Yesterday, I was fly fishing with my boyfriend. It was below 30 degrees outside and we were fishing in a dark canyon with little sunlight. Naturally, I run cold, despite having grown up at 8,000 ft, I am usually cold even in the summer. This could be a result of type one diabetes and a lack of circulation, who knows. Needless to say, my body was working extra hard to stay warm and despite my best efforts, my blood sugar numbers would not stay regulated. I saw the dreaded diagonal arrow down on my Dexcom cgm and tried to mitigate before it was too late with glucose tabs and temp basals. Suddenly I was that kind of low that you just can't function. It is so uncomfortable and painful. I just wanted to cry, "Why ME! I am so TIRED of this!!!" but I didn't because what good is that? So I sat, watching the far away sun on my face waiting for the time to pass until I could function again. It was so cold and I felt so awful but I had to surrender to that light of the sun to hold me, help me stay patient and separate from the horrible feelings and sensations that I was feeling, not to mention the guilt of not getting the equation right and missing out on prime fishing.
This is a common scenario for the adventuring diabetic. What did I do wrong? I thought I knew what I was doing? How did I get it wrong? Sometimes you just do everything right and it is still wrong! It is hard to resolve these uncomfortable feelings and emotions that follow any type of chronic condition. When you have done everything possible, the only thing left is to surrender.
Surrender – One of the core tenants of yoga is a Sanskrit term called isvara pranidhana: to surrender to something that is bigger than you. This implies that there is a force that is bigger than you. This has nothing to do with dogma or religion, simply the belief that you come from something that cannot always be explained. It implies that you are not in control of EVERYTHING in your life. Isvara is the ultimate power that has never ever experienced sorrow. It knows what it is, but is impervious to fear and darkness. It is the strongest most pure force that is completely fearless and wise. It is a guiding light in turbulent moments. Now I get it, this sounds a little new agey...but stick with me. Sometimes these ancient beliefs are universal truths that surpass all time.
When you can surrender to the fact that despite your BEST EFFORTS you still missed the mark, this will save you time, grief, stress and unnecessary self-ridicule. You can learn to surrender more in your life with regular practices like yoga nidra, pranayama (seated breathing) and meditation. These simple, yet incredibly potent, practices can help you to see where you are contracting, straining or holding on to something that is not useful.
Don’t waste energy on your mistakes. See diabetes as a relationship that is constantly evolving and changing. Once you try less and surrender more you can choose what you give your energy and power to, saving you time and vital energetic resources that can be put forth to the things that REALLY matter.
I would love to show you how you can start to do this work for yourself. It is definitely work but the benefits can change your world and relationship to your disease.
YOGA THERAPY FOR T1D & GASTROPARESIS
Gastro-what-so-sis? Don’t worry, I hadn’t heard about it either until I realized that I had it. Gastroparesis, also known as delayed stomach release, slows down or even stops the stomach’s ability to release food into the small intestine. It’s a common side effect of diabetes and other chronic illnesses, but most common in type 1 diabetics who have been diabetic for over 10 years (me!!)(3). This causes a trifecta of gastrointestinal problems such as gas, bloating, acid reflux and general feelings of ick and discomfort. And if that wasn’t bad enough, this also wreaks havoc on blood sugar control, which inhibits a type 1 diabetic’s ability to discern when to take insulin for a meal.
As a type 1 diabetic, for years I had suffered from gas, bloating, slow digestion – you name it – and insulin resistance. The inability to anticipate my digestion time caused me to miscalculate my insulin to carbohydrate ratio, which led to crashes followed by subsequently a skyrocket – think blood sugar yoyo. Its onset was cyclical but unpredictable and extremely disruptive to my life. I had no clue what was causing this!
Like a good diabetic yogini, I tried every natural remedy under the sun. Candida-cleanse, parasite cleanse, I went vegan, I went paleo, I went auto-bleeping-immune paleo…I took A LOT of vitamins. When that didn’t work, I went the other route: antibiotics, sonogram and MRI.
To no avail, I spent a small fortune on trying to figure it out. I didn’t “figure it out” until I started using a continuous glucose monitor. With a newfound ability to be hyperaware and vigilant of my blood sugar patterns, I saw a correlation between my stomachaches and blood sugar levels. I read about gastroparesis in Dr. Bernstein’s Diabetes Solution and was shocked to see my whole life in one description. When I asked my doctors and nutritionist they all responded like “oh yeah, at this point with 20 plus years of diabetes, you should definitely have that.” Light bulb!
So, what causes gastroparesis? Gastroparesis is caused by damage to the vagus nerve, which can be occur with illness or, in my case, high blood sugars. The vagus nerve, is a vital part of the body’s natural ability to relax and aids in parasympathetic control of the heart, lungs, stomach and digestive tract. The health and resilience of the vagus nerve is known as vagal tone and healthy vagal tone helps us regulate and calm our bodies after a fight-or-flight stress response to danger. Low vagal tone does the exact opposite (1), which in turn leads to higher levels of stress and decreased ability to control blood sugar – a diabetics worst nightmare.
This is where we fuse yoga therapy and diabetes. Here’s what we know so far: gastroparesis is caused by higher blood sugars that damage the vagus nerve, a side effect of gastroparesis is higher blood sugars and the vagus nerve is important to our body’s ability to regulate stress. The key to healing the body’s response to stress is by improving vagal tone. You can stimulate vagal tone and reduce gastroparesis flare-ups by specific yoga therapy techniques that aid in parasympathetic activation.
Here are what I’ve found to be most effective: Yoga poses: If exhale is calming, so too are twists and forwards bends. Always move into twists and forward bends on exhale. Try moving into a standing forward bend or twist on exhale, lengthening your exhale each time, then stay for several breaths maintaining ujjayi awareness.
Caution: twists and flexion should be done lying on the back before any seated twists.
Meditation: Meditation is good for everyone, but just like flossing your teeth most of us do not do it enough. After you practice some dynamic forward bends and twists, sit and practice your breathing exercises. Next, relax your breath and simply feel your breath move in and out without trying to breathe. Watch what arises in the field of your attention. Your breath affects your mind and your mind affects your breath. If you’re just getting started on meditation, you can explore a few popular apps like Headspace and Calm.
Agnisara: Dr. Bernstein refers to agnisara as a way to stimulate the stomach to release. Agni sara is considered a purification technique. There are many versions of agni sara and it can be quite complicated for even an experienced yoga practitioner.
I recommend starting simple as you do not want to induce a stress response.
Just like yoga therapy, type 1 diabetes and gastroparesis do not have a one-size fits all cure. We cannot cure type 1 diabetes (yet) but we can manage its symptoms and side effects with patience, curiosity and kindness. Be patient with the process as it will not be automatic. With practice, you will become progressively more aware of not only gastroparesis onset but also how other factors in your life (and low vagal tone) may in fact be contributing to your level of suffering. If you want to learn more about how to use yoga therapy to manage type 1 diabetes or any other chronic condition, please subscribe to my newsletter.
4. Bernstein, Richard K. The Diabetes Solution. Little Brown Publishers. 1997.
©Evan Soroka Yoga Therapy 2017
Evan Soroka, C-IAYT, E-RYT 500, is based in Aspen, Colorado. She specializes in the art of yoga therapy, a blending of modern-day physical & psycho-therapy with the ancient science of Ayurveda and yoga. She attributes her health and wellbeing to the science of yoga therapy discovered through her own personal journey with type 1 diabetes as well as under the seasoned direction of her teachers. You can find her online at diabeticyogini.com and on instagram @diabeticyogini Learn how you can work with Evan personally today!