hypoglycemia

At least, I’m going to call it hypoglycemia for convenience. You’ll see why later.

Background

The first time I spontaneously got dizzy I was 12 when I tipped my head sideways to see into my desk. Although I don’t remember circumstances, I do recall having very occasional dizzy spells from that time and into university, at which point they became a little more frequent. I’d usually go home and have a rest, which sometimes helped and sometimes didn’t. Someone suggested it was low blood sugar but it didn’t seem likely because I was sometimes dizzy after a meal.

When I eventually went to the doctor, he diagnosed vertigo, meaning “I spontaneously get dizzy sometimes” and advised me not to move my head around too much. Uh, thanks. He was wrong, but in fairness it took me years of experience and a few other doctors and finally a particularly knowledgeable and helpful school nurse to figure it all out.

A couple of years after this most unhelpful of diagnoses, and after I’d graduated and moved to a different city, I’d been struggling with diet generally. I’d moved away from home with my boyfriend and neither of us were very interested in cooking. I generally ate food cooked from scratch rather than convenience food, so I was having trouble figuring out what the problem was. There had been dizziness, one occasion of an inexplicable sensation of nervousness, feelings of nausea, and no doubt other symptoms I’m forgetting. I went to the doctor, who said it sounded like hypoglycemia, though he didn’t order any tests. Just as well because the test is a glucose tolerance test in which you consume a sickly sweet glucose drink and then have blood tests every half hour for 2, 4 or 6 hours. As a needle-phobic, I was happy to give that a miss. His advice was to eat more meat and drink more milk to increase protein intake, but I found this challenging because I preferred to go more vegetarian and I was off milk at the time. So I attempted to manage my blood sugar through diet, albeit with limited success.

A few years later, when I was teaching English in Japan, I often struggled with low energy, low mood and difficulty focusing. One morning I was having a tough time. I’d made friends with the school nurse and her assistant; both of them had pretty good English but mostly they were nice, and I enjoyed being around them. So feeling unable to focus on work, I retreated to the nurse’s room and as we were chatting I told her I wasn’t feeling all that well, so she asked some questions. The main thing was dizziness and feeling generally blah. What kind of dizziness? This was the first time anyone had asked that question and I wasn’t sure how to explain it. Was it a sensation of going up and down like on an elevator, or was the room spinning horizontally? It was the up-and-down type.

This concerned her because up-and-down signifies high blood sugar, while horizontal spinning is typical of low blood sugar. It was very troubling to her, a nurse whose supervising doctor specialised in diabetes, that I should be having high blood sugar in the morning. Ah, I said. I ate something very sweet for breakfast. But from then on I paid attention to the type of dizziness and it was always pointed to low blood sugar.

I continued to struggle with blood sugar issues in Japan, so when I got back I consulted a nutritionist. Doctors don’t really get any instruction on nutrition, but some nutritionists aren’t much better. When this person encouraged me to eat things like Cheez Whiz and diet soft drinks, I knew I was unlikely to going to get any useful information out of her.

Anyway, since then I’ve just continued to treat it as hypoglycemia and try to figure out what works for me through trial and error.

Reactive hypoglycemia

If you consume sugar and a short while later your blood sugar is actually lower than it was to start with, that’s reactive hypoglycemia. The science is still somewhat unsettled on the precise mechanism, but one theory is that when the sugar is consumed, the body overproduces insulin. Insulin’s function is to lower blood sugar but here it kind of freaks out, and then you crave sugar. If you succumb to that craving, your blood sugar bounces up and down, and generally wreaks havoc.

Because I haven’t had the test, I’m not certain that this applies to me, but my current doctor says they don’t really do the glucose tolerance test for this anymore. And I know from experience that if I were to have a coke or even orange juice without eating some real food at the same time, it would fuck me up, so I probably do have reactive hypoglycemia.

But this isn’t the only issue for me.

Low blood sugar before meals

I also get low blood sugar before a meal, but since this isn’t provoked by consuming sugar, it can’t be reactive hypoglycemia. I suppose it’s just a normal low caused by my body burning off whatever I ate last. In other words (though I hate the term), it includes being ‘hangry’.

There’s another issue at play — I don’t really feel hunger and instead I eventually get low blood sugar symptoms. At first I thought this was an inconvenient coincidence, but now I wonder if I’ve actually learned (or was taught) to ignore hunger and if so this would be part of the cause of my blood sugar woes.

Even so, my low blood sugar symptoms seem to be more sudden and intense than what most people experience.

Symptoms of low blood sugar

Low blood sugar can cause a variety of symptoms. These are the ones I’ve experienced:

  • mood: from irritability, through grumpiness and foul temper, to full-on meltdown (crying etc.)
  • cognition: brain fog; my natural indecisiveness gets worse to the point of complete inability to make a decision (including, inconveniently, what I want to eat or where); inattentiveness; sensation of nervousness
  • dizziness
  • stomach: I’ll get a sudden feeling not of hunger but of void, which quickly turns to nausea (though I’ve never thrown up)

How I try to avoid low blood sugar

Avoiding reactive hypoglycemia is pretty straightforward: no sweets outside of mealtime, and especially no sweets as a meal. This includes sweet drinks such as soft drinks or fruit juice.

Avoiding low blood sugar at other times is more complicated because of my largely absent sense of hunger.

In general, I need to eat proportionately less carbs and more protein and fat than other people seem to need. If I eat carbs, I opt for complex carbs (e.g. rolled oats, brown rice, potatoes) instead of refined starches or sugars, but some carb-centric meals are best avoided (e.g. pizza, pasta). (You can get an idea of the effect of a given food on blood sugar by checking its glycemic index, but in general the less processed the better.) I eat meat, and dairy is a big part of my diet (full-fat everything). I eat on a schedule and frequently (breakfast, lunch, afternoon snack, supper, bedtime snack).

All of this becomes more complicated when I’m travelling because I don’t necessarily have access to a fridge, I can’t cook for myself, and I may be stuck with someone else’s schedule (especially on planes!). You can get carbs in any vending machine but protein is much harder to source. New restaurants are mostly a source of worry: will I be able to find something to eat here and will it be served before I have a crash? Do I have the language skills to figure out the menu and advise of my dietary issues? If I’m travelling, I don’t go anywhere without emergency rations.

As a result, travelling (or even going out to a new restaurant, or having a social event that centres food) causes me some low-grade worry. Will I get what I need when I need it? Dipping into my emergency rations around people is awkward because sometimes I sense they think I should share.

How I deal with low blood sugar when it happens

If I sense that my blood sugar is just a bit low and I can’t eat real food immediately, I’ll go for protein and fat (e.g. nuts). If it’s a little lower, then I’ll add something sweet (e.g. nuts plus chocolate, chocolate almonds). If it’s more of an emergency situation and my blood sugar has fully crashed, then I go for something sweet, preferably liquid because the sugar starts being absorbed into the bloodstream directly from the mouth (e.g. soft drink, fruit juice).

If my blood sugar is low enough that I feel I need some sugar right now, then sugar is the first step and real food is the next step. Real food doesn’t work as a first step in an emergency because it takes too long to be digested — I’ll end up having a full on blood sugar crash while I wait for the food to kick in. Not fun.

Conclusion

Blood sugar issues are inconvenient and become more of a hassle the farther away from home I get. I get anxious about it when I travel but I’m more relaxed if I have a travelling companion who understands my issues and can problem solve when I’m not able to. It’s not all negative though: it forces me to eat healthy food on a regular schedule, which is not the worst outcome. Uncontrolled hypoglycemia can encourage development of diabetes, so managing the issue through good diet is long-term self-care.

 

Notes on dizziness

The nature of the dizziness can be diagnostic (too bad my doctors didn’t know that). I’ve experienced the following:

  • low blood sugar: feels like the room is spinning, a horizontal feeling
  • high blood sugar: feels like you’re on an elevator, a vertical feeling
  • benign paroxysmal positional vertigo (BPPV): sudden and rather violent dizziness, provoked by changing the position of your head, can be calmed by moving your head back; results from crystals spontaneously forming in the semicircular canals of your ears and then interfering with the messages that the liquid and cilia in the canal send to the brain about position and movement (I’m certain that this is the first dizziness I experienced at age 12, and as of fairly recently it has become chronic)
  • extreme tiredness: to me feels like non-directional wobbliness; confusingly, the dizziness can happen even after I’ve slept, if the tiredness was bad enough (in university, I think I had both this and low blood sugar dizziness – the doctor’s mistake was thinking that there was only one kind of dizziness and thus one cause)

Notes on fatigue

In Japan I struggled with fatigue, at any time of day. At the time I assumed that my fatigue was all blood-sugar related, but I underestimated how exhausting it was for me to be surrounded by a different language and culture all day. I should have been eating a different balance of food, more of it, and having more naps. Fatigue is a difficult symptom to work with because a huge number of issues can cause it.

Food Matters

Better Sex through Mindfulness project

Other than the first two or three years after my epiphany, I’ve had low libido my whole life, so when I came across Lori A. Brotto’s Better Sex through Mindfulness: How Women Can Cultivate Desire a little over a year ago, I bought it and promptly started reading. Unfortunately I didn’t get far. The mindfulness it was asking me for felt out of my range.

I had assumed that mindfulness was a thing I’d be good at. I’m observant. I’m introspective. I’m a highly sensitive person. I have good physical awareness for both movement and health issues. So it threw me for a loop when a body awareness exercise felt difficult.

But maybe it shouldn’t have. Now that I give it some thought, there are also ways in which I can be rather disconnected from my body. Relatively recently I developed a tendency to hold my breath under certain circumstances and it took some time (and a trip to the doctor) before I figured out what I was doing. I always have a certain degree of muscle tension, especially in my neck and shoulders. And then there’s the big one: the nighttime jaw-clenching habit that I’ve struggled with for my entire adult life. Oh yeah, that!

There’s also the puzzling fact that I have no memory of my first orgasm even though I’m certain that it was with a boyfriend (pretty sure I know which one), and resulted from him giving me oral sex. I’m also certain that I didn’t dissociate in the moment, but my former sexual shame seems to have cast the memory of it adrift. In reading about dissociation (the current SB4MH prompt), I also brushed up on the related concept of emotional detachment, which is much more familiar to me, especially as demonstrated by my mother who I believe experienced some kind of sexual trauma as a child.

Although I set the Brotto book aside, I started trying to tune in more to certain physical sensations that I seem to habitually ignore.

For instance, I don’t really feel hungry when it’s time to eat, and I now wonder whether my lack of a sense of hunger is somehow learned and is an example of an idiosyncratic disconnect between physical sensation and awareness. It’s a real issue because it leads to issues and symptoms relating to low blood sugar, especially when I’m not able to eat on a schedule like while I’m travelling. This is something where mindfulness might really help.

I’ve also been paying more attention to the times when I feel (spontaneously) turned on. I’ve found that I rarely feel any arousal at all, and if I do, the sensation tends to be very mild and easily ignored. It’s usually only perceptible it in the morning when I wake up, and getting up to go to the bathroom or retrieve my vibe has often been enough to kill it.

In addition to working on this ‘remedial physical awareness’, I also started meditating. In the past I’d never got beyond a bit of dabbling but this time I actively sought out meditation classes as a way of building a foundation for mindfulness. I found a Buddhist class that was conveniently located and had a set of talks aimed at beginners. Perfect! While I haven’t quite gotten into a regular meditation routine, I now feel that I have the foundation I was after.

And with that, I think I’m ready to dive back in to Better Sex through Mindfulness!

As I read Brotto’s book, I’ll be using each chapter as a writing prompt as a way of encouraging myself to slow down, reflect, and engage with it deeply.

Below is the table of contents, which I will link to my posts as I work through it.

Introduction

Chapter 1. Sex in a Multitasking World

Chapter 2. Seeking Sexual Ecstasy – From the Couch to the Brain Drug

Chapter 3. Introducing the Raisin

Chapter 4. Becoming Aware of Your Body

Chapter 5. “Your Attention, Please!”

Chapter 6. How Mindfulness Works

Chapter 7. If You’re Happy and You Know It

Chapter 8. It Takes Two

Chapter 9. Tuning In to Pain

Chapter 10. You Have My Attention – Now What?

Chapter 11. The Next Chapter of the Present Moment

Masturbation Monday

creating a home

Home is a feeling of safety and security. It’s where you can relax and be your whole authentic self. It’s where you feel welcome and a sense of belonging. It’s comfort.

As I remember it, I don’t think I ever felt entirely welcome at home as a kid. It was not an emotionally warm or supportive place. My parents split when I was 10 and they lived close enough to each other that I spent half the week with each. I think my mom was more accepting of me, but the emotional temperature was always chilly; my dad was warmer but critical, and it got worse when he and his girlfriend moved in together — I felt actively unwelcome.

I attended university in my hometown so my first time living away was when my boyfriend and I moved across the country to a big city. It didn’t take long until the relationship became strained (at least to me — I think he thought everything was fine). We had an apartment together in an expensive city and neither of us could afford to move out. I didn’t feel comfortable; I felt trapped.

We moved back. My mom’s house was bursting at the seams. My dad (and his girlfriend) had moved to a smaller house. There was no room but I didn’t want to go back to someplace where I felt unwelcome anyway. My boyfriend’s family took us both in, which was very generous of them, but I never really belonged and the sense of being trapped returned. How can you break up with someone when you’re living with them and their parents? (I did try my dad’s place after all. I lasted three weeks.)

Much time has passed and Wolf and I have made a home together. (It still counts even though he’s living away right now for work.) We are entirely at ease together, entirely accepting, and I now have the warmth and welcome I always craved without knowing what was missing.

Our home is comfortable and cozy, a safe haven where we can close the door and lock the world out. The comfort of one’s own bed, especially when coming home after a trip, is well known. But for me, home is also where my fridge and pantry are, which means that I can eat food that I know won’t cause me health problems whenever I might be hungry and not have to rely on anyone else’s schedule or tastes. It’s also where my yoga mat, ankle weights and other gear are, which means I can do the stretches and exercises that keep my back and hips happy. So it represents my physical comfort as well.

And now that I’ve paid off the mortgage, there’s an extra feeling of accomplishment, contentment and security. Bliss.

 

F4Thought

reflecting and looking forward

“No peeking”, a Sinful Sunday photo from May 2016.

Well, 2019 was a year. Fortunately there was more positive than negative.

IBS-friendly diet and improved energy

In late 2018, I started managing my IBS using a FODMAP-based diet and by January 2019 I could tell that it was having a positive effect, and not only on my digestive symptoms.

The most unexpected — and utterly delightful — effect was that it largely resolved the fatigue that I’d struggled with for over seven years at that point, despite having undergone every relevant test my doctor could think of. As a result, instead of being constantly dragged down and only randomly experiencing the occasional unpredictable ‘on’ day, most days are now good days and if I get blindsided by some surprise fatigue, reverting to a conservative diet and waiting out my digestive process for a maximum of three days almost always resolves the issue.

For an accidental discovery, it’s had a huge effect on my day-to-day life. A few years ago, the combination of fatigue, poor sleep, depression and then antidepressants meant that I never knew for sure if I’d have the energy, cognition or focus to a given thing at a given time. (A few weeks after I tapered off the antidepressants in April 2018, the cognition and focus came back, but fatigue remained.) Eventually I got tired of disappointing myself so I just stopped planning anything and instead would decide on the day whether I was up for doing the thing. Which was me doing my best to cope, but it wasn’t very effective and it had exacerbated my inherent tendency not to make plans or have goals.

I now have the energy to plan and set goals, though I’m not actually very good at either of those things. So I’ll be working on that in all areas of my life, especially food (shopping, prepping, cooking), and sexuality (specifically exploring the factors that may be contribute to my low libido).

meditation

At the beginning of 2019 I started going to a weekly meditation class with a Buddhist group that meets conveniently near my place. I’d been thinking for some time that meditation would probably be good for my buzzy brain. And during my most recent meditation, I became aware that even though my brain is still far from quiet, it’s perceptibly quieter than it was when I started a year ago. It’s nice to feel that sense of progress.

I’m not practicing regularly at the moment but I’m working on making it part of my routine. And I’ll continue going to the classes because I find them helpful and I like the people: folks who are actively working on themselves to to decrease criticism and increase compassion are people I want to be around.

Wolf’s new job

Another significant change was that at the beginning of 2019 Wolf got a good contract job in a nearby city. For a change, we’re now both working at the same time, so things have suddenly gotten much easier financially, although he now has the expense of his own apartment and utilities. I’m in the process of paying out our mortgage early (we’re currently in payout limbo as the request has been made but the bank hasn’t withdrawn the money yet), so there’s a financial freedom on the horizon for us.

It’s not a secure enough job for me to consider upping stakes yet. But we’re making efforts to remain connected despite the distance, and he’s going to look for enjoyable things we can do when I come to visit to help with my project to have more pleasure in my life.

solitude

But with Wolf away, I’m once again alone here. It’s less than ideal but nowhere near as difficult as when he was overseas doing his doctorate: I tend not to get especially lonely; we talk on the phone every day and see each other every few weeks; neither of us are dealing with depression and/or anxiety the way we were before; and I still have support from Jaime.

Some time ago, I discovered that I couldn’t answer the questions “what do I like? what do I want?” in relation to sex. I now see that I struggle to answer these questions at all, for anything. I think this is largely because other people’s needs and wants seem much louder to me than my own. (It’s no coincidence that my epiphany occurred only after Wolf had been away for the better part of two years.)

But there is a mental quietness that comes from being by myself virtually all the time, enhanced by the fact that I keep the house literally quiet most of the time too. That literal and figurative quiet allows me to listen for my inner voice.

I’m going to make the most of my quiet time, keep trying to figure out my answers to those questions, and see what I can do to remain tuned in to my gut even when I’m not alone. I currently subject myself to a certain amount of mental chatter via social media, but I’m considering cutting down in order to be more deliberate with my energy; no decisions made yet on this point.

car theft

Our summer was marred by the theft and subsequent destruction of our car. Someone came in the back door of our house in the early evening and stole a handful of keys that were right there, including the car keys. I experienced a bunch of difficult emotions, chiefly anger, but in the end it didn’t hit me as hard as I (and others) expected. It was too much to process at once (similar to grief in that way) and I was concerned that perhaps I was at risk of burying the emotions rather than processing them. But I’m able to think about it now and while it’s still a bit sensitive, I don’t feel the need to avoid it, so I guess I’m OK.

Despite various anxieties I experienced that made it difficult to buy a new car, I did buy one, and I like it. Rather than getting a colour that would blend in, I got red because it’s my favourite colour, and despite the fact that some people judge drivers of red cars. Rather than getting a standard licence plate I got a personalised plate because it makes me happy to see it. It was an exercise in determining what I like and want, and prioritising my own pleasure.

I still have some anger, sadness and frustration about this episode, but I trust that it will ease over time and that giving it some attention today will help that process. We’ve taken some steps already for increased security and I’ll give some thought to some others, all with the goal of keeping my response reasonable and proportionate and not turning into an angry misanthropist in a walled compound.

looking forward

I’ve spent a lot of time over the holidays planning, which is unlike me. But I think I’m ready for planning and strategizing now in a way that I wasn’t before, thanks partly to the meditation I’ve been doing. (One of my common intrusive thoughts while meditating is my to-do list, so it would be helpful if I gave it its own dedicated time.)

This process of listening to my gut and planning has given me a clearer idea of what I want to do with this blog going forward. Having realised and accepted that I still have unresolved issues around sexuality, I want to work on those and I’m going to try harnessing the power of memes to give me a kick in the pants to get that stuff done 🙂

 

F4Thought