What’s Your Wild Card?

By Joe Nelson | November 1, 2006 11:09 am

Yesterday, I spoke at a conference called TCOYD: Taking Control of Your Diabetes. It’s a great conference devoted to helping people who live with diabetes do it better. I gave two talks: one about “Emotions: The Wild Cards in Diabetes” and another on “Dealing with Diabetes Related Stress, Burnout, and Other Emotional Issues.”

These topics are generally well-received because people who live with diabetes understand that emotions, stress, other life issues can make diabetes more unpredictable than it normally is. The hormonal fluctuations that come with stressful events can lead to changes that often make blood glucose levels go up (but can sometimes make them go down). Understanding may only come after an experience, when you look at your meter, see that it reads 305, and say, “Oh my, I guess that meeting was more stressful than I thought.”

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During my first presentation, I asked the members of the audience to identify their own “wild cards.” They each received a 3×5 card on which to write down this information and come up with a plan to deal with the issue in a positive way. Our usual methods of coping are often the ones we’d prefer not to admit to, such as overeating, smoking, drinking, watching TV, or raging at others when they look at us the wrong way. These behaviors are human, and some may actually make us feel better briefly, but they don’t always line up with how we want to behave or with how a person might like to care for his diabetes.

For example, here’s a potential situation: A person experiences stress (which can cause blood glucose levels to be erratic) and does something to make himself feel better (like overeat, which also affects blood glucose), so his blood glucose levels end up experiencing a double whammy. This is also something he’s not likely to be proud of, so maybe he stops checking his blood glucose levels because he knows he won’t like the results and don’t want his health-care provider to judge him. This, in turn, can lead to more stress, guilt, and shame, further compounding his struggle to live well with diabetes. How can he address this vicious cycle?

The second presentation I did yesterday was on the stress of living with diabetes and its interaction with other life stresses and depression. For this presentation, I had a solid hour of slides and planned to cover all the potential interactions in addition to the ways people might do a better job of managing this complex issue. But I changed my mind right before the talk began; I’m not sure why, but I’m glad I did. Instead, I simply asked the audience why they came to this session and then I listened to this wonderful group tell me about the combinations of issues they had in their lives.

A couple told me about how they had each struggled to control their blood glucose since the loss of their daughter three months ago. One woman talked about her loneliness since her husband’s death and how hard it is to be interested in any food preparation since she has no appetite anyway. Another young woman said that she struggles to balance caring for her children, dealing with a husband who is out of work, and helping a mother who has complications with her own diabetes in addition to holding a job and managing her own diabetes. These are just a few examples of the voices that were looking for some compassion for the combination of issues that made their lives and their diabetes more challenging. In addition, it was clear that none of them were offering these issues as excuses to avoid doing what they knew would be good for their diabetes control. All had come to the conference to look for a better way; they wanted someone to understand that their lives were just not easy, but they also wanted support and information to help them improve on what they were already doing.

I write this blog today to ask you, what is your wild card? What stressors do you carry with you? And is there anything you want to say about this interaction? Finding your voice about these issues and owning them is the first step in beginning to do something different that can help you improve your reaction to stress and your diabetes control. So take the time now to identify your wild card, talk or write about it, and then start looking for some fresh ideas for how you might address it in a new way.

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Joe Nelson: oe is a psychotherapist in private practice in Minnesota, where he specializes in the psychology of chronic disease and sexual problems and works with couples, families, children, and teens. He has been a Licensed Psychologist since 1985 and has earned a master’s degree from St. Mary’s College Winona, a bachelor’s degree in social work from the University of Minnesota, and an associate’s degree in human services from the College of DuPage in Glen Ellyn, Illinois.

Joe has worked with troubled youth in Chicago and Minnesota and on a special project on Turtle Mountain Reservation in North Dakota. He was the first social worker hired by an affiliate of the American Diabetes Association. He worked at the International Diabetes Center for 20 years, directing psychological services there for 12 years. A Certified Sex Therapist, Joe co-developed the Sexual Health Center at Park Nicollet Clinic.

Having practiced meditation for over 30 years, Joe offers instruction in mindfulness-based meditation to patients in groups and as individuals. Joe is married, has a 23-year-old daughter, and enjoys scuba diving, motorcycling, golf, and being outdoors doing almost anything.

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