Diabetes and New Year’s Resolutions

So, it’s almost the new year. I’m sitting in my newly cleaned living room in my new (to me) house, simultaneously half-watching a basketball game with my husband while contemplating the year ahead. If the following post contains many sports metaphors, you’ll know why. 

2012 has been a stressful one. It started with buying a house (see above), an exciting and satisfying experience, but one that has left us both emotionally and financially drained. (It turns out that a 1862 house last renovated in the early 70s needs a lot of TLC.) It also began with me recovering from shoulder surgery from a torn labrum — meaning I ripped the cartilage in my shoulder from the bone — which I sustained not in a bar fight, not while lifting 200-pound weights, but while stretching. (Six months of daily PT later and I’m almost but not quite back to normal.) Work-wise, I’ve spent the year mostly on my upcoming book about the history of vitamins, which has been simultaneously exhilarating (to have a project that is entirely my own) and also intimidating and overwhelming. Many days have begun with a 6:30 am attempt at meditation followed by a 7:30 session at the gym followed by seven or so hours of book work (or attempted book work and then feelings of guilt resulting from not having been as productive as I would like) followed by a review of the day’s house renovations and endless, strangely exhausting decisions about things like shower fixtures and toilet paper holders. Oh, and eating and sleep. Those figure in there, too. As does diabetes. 

As I type that, it occurs to me that perhaps it is not so strange that I spent the last 24 hours participating in a new experience: collecting a sample of urine for a free cortisol test. Translation: in order to figure out whether my cortisol levels are too high, I collected 24 hours’ worth of urine into a brown, half-gallon jug that is now sitting in the refrigerator next to the milk. Supposedly this experience is going to tell me and my endocrinologist whether my repeatedly elevated blood cortisol levels are indicative of some new medical issue, or whether I am simply just very, very stressed. 

I am curious to see the results, for several reasons. First, I don’t think I actually have hypercortisolism, otherwise known as Cushing syndrome, because I don’t have any of the symptoms. I don’t, for example, have upper body obesity with thin arms and legs. I am not developing a lump of fat between my shoulder blades, a condition referred to by the NIH as a “buffalo hump.” (There’s always something to be grateful for.) I have no rib or spine fractures and my face is not round and red. Nor do I have excess hair growth on my chest. These are all very good things, because Cushing syndrome is often caused by a tumor in your adrenal or pituitary glands, and I do not want tumors. 

With that said, I’m curious to see the results because despite all that I have written in this post so far, I don’t actually feel stressed. By which I mean, I know that I’m mentally stressed because I’m exhausted and overwhelmed nearly all the time. But I don’t feel it in my body. I have a very specific physical stress symptom: my chest tightens and I find it impossible to take a satisfyingly deep breath. This started when I was college touring when I was 17, and has continued ever since, to the point where my good friends can actually call me on it and ask what’s going on. It’s not happening right now. But other odd physical things are happening, most notably the development of atopic dermatitis, an autoimmune skin condition that usually only hits children that I somehow developed at age 33. As I watch new patches spring up on previously unitchy areas of my body, I ask myself: is this my body’s way of complaining?

It’s a strange thing, the human body. We spend so much time trying to control it, trying to shrink it to a certain size or dressing it in certain clothes or painting it with makeup. We spend so much time on our exteriors that it’s easy to forget all that’s happening inside. But our bodies have inner lives of their own, our glands and organs bathing our insides with chemical brews that, ideally, keep us in such a perfect balance that we’re free to never give them a second thought. It’s only when something goes wrong — diabetes, for example, or this cortisol thing — that we find a reason to stop and think about what goes on beneath our skin. 

It’s simultaneously miraculous and scary, like a fine clock whose machinery is so precise, so perfect, that you know you could never fix it if it were to break. I think about that all the time with diabetes. And now I’m concerned that something else seems to be awry. But whereas my pancreas’s destruction was, unfortunately, out of my control, it seems like the cortisol — if this test confirms that it is indeed high — will somehow be my fault. Or, rather, my responsibility to fix. Because if it is simply a result of stress, then it would seem that the solution would be to reduce stress. And the person to do that reduction would be me. 

And that’s where things get confusing. Because if you look at the list of things people usually recommend for reducing stress — like getting adequate sleep, or meditating, or doing yoga, or exercising regularly, or eating well, or stretching — I am already doing them all. I really can’t think of any stress-reducing activity to add, minus, perhaps, temporarily abandoning my current life for some mountain-based retreat (but let’s be honest: that sounds stressful). Besides, trying to figure out how to reduce stress is stressful.  I also find it stressful to think about what I know about cortisol: that it increases inflammation, and that chronic inflammation is being linked to all sorts of bad health effects (I’d find you links to some illustrative articles, but I’m too tired — so instead I implore you to trust me: inflammation is a hot topic these days).  

In any case, that gets me back to where I am, which is still on the couch, still half-watching basketball, and definitely about to end this to go to sleep. It’s almost the new year, and it’s time for resolutions. And I’m thinking that as far as health activities go,  perhaps the best one I could make would be to allow myself to let go. That seems like the antithesis of a New Year’s resolution — who resolves to not go to the gym, or not obsess over what they eat? But I happen to have spent the previous part of today (okay, before I went to a spin class) lounging around the house doing whatever seemed interesting in the moment, and trying to refrain from doing anything related to work or home improvement. It took much of the day to get into this, but eventually I finally curled up in a chair in the living room, picked up a book and read. I am embarrassed to say how long it’s been since I, a writer, have done that. It was a great reminder of the importance of doing just one thing at one time (she says, while watching Tyson Chandler compete for rebounds as she types). It might even have had an effect on my cortisol, too. 

So let’s be honest here: I know myself too well to think that I’ll actually be able to “let go” in any substantial way (I even feel the need to enclose it in quotation marks). But I do like the idea of trying to be more mindful of the times when I’m pushing myself too hard, and using that mindfulness as an inspiration to take a little break. I would also like to get back into the practice of an exercise I learned from a mindfulness teacher a few years ago. It was called “stop, breathe, and be,” and was exactly what it sounds like: pausing in the midst of what you’re doing, taking a deep breath, and dropping whatever thoughts might be going through your mind to reconnect with the moment. He gave us a sheet of little round stickers and told us to put them in random places around our home, like on our bathroom mirror or above the kitchen sink, and to practice “stop, breathe, be” every time we happened to look at one.

So those are my new year’s thoughts. I don’t want to make any giant resolutions (my only resolution to speak of is to finally learn to sight read after 29 years of playing the piano by ear — details to follow). I’m already taking good care of myself, cortisol be damned. The challenge now is to try to give myself a break from my challenges, so that my stress — perceived and otherwise — leaves my body alone.  

Catherine Price
Catherine Price

Catherine Price was diagnosed with Type 1 diabetes when she was 22 years old. She has written for publications including The Best American Science Catherine Price is a professional journalist who was diagnosed with Type 1 diabetes when she was 22 years old. Her work has been featured in publications including The Best American Science Writing, The New York Times, Popular Science, The Los Angeles Times, The San Francisco Chronicle, The Washington Post Magazine, Salon, Slate, Men’s Journal, Health Magazine, The Oprah Magazine, and Outside, among others. A graduate of Yale and UC Berkeley’s Graduate School of Journalism

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Bridget McNulty
Bridget McNulty
11 years ago

My New Year’s Resolution is to have a moment of stillness every day – so I can totally relate to this! I also think that so much of life is about doing less (for those of us who are over-achievers) and I’m consciously trying to be less busy, and read in my hammock a lot more.
I look forward to seeing how good we are at keeping our resolutions :)

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