Diabetes Self-Management Blog

As anyone who reads this blog with any regularity knows, I am a musician (among other things). I have played keyboards since I was about eight years old, and while other interests, and even careers, have come and gone, music has remained a constant. Of course, it is a rare few who can earn their living purely from performing. Like most musicians I know (well, those who earn their living legally), I split my time between teaching music and playing it, scrounging together a meager monthly income that covers expenses but not much else. Still, it leaves me happy, and that has to be worth something.

But I digress — the topic of this entry is not the financial hardships of a life in the performing arts. What I want to share is a phenomenon I have seen firsthand as a musician with diabetes. And that is, the complicated relationship to mind–body awareness that comes as a result of living with diabetes.

Playing music is a very physical act. It is not an athletic endeavor, but it does entail equally sophisticated and demanding physicality. Learning to play a musical instrument is a process of training particular muscles (the hands for a pianist, the diaphragm for horn players and singers, all the extremities for drums) to pull off intricate, minute movements with dexterity, speed, and precision. This requires thousands of hours of practice.

Of course, learning an instrument involves a great deal of “mental” learning, as well — learning to read music; learning the rules of music theory; learning the rules of rhythm, harmony, and melody. For improvising musicians, we need to learn literally hundreds of different scales, chord structures, and patterns that combine to create improvised melodies. All of this is intense mental training, often equated (rightfully so, I think) to learning a second language.

Where the “mind–body” idea comes into music is in the “internalizing” of these skills. In musical circles, it is not uncommon to hear people talk about learning something “in your bones” or “in your fingers.” The idea is that you internalize the learning, both the mental and the physical, so deeply that the skill is literally IN YOUR FINGERS — that the knowledge is so readily and deeply available that you almost bypass the typical brain circuitry. Rather than seeing written music and translating in your head and sending it to your fingers, your eyes send that information straight to your fingers, and it instantly materializes. If you are improvising, you don’t have an idea, translate it, “figure out” the scale, and send the information to your fingers — no, you hear what you want to play, and your fingers simply KNOW where to go on the instrument to manifest that melody. There is no translation, no top-down dictation from your brain.

So, what does all of this have to do with diabetes?

Diabetes is very similar in that it is a physical condition that requires finely attuned physical awareness coupled with sophisticated intellectual calculations and adjustments for tight management. It, too, demands that we pay attention to SMALL physical signs, particularly in noticing low blood glucose. And this awareness needs to grow over time, as the signs of low blood glucose become less and less noticeable. In my early years, I noticed BIG signs when my blood glucose hit the 65–75 range — feeling shaky, sweating, suddenly weaker. These days, the signs of this range are incredibly subtle. They are more perceptual than physical — I notice my focus is a little looser, my short-term memory gets a little shaky, my ability to write a coherent sentence begins to fracture ever so slightly.

What’s interesting to me about diabetes and mind–body awareness is that it can both help us to build this skill, and it can also take it AWAY. And this is something that ties back to my experience as a musician. When I’m low, my ability to tap into the “brain in my fingers” is diminished. My capacity for finely attuned awareness lessens because my own body chemistry is off. My fingers move more slowly, and the ideas that usually come with very little effort suddenly seem to require intense mental calculations. And so here, diabetes seems to be taking AWAY my capacity for awareness. And yet, part of what has GIVEN me such deep awareness when I play music is the 19 years I have spent listening to my body for any signs of imbalance in my blood glucose.

This is the Catch-22 of diabetes. We have a daily practice that helps us build up our capacity for mind–body awareness, and when our blood glucose is in balance, we reap the benefits. Some may be talented athletes, some may be artists, actors, or musicians. Others may be gifted scientists and mathematicians who have built up an almost physical “sense for numbers” or scientific patterns. But when our own chemistry slides out of balance, diabetes becomes the obstacle to this awareness. It blocks our ability to attune, to perform at our highest levels.

I would love to hear stories from readers on this topic. Share your experiences and tell us how this complicated, seemly contradictory mind–body phenomenon has shown up in your life.

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