enjoy.

  • Understand the important numbers - Over the last 12 years I've become more educated and well-versed in things like A1cs, creatinine levels, cholesterol numbers, etc., than I ever thought I would at my age. But I've stayed interested and involved in my husband's journey with these things. I attend appointments with his Endocrinologist when I can, just to stay visible and to be involved in the "behind the scenes" talks that my husband has about any issues or concerns he's having. When he gets a good A1c back from his labs, we cheer! I know the hard work it takes to accomplish something like that, and I make sure to recognize that.

  • Collaborate, don't dictate - if there is one thing that I have learned doesn't work in my relationship with my husband, it is my becoming the "Diabetes Police". How many years did it take me to figure that one out?? Only about 12... I recognize now that it is my collaboration with my husband that is meaningful, my ability to partner, to be a team-player in his diabetes management that keeps us aligned and moving forward in the same direction. As soon as I feel myself slipping into "dictator" mode, I can see the reaction and the subtle (and not so subtle!) ways it pulls us apart into different, opposing directions. Not a good place to be in a relationship. It takes time, and some good communication, to figure out how to become that collaborator... but it is possible. And definitely worth it.

Tuesday, August 4, 2009

“Fact of Life” #2: Anxiety

What’s the one thing that all of us who are partnered with someone with diabetes have in common? We are all anxious. It varies by degree, but it is a common strain that runs beneath many a calm, functional exterior. It can be related to fear of lows, anxiety around complications or co-existing medical problems, fear of the future, or the biggie, death of our loved one. Since my husband was diagnosed with type 1 in 1997, I have felt the omnipresent sense of worry that stays with me day-in and day-out. Sometimes the worry is very specific (“he’s driving home – is he low?”), sometimes more generalized (“I can’t reach him … what's happened?!”), but it is always there. After 12 years it doesn’t bother me as much anymore – and I have learned some important ways of dealing with this unique form of “diabetes-anxiety”... they include the following:

  • Try not to “anticipate” – just because something has happened in the past does not necessarily mean it will happen this time … I try hard to live in the present moment and judge situations for what they are.

  • Actively gather information from people who know what they are talking about – for me, knowledge is power, and it helps quell my anxiety (about my husband’s lows, or his risks for complications for example) if I know what I can expect to happen… asking people I trust (my husband’s physician or other people I know with diabetes) helps me to feel prepared “in the event of” - of course I recognize that things may always change, but at least I know what is likely to happen in most instances

  • Come up with tools or things to make sure you are prepared – I try to be active in my coping ...making sure we always have juice in the house for lows, or that I know exactly where the glucagon is (even though we’ve never had to use it!). In this way I know that if these things are needed, we’re covered, and I can relax just a bit.

  • Remember that you’re not alone in this – when things get too much sometimes, it helps me to remember that there are others out there who understand my situation, and who are facing the same things every day. All I have to do is seek these people out (by connecting with friends or finding groups online), and I’ll find people who really “get it”. Hearing other peoples’ stories about their loved ones with diabetes always put my own into perspective.

  • Try to be kind to yourself and have some understanding of any “knee-jerk” anxiety around your loved one’s diabetes – it is not easy to constantly feel “on guard” around my loved one’s health, especially when it is related to a past negative event (e.g., a near-miss while driving, a midnight call to 911). However, I take responsibility for my own anxiety and try to separate out the “rational” from the “irrational” worry about his diabetes that I may feel on any given day. It’s my responsibility not to bring baggage into our daily relationship. He doesn’t need one more thing to have to manage!

  • Try to work out better ways of responding – someone once told me if something wasn’t working, to try doing the opposite to see what would happen. For me it’s been the same with my reactions to my husband’s diabetes – sometimes when I feel the most anxious about a situation or his response to it (or lack thereof!), I try to be the most calm, the most objective… and it often works to stop my anxiety in its tracks! I feel more empowered, and it also seems to make the situation better… go figure!

“Fact of Life” #1: Blood Sugar Lows

One of the hardest things for people who love someone with type 1 diabetes is dealing with the blood sugar lows that happen on a fairly regular basis. Over time we may get used to them, and get more competent at helping our loved one come back to normal levels more quickly. We also become experts at recognizing the signs that a low is imminent, if not already happening (for me it’s all in the eyes!). Since my husband was diagnosed with type 1 in 1997 and keeps his diabetes in very tight control, we’ve been through many, many low episodes – some worse than others.

Over the last 12 years I’ve learned some very important lessons – what I call “How to Keep Your Head When Your Type 1 Spouse is Losing Theirs in a Low”… here they are:

  • Don’t panic – you freaking out can cause the person extra stress which can actually make them go lower … so hang in there, and project a calm face if you can … even if you’re absolutely faking it

  • Be supportive – offer to get them some juice and/or make them a quick snack … just because you “felt like one too”

  • Don’t force them to treat their low the way you think they should and/or “hover” – use your judgment, but remember that they are adults, not children, and treat them accordingly

  • Let them guide you – if they just need space to come back up, give it to them without overdoing the “just checking in”

  • Have empathy for what they are going through – remember that they didn’t do this on purpose, or to get attention, to delay doing something around the house, or because they “felt like it” … lows feel bad, no matter what.