Talking Yoga Therapy, Diabetes, and Breathing
"On this episode, I sit down with Evan Soroka. Simply put, Evan is a bright soul in the darkness that we are all experiencing right now. In this conversation, Evan shares details of her early childhood in NYC and how her family moved to Colorado so her dad can follow a passion for a creative life. She talks about the beginnings of her life with type 1 diabetes during a 24 hour wilderness survival experience, and how yoga ultimately entered the picture and changed her life. Evan is fascinated with exploration, internal and external, and we go deep in this conversation. We discuss the intricacies and interconnectedness of yoga therapy, the breath, and the mind. We talk about Evan’s definition of the meaning of life and the importance of not wasting our one beautiful opportunity to make the most of our time on this planet."
I travel with my husband to spend time with his family for Thanksgiving. It is a multi-day celebration that is joyful, yet without self-care strategies, it can be a diabetes disaster.
The holidays get a bad rap as a difficult time for blood glucose levels, but they don’t have to be. There is nothing inherently unhealthy about the food we eat during Thanksgiving.
What is problematic are the cultural behavioral norms which support all-day snacking, larger meals and sedentarism. Couple this with the added stress of being in close quarters with beloved family members and suddenly Thanksgiving is taking you for a wild diabetes ride.
It does not have to be this way. In this video I will address my top behavioral and self-awareness recommendations for diabetes management during Thanksgiving.
A core component of yoga therapy and diabetes care is self-awareness. Self-awareness with diabetes is our ability to discern how certain behaviors, whether it is over-indulging, lack of exercise, or stress from a family dynamic, affect how we feel, think and act. When we are aware of what causes us to feel negative, we can implement new and positive behaviors to improve our quality of life.
The formula for a healthy and joyful holiday season is unique for everyone with diabetes. In this video, I will go over my top strategies for improving self-awareness and implementing healthier behaviors during the holidays. These tips will allow you to flow through the season without the typical BG rollercoaster and emotional upheaval that can occur when we are in close quarters with the people we love most.
When I switched to a new Medtronic 670g a few years ago, I hated it. It was so unfamiliar, and my old pump I knew like the back of my hand. I was overwhelmed by every nuance from its fancy features, to its size and weight. There were many times when I wanted to give it up, go back on my old pump, but a part of me persisted and gave it a chance.
Now, nearly two years later, I love my Medtronic pump and would not change it for the world.
It is funny how attached we become to our devices. They are, after all, a relationship. When we change that relationship, it is reasonable to mourn what you used to have rather than looking forward to what you will have; in my case, a much-improved HbA1c.
Yoga talks about change as a cause of suffering. We suffer because we think everything is going to stay exactly the same. Cognitively we know that a new pump or cgm will be of benefit, but because it is so new, we resist embracing the changes wholeheartedly. We may in fact reject the new pump as faulty because it is not the same as the old one.
The resistance to change with diabetes technology is a source of overwhelm and distress. In this quick yoga therapy inspired video, I will go over my top tips and strategies for overcoming the transitional woes, so you can LOVE the pump (or CGM) that you are in and move forward with your life.
Today is a day of celebration. It’s world diabetes day but also it’s my mom’s 70th birthday. I want to invite everyone who has diabetes, at least for today, to celebrate diabetes. Think about how a diagnosis has molded and shaped you into the incredible being that you are!
It’s true, diabetes is no picnic but that does not mean that it all has to be negative.
If it weren’t for diabetes I would not be:
Thank you diabetes for offering me an opportunity to see you in a positive or negative light.
My gift you you is a yoga therapy practice for the heart and circulation. Heart disease is the number one killer of people with diabetes. It is of the utmost importance that we not only take care of our heart with diet and exercise but also through therapeutic practices like this one.
Please leave your comments below! How has diabetes made you the person you are today? What can you celebrate?
I'm embarrassed to admit that I still struggle with night time hypos. Ever since I was a kid, nighttime highs have messed with my HbA1c and damper my otherwise perfect endo visit.
Correcting for hyperglycemia at night is challenging too. It is like my body does not absorb the insulin until I wake up and start moving, often plummeting low within minutes of waking up. Then you begin playing the catch-up game, all day all night weeks on end. Its why so many of us get burnt out on diabetes.
So what to do? Yoga teaches us that if you want a different effect, you need to change the cause. I did not know the source of my night time
highs, so I came up with a lot of hypotheses:
Incorrect bolus to carb ratio
I have tried so many things over the last 21 years that worked for a while but then stopped working. Until I tried this latest thing and….IT IS WORKING. I do not want to jinx it or claim this to be the fix for everyone, but it has been working SO WELL for me. I have to share it with you. I have not had a single night time high in two months, and subsequently, I have avoided a lot of lows too.
Check out my tips about how to actually do this with type 1 diabetes. My biggest tip is skip it if you are going low! BG comes first.
It is mental health awareness month, so I thought that I would take the opportunity to talk about it as an essential pillar of diabetes success and what you can do to improve your mental health right now that you might not already be doing.
We all know how stressful the unpredictability of diabetes can be. What works one day, doesn’t the next. It seems like at times despite our best effort, we still get it wrong. There are so many moving parts to ‘stay in balance’ that our mind takes a beating. Life is stressful enough without diabetes but then you couple it with highs and lows, alarms, needles and annual deductibles suddenly you have got a great recipe for chronic stress.
If you live with diabetes like me, it is essential to prioritize your mental well-being. I want to share with you how I have been able to reduce my diabetes related anxiety for good with yoga therapy.
It is not news that yoga and meditation are an effective way of reducing stress and improving self-awareness. Given this fact it would be healthy to assume that the practice of yoga and meditation would be beneficial for reducing diabetes stress.
You may be practicing both yoga and meditation but what you might be forgetting to do is this one very simple thing: seated breathing.
It seems so simple, it is most often overlooked. But let me tell you it is the most important tool in your self-care toolkit.
The breath influences the mind just as the mind influences the breath. When you are shocked, you gasp for air, and when you are relaxed, you take a long sigh of relief. The feeling of the breath is indicative of the mental state.
Simply inhaling and exhaling in a comfortable way activates the parasympathetic nervous system eliciting a calm and relaxed feeling in the body and mind. Regular daily practice allows the mind to slow down so you can start to see the causes of your stress and do something about it.
I have been MIA the last few weeks because I was getting married and honeymooning in Belize. My husband and I had an amazing experience and I'm happy to say that thanks to my yoga therapy practice diabetes did not get in the way from the fun and adventure.
In preparation for the wedding this last March, I decided to take an extended pump break, the longest I have ever taken! Originally my intention was to prepare for the trip but soon realized that I needed a break from my routine. I needed a legitimate detox from being constantly plugged into diabetes and challenge myself to understand a new way of diabetes management for personal growth and development.
We are taught early on that diabetes is about consistency. We should have routine, plan for all unexpected circumstances and rely on the memory of what worked in the past. Just like all of life, however, nothing is constant. The moment we get stuck in a routine, we stop growing, fear, and anxiety of the unknown set into the mind. This can also happen with diabetes management.
Yoga is a process of personal growth and development. Through the practices of yoga, the individual can begin to awaken and shift their concept of reality. They harbor less anxiety and fear, become less stagnant and habituated in their patterns and beliefs. I genuinely believe that all of the challenges that we face with diabetes are mirrors onto the challenges of the human experience. Through diabetes, we have the opportunity to master life’s challenges and accelerate our growth, happiness, and wellbeing.
Changing up your diabetes routine can be a yoga practice onto itself. It requires you to look at your fears, habits and comforts. Before you begin, ask yourself "what is my intention?" Why do you want to make a change? What is not working? It can be as simple as mine: To take a break from perfect numbers, try something new, and have a digital detox.
This experience over the last two months taught me a lot about myself, diabetes, and the process of letting go.
Changing your routine is a process of adjustment and letting go. The first few weeks on break I was not jiving with the long-acting insulin. I listened to my intuition and changed to a different, more familiar brand and immediately my blood glucose improved. Although my cumulative numbers were not as stable as when I was on an insulin pump, the break allowed me to be less worried about perfect numbers. I was less stressed out by highs and experienced very few lows.
Every time I noticed that I was frustrated with shots and wanted to go back on my pump, I reminded myself of my intention. It is not about perfect numbers right now; it is about taking a break.
Being on shots has its own set of positive and negative qualities.
Here are my top + and - from MY personal experience. You might agree or disagree.
1. Freedom – I feel less of a billboard for diabetes when I do not wear an insulin pump
2. Comfortability – getting dressed is a much more enjoyable experience
3. Exercise—I did not need to eat as many carbs before and during exercise
4. Relaxed –without having a smart pump (and just Dexcom), I was able to sleep better and be less involved with ups and downs.
1. Flexibility – It was harder to mitigate high blood glucose readings, make impromptu decisions. More planning for exercise and food.
2. Shots –frankly, my skin was bruised and keeping on top of site rotation was challenging
3. Quality of insulin –despite using a Frio bag, and Myabetic thermometer, traveling with my insulin pens in varying temperatures caused me anxiety. I noticed that after a week or so, the insulin was less potent. I found myself taking way too much short-acting insulin and had to increase my long-acting insulin daily.
4. HbA1c – My average blood glucose numbers went from being about 90% in range to 70% in range on shots.
You might be on a pump and have no interest in changing. I get it. You might be on shots and absolutely love it. There were times over the last two months when I considered making the long term switch to shots. Everyone has got to find their way of living with diabetes that is not only authentic to your lifestyle but also in alignment with your insurance and pocketbook. If you do have the ability to experiment, I highly encourage it!
Here are some ways that you can try a new way of diabetes management:
1. Contact your doctor or diabetes educator, let them know that you want to take a pump break to see if they have insulin pen samples, and have them recommend something for you.
2. If you are on shots and want to try a pump, you can also contact your diabetes educator. Sometimes they have demos on hand. A few years ago, I wanted to try the Omnipod and purchased a used one and two boxes of pods on a diabetes community Facebook page for only $200.
3. Give yourself a specific timeframe. I gave myself two months. I do not think that anything less than a month is adequate.
Fast forward to today. I am now back in the States and on my pump. It took a second to get used to the tubes and size but I am happy to be back. It is what works best for me. Yet, I am not attached to it. I am sure that I will take another pump break because it always good to change up the routine.
If you want to learn more about how the practices of yoga therapy can help you awaken and shift your relationship to diabetes check out my RISE ABOVE T1D PROGRAM launching again soon! Just sign up for the waitlist and you will be the first to be notified when the program opens for registration.
Next week, I will share with you a special practice for overcoming the anxiety of change and uncertainty. Stay tuned!
I'll be honest with you. Even though I consider myself to be in optimal control over diabetes, I still have days where I do not understand why I am running high.
On those days I follow a process of deduction to figure out its cause. Once you can pinpoint the why you can focus on the how.
In order to live mindfully with diabetes, it is essential to have a process of deduction to nip your high’s in the butt to the best of your ability.
In this short video I'll walk you through my personal steps for bringing down highs more consciously.
We all want to improve our HbA1c. If you watched last week’s video on diabetes perfectionism, for some it can become an obsession and actually hinder your efforts.
This week is all about what you can do right now to improve your numbers without fail. Just by bringing down your average one hour extra a day you can significantly decrease your HbA1c.
You will learn:
How to consciously create a relationship to hyperglycemia management that is fun
My personal checklist of how to deduce cause of hyperglycemia
What to do once you have inferred the cause of the effect
That you already possess the ability to improve your health
Is Diabetes Perfectionism Hindering Your HbA1c and Controlling your Life?
In this yoga therapy inspired video, I will teach you my favorite mindful strategies for overcoming diabetes perfectionism and optimizing your mental wellbeing with type 1 diabetes and beyond.
I’ve been type 1 for over twenty years, so I remember a time when testing took over 30 seconds and insulin pumps were a rare and highly coveted item. Fast forward to 2019 and life for the person with type 1 diabetes has improved tremendously. We now have continuous glucose monitors which enable us to observe blood glucose readings in real time. Many systems integrate with an insulin pump which will self-adjust to the CGM reading. Parents can view their child’s glucose readings when they are at school. Long-acting insulin works so darn well. We can see the graphs and trends related to food, exercise, hormones and make more educated decisions. Thanks to these achievements we can live more meaningful and more courageous lives with diabetes.
Despite the advances the system is not perfect. I think we know this but still expect it to be. Diabetes TMI is part of the problem. We know too much. Alarms, social media impressions, images of arrows pointing every which way. It can be exhausting. The modern-day person with type 1 diabetes is always plugged in, turned on and eventually without recharging, can quickly burn out. Without self-awareness, CGM’s can turn even the most relaxed person into a perfectionist. This was, and sometimes still is, me. I have had to work hard on letting go of perfect numbers and allowing the imbalances to teach me more about myself and diabetes. Curing this habit with diabetes has helped me heal perfectionist tendencies in other areas of my life.
According to the American Diabetes Association, optimal diabetes management is maintaining an HbA1c under 7 and blood glucose reading of 70-130 mg/dL before meals and under 180 mg/dL two hours after meals. These are not unattainable goals, but they are not always the numbers we see during the day. Due to an intense desire to remain “within the lines” diabetes perfectionism can actually cause hypo and hyperglycemia episodes because you react rather than listen.
All of this measuring up and striving to fit into the lines leaves a subtle imprint in the psyche. Isn't there already enough pressure in this world to be perfect without diabetes? The mind holds on to negative thoughts and beliefs further perpetuating the inability to be satisfied. Perfectionism is a product of fear. It is the fear of being inadequate, of making mistakes, of being vulnerable. Many of us are successful at living with diabetes because we put on the face of being capable. I always told my parents, “I’ve got this. Please don’t worry about me.” But that attitude only gets us so far. We have got to have the courage to make mistakes, learn from them and grow.
Please share your experiences with diabetes perfectionism below. I'd love to hear them
Skip to min 3:15 to get directly into the practice
The key to master diabetes lies within the mind. Diabetes requires an enormous amount of mental fortitude when it comes to decision making. Strengthening your mind is like developing a muscle. Like any muscle, if you don't work on it, it will stay weak and eventually atrophy. Without willpower diabetes will always be the one in charge of your decisions and destiny.
Just as important as it is to administer insulin, eat right and exercise, so too is developing your internal strength, willpower, and determination.
As a recently diagnosed person with diabetes, I remember how challenging it was for me to say no to certain foods. What were once everyday daily treats like pop-tarts and cereal were suddenly off-limits, and subsequently, I wanted them even more. I would pine at my brother’s cereal bowl every breakfast while I ate my less-than-exciting eggs.
To make matters worse, as a newly diagnosed diabetic, I could not control the impulse to overeat when I was low. My internal emergency alarm clock for low blood glucose was so loud that I could not separate my desire to eat cereal from the wisdom to know that I had enough. At one point, my mom had to padlock my brother's cereal so I would not eat it all. I lived for years a slave to my cravings on a physical and emotional rollercoaster. It wasn't until I began a regular yoga therapy practice involving breathing and meditation when my life turned around.
Inside the mind, we battle with our impulses, which are profoundly rooted in survival mechanisms. All day long, the mind waivers from distractions, desires, worries, cravings. When you have diabetes, the common internal disturbances are amplified. Externally the mind responds and relates to information received from our senses. For instance, if you see a disagreeable number on your CGM there is an emotional response, which is then internalized, triggering the heart rate to rise, the brain to release stress hormones, increasing insulin resistance, the mind spins, and you are caught up in the inner and outer drama of diabetes.
A primary tool for developing your willpower muscle is something you already have, something you are doing right now…breathing!
By consciously slowing down your breath you can:
In this short video, I’ll walk you through the steps to practice conscious breathing for developing your diabetes willpower muscle.
The steps are as follows:
1) Sit comfortably and close your eyes
2) Shape your breath slowly and continuously without pause
3) Relax at the beginning and end of each inhale and exhale
4) Allow the exhale to lengthen up to twice as long as inhale (purse your lips if you need)
5) Slow breath down as effortlessly as possible and maintain for several minutes