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Location: Minneapolis, Minnesota, United States

Diagnosed with Type 1 diabetes in April of 1980. I recognize the incredible mental struggle of living with diabetes. I hope to share my struggles, my successes, and everything in between.

Monday, June 25, 2007

The Fatigue Factor

Signs of a slump? Let me count the ways:

  1. Eating with no regard to blood sugars (I'm testing and bolusing, but just not making good decisions on what to eat (read "High Glycemic Index").
  2. Eating with no regard to weight management (I'm managing to gain weight).
  3. Seeing more readings above 300 mg/dl than I have in a long time. All self induced, see #1.
  4. Choosing to take the "Ostrich" approach (stick my head in the sand and wait for the trouble to "go away").
  5. Not logging a damn thing.

I am so in touch with my buddy "G-Money" that I don't even know how to better explain it. I know I need to get moving - and I am, slowly but surely. But damn, it sure does feel like a lot of work sometimes.

I go through these slumps often enough to recognize that there is a cycle to them. I have not yet tackled trying to figure out what causes them. I have also not yet tried to recognize the signs and stop the slumpage before it gets too bad.

Maybe periodic slumps are part of living with diabetes?

Not too long ago I was trying to figure out what exactly it is that makes me defy the logic of it all. If I know in my head that my behaviour is bad for me, why on earth do I continue? If it makes no logical sense, why is it so hard to pull out of the funk?

The next thing my brain threw out at me was "so you can feel like a 'regular' person once in a while".

Wow.

I'm not sure I want to feel like a regular person - whatever that means. But what was clear to me was that there is a "Fatigue Factor". That the constant demands of managing diabetes makes me tired of dealing with it all.

I think it gets deeper than that though. I think that there is something that kicks me into the slump, and identifying whatever those things are will be key.

I don't enjoy feeling crappy.

So what is it that sends my head into the sand?

28 Comments:

Blogger Megan said...

Oh man Scott. You hit home with this one. I see my endo in three weeks, so I've actually been going through my pump history to try and get some logs together. I have no clue how to test with regards to my new night schedule, and further no clue how to log with regards to my new night schedule. Looking at this, I have days I've bolused one time throughout the day. I know it's not because I ate one time that day. I full expect both my a1c and weight to be up (ugh). I even dreampt last night that I ended up with high cholesterol and high blood pressure too (though I know I don't have those things- I have copies of my labs!). Things will get better- now pass the pizza please!

8:03 AM  
Blogger Scott said...

Fatigue is a great description, as it explains something William Polonsky's "Diabetes Burnout" does not address: just tired of the entire process. This is where all the ideas that practitioners have about improving "control" really miss the point: its tough to live with a chronic condition 24/7/365 and have the ability to have the same degree of commitment to it throughout life. That doesn't mean we abandon managing things, only that the enthusiasm suffers from periodic attention (interest and enthusiasm) deficits.

8:09 AM  
Blogger Vivian said...

I so wish I had the words to help with this problem. I often suffer from this same "Fatigue Factor" from dealing with the bears. When I realize that I am on autopilot then the guilt sets in that these lives I am affecting by not being at high alert belong to someone else. The OC has been great, because without it I think it would be even harder to come out of the slump. I kind of lean on all of you as accountability partners. Otherwise without seeing that you all go through the same things, I think depression would win out. I am so sorry you are struggling with this, if there is anyway we can help you just let us know. Maybe we could set up some sort of accountability system.

8:56 AM  
Anonymous kimberly said...

Go, Scott, go! This has been the prevailing issue for me -- the cycles. I think that cycles can be normal, but mine, like yours, seem to be extreme. I totally relate to the "regular" or "normal" person thing; but consider this -- who out there is really normal? This hit me one day when I was setting the dishwasher to run; normal is a dishwasher setting. Ha. One thing that's really helped me as of late is letting my beloved be more involved in what's going on; it's like sharing the burden. When I encounter ongoing highs (even if they are my own damned fault), it's so easy to just say "to hell with it." Sometimes when I can't get myself back on track, I think on a subconcious level, I'm punishing myself for being "bad" diabetic. You're asking yourself good questions; if you start answering yourself and come up with the answers, be sure to let us all know!

9:39 AM  
Blogger Kevin said...

While wikipedia points out:
"In popular mythology, the Ostrich is famous for hiding its head in the sand at the first sign of danger. There have been no recorded observations of this behavior."

It also points out:
"Ostriches are known to eat almost anything (dietary indiscretion)"

Hang in there buddy.

12:53 PM  
Blogger Zazzy said...

"If I know in my head that my behaviour is bad for me, why on earth do I continue?"

How many times do I ask myself that? Your answer is an interesting one. I think I'm more in that kid "because I want to" place but I can see the desire to just be like we think everyone else is.

1:33 PM  
Blogger Bernard said...

Scott

I hope you can get out of this man, it doesn't sound you can physically feel all that good.

I hate getting off the d-wagon. Generally I overeat and then have to overbolus for it. And probably I get the extra boluses right about 25% of the time. So I run high or low. And feel lousy.

The geocaching I did last weekend gave me a real lift. It was very much out of the ordinary.

Maybe doing something very different (and keeping your control good) would help?

3:13 PM  
Blogger Drea said...

I call these "diabetes vacations"........I go on them from time to time, but like any vacation, I know there is a return to real life....I wish you all the best :) We're all here for ya!

4:04 PM  
Blogger Minnesota Nice said...

Oh man, Scott - I saw this picture of an ostrich on Krystle's Tu Diabetes page and thought, "now who in the heck is that"?
I was thinking about the maladaptive behavior patterns that I've been prone to and here are ten reasons that I brainstormed on my bus ride home:
1) I want to be carefree, like other people.
2) I went through several years of no control and feel that the damage has already been done, so what's the diff?
3) I HATE diabetes. Therefore I'm not gonna give it what it needs (i.e. moderate portions and adequate insulin converage).
4) I am a "good girl", a model citizen and always wait until the light turns green to cross the street. Eating poorly is my one silent rebellion.
5) Poor control has its own momentum, just like good control.
6) My perfectionism saying that if everything can't be perfect, why bother.
7) My use of food to deal with anger, sadness and boredom.
8) Some evasive self-loathing that says I don't deserve to feel good.
9) Laziness.
10) And, ditto the need to "take a vacation".

Would I have good issues if I didn't have db? Most certainly.

4:36 PM  
Blogger Minnesota Nice said...

Was that a Freudian slip - "good" issues, when I meant to say "Food" issues................

4:38 PM  
Blogger type1emt said...

This comment has been removed by the author.

5:18 PM  
Blogger type1emt said...

nothing brilliant to say..slumps are viscious both mentally and physically. It's impossible to care about all aspects D 100% of the time, the brain just shuts down to prevent going entirely crazy(or at least, mine does).
Hang in there,you'll get back on track.

5:24 PM  
Blogger Bams said...

Hey Scott, I hear you! I also can list some of the same reasons for wanting to bury my head in the sand as you and Kathy:(

I agree with Bernard, maybe doing something different while maintaining good control would help.

Or find a new way to reward yourself for having "better" control, like a new book, CD or movie, or even trying something you always wanted to try as the reward for all your endevors. That usually works for me :D

Good luck!

5:37 PM  
Blogger Shannon said...

PWD and non-PWD alike can relate to this post.

I've figured out why I'm not more disciplined with eating and exercise, now it's time for me to fix the problem.

Have yet to do that!

7:41 PM  
Blogger Amberthyme said...

Scott, I hope you can fight your way out of your fatigue. Can you look back in your blog and see if events, times of the year, solar convergances, or other wierd (or normal) happenings trigger your blahs? Up coming endo appointments, icky A1c's after an endo when you thought you'd done well, the annual company picnic? Just a thought.

8:11 PM  
Blogger Chrissie in Belgium said...

You ask yourself - why do I continue to hurt myself? It is b/c you don't think you have any alternatives. Nothing works! No matter what you do it fails! Isn't that what your heart is saying load and clear? Try and see if there is something, some LITTLE part of all that is going wrong that you can improve. Set up a plan to improve it. When you see that you have suceeded with that teeny little thing, you can like yourself a teeny bit. You can add on and try another improvement b/c hej you could improve that first little thing so why not try and add on another. Success breeds more success. Failure leads to more failure. I have been there. What is hard is that you have to decide yourself what challenge YOU want to tackle. Nobody can help you with that. Scott, I am so sorry that you are having a shit time!!!!!!!!!!!!!!!!!!!!!!!!!

12:37 AM  
Blogger Wingman said...

Scott,

Although I'm new to all this I've certaintly felt the fatigue factor a few times in my months as a diabetic. But have felt it more often in my quest to get into a top MBA program. It is physically impossible for a person to maintain perfect control of their diabetes 365 days a year but like in golf it's not the good shots that say how good we are, it's the bad shots that determine our score. You have to realize that it's ok to take a break every now and again and not get stuck in a rut when you do take a break.

For example, I allow myself one unhealthy meal a week now - be it pizza, a cheeseburger, a piece of cake and don't worry about it. I also know that the day after that unhealthy meal I'm going to go for a little extra on my run or bike ride. The weekly break is just a reward for working so hard to keep all this under control.

Also, like Bernard said - try and break your routine do something different and then relax and take a deep breath. There isn't anything you can do about changing the past couple of weeks but there is something you can do about changing tomorrow.

10:40 AM  
Blogger Kendra said...

This comment has been removed by the author.

2:43 PM  
Blogger Kendra said...

I know what turns me into an ostrich: travel. Business or pleasure...if I'm traveling, I'm eating out. And if I'm eating out, or eating at weird times, or eating unfamiliar foods...this little voice in my head shrugs and says "Ah, what the hell. Sure, I'll have the burger and fries." It's a response to "Well, I'm just going to end up with a high or low anyway, so why should I bother?"
The bad part is when I'm on the road for 2 weeks at a time...that'll really put a dent in the ole A1C. It usually takes a looming endo appointment for me to start logging and acting like a "good diabetic" again.

I won't wish you luck getting out of the slump cos we all know you will - you are in fact a "good" diabetic, whatever that means - but I just wanted to say I empathize with you 210%.

2:47 PM  
Blogger caramaena said...

Ahh so that explains the profile pic on tudiabetes :)

Scott, I'm living that fatigue factor right now too. I don't have to deal with insulin or other medications since I'm on diet and exercise right now, but... your first paragraph could be me.

I'm supposed to see the doc every three months for my a1c but I haven't been since December last year. I am so sick and tired of seeing doctors etc.

I've been slacking off on my exercise lately so this last week I've been making myself do at least half an hour a day.

Everything to do with diabetes feels like a lot of work to me lately.

7:07 AM  
Anonymous Anonymous said...

I am SO THERE. And, I have no advice. And,to tell you the truth, none of these other comments are helping me either. Maybe I can look at fatigue differently. Maybe it is a path that has a reward at the end. In the meantime, my diabetes does suffer. But, maybe there are worse things. Yes, there are.
OK...now I don't resent the fatigue so much. So, maybe it will start to pass. We will see.

12:17 PM  
Blogger mollyjade said...

Thanks for so much honesty. I think those of us without "perfect" numbers aren't always as vocal as those with really low A1c's. That makes it so easy for someone to tell us we're just not trying hard enough. Each of us is struggling with a similiar but very individual disease. I hope you find your way out soon.

11:11 AM  
Anonymous Anonymous said...

Scott, I am a type 1 diabetic (39 years)on insulin pumpsince 10/2003.I know where you are coming from, as I am in a recent slump, with an A1c of 8.2 recently after having had really great ones 5.7-6.7 for 2 years. Manging diabetes is very hard, and I have done all of your afroementioned things, eating without bolussing, overtreating lows, the whole schmiel. I, too have had an extrememly stressful time at my job ( I work in the Public schools under the "Every child's behind will be Left" Law(LOL); and feel that my efforts to help kids have been thwarted by bureacracy. I know that STRESS and how we deal with it will negatively impact blood sugars.

The good thing is that You and I both know that the slump will end, we will start treating ourselves better, with love and caring, by eating nutritiously and monitoring ( Yes I said the "M" word) judiciously and frequently.
It will get better
Take care.
Ms. BRG

2:38 PM  
Blogger George said...

I haven't even seen this until now.

I am such a fucking loser right now dude.

It is like i am peeking out from under a blanket, ready to get up and get out and get over my crap.

It is scary that we go through a lot of the same shit.

sorry man. Maybe one of us can win the lottery or something! SWEET

12:57 AM  
Anonymous birdie said...

I'm so sorry you're struggling right now. What sometimes helps me at times like these is really trusting the word: fatigue. Maybe it's a good time to literally take a rest or give yourself a treat like a massage. At times like these whats helped me too is to remove the variables, go back to the foods I know, the exercise routine that works. I try to quiet the noise so that the top can stop spinning a bit. It's never a perfect solution, but sometimes it really helps. Regardless, I hope that you will be in a better place soon. You deserve only the best.

11:20 AM  
Blogger Wendy Morgan said...

These phases are totally normal. We become physically, mentally and emotionally fatigued about life, so why not about diabetes.

I have found the best gift I can give myself is recoginzing that I don't give a s**t right now and give myself permission to feel this way and let it pass in its own time. I really think that saying, "Wow! I don't feel well and I don't care (with a tiny whisper, 'and that's ok')" is very healthy. It is when we start to "think" about how we ought to be or about what we should be doing we get in trouble.

Now, I try to observe what is happening (as best I can) without judgement, becuase I have seen over and over that this too shall pass.

Give yourself a break and give in without analysis. You take such good care of yourself that a break now and again is normal.

8:53 AM  
Blogger Wendy Morgan said...

Scott, you inspired a new post for me. Thanks for addressing this issue.

We all face diabetes fatigue, and in my post I am asking the question, "How do you go with the flow?"

9:55 AM  
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10:18 PM  

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