Need help navigating life with diabetes? You can always Ask D'Mine!

Welcome back to our weekly Q&A column, hosted by veteran type 1 and diabetes author Wil Dubois. This week, Wil's addressing that Fall feast day that's almost upon us, and the huge diabetes challenges it brings.

{Got your own questions? Email us at AskDMine@diabetesmine.com }

 

James, type 1 from Ohio, writes: Oh God. It’s almost here. Thanksgiving. Carbs. Travel stress. Carbs. Time zone stress. Carbs. And then the biggie: Family stress. I wish, like a car, that I could trade my family in on another! What say you, Master Wil, any new holiday survival tips for us this year?

Wil@Ask D’Mine answers: Well, while you can’t just go down to the family sales lot and trade your old family in on a brand spanking new one with all the bells, and whistles, you can—metaphorically speaking—refurbish the one you have. You know, overhaul the engine, put in a leather interior, new paint, fancy rims. Why, by the time you’re done no one will recognize your old family!

Have I lost my mind?

Possibly, but bear with me. I see you are T1 like me. That means more than likely you’re the only representative of the D-tribe in your family currently, and probably the only one in your family history as well. That, in turn, means that you’re the only one who understands your needs. If your family isn’t responding to those needs, I submit that the blame falls squarely at your feet. Sorry, but it’s true. Somehow, you’ve failed to communicate what you need in a way that made you heard.

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Now I understand that there’s a problem of critical mass here. If you were T2 in a family with a strong family history, everyone might be motivated to change, but still, it’s not impossible for entire families to change to accommodate the needs of a single member. We only need to look to peanut allergies to prove this. In families where one child develops the anaphylaxis-prone severe reaction to peanuts, you won’t find the bowl of peanuts simply moved to the far end of the table, right? Uncle Joe won’t be saying, “One peanut won’t kill you!” If more than 15 carbs were fatal in minutes for type 1s, our families would be on board with low-carb eating in two seconds. The problem is that excessive carbs can kill us in slow mention, so it’s easy for our loved ones to ignore the long-range toxic effects.

Still, families can change. But just like 'refurbing' a car, refurbing a family into a diabetes-friendly one is a long-term project that takes patience and perseverance. My advice is to choose your battles wisely, take baby steps, and ensure that your peeps have mastered one change before you introduce the next. If you overwhelm people, they’ll throw in the towel thinking it’s too much for them to take on. I understand this is even more challenging with families who are widely dispersed and only unite at the holidays. 

So what to do? My advice is to decide on one accommodation that you want this year, then harp on it until you get it. When you do get what you want, be sure to rave about what a great family you have (this is called positive reinforcement, and I’m told that dog trainers use the technique, too).

What is it you want, James? For no one to say, “one plate won’t kill you” this year? To be automatically served a main plate carb-free with no discussion? For blood sugar to be a forbidden subject at the dinner table? Or for a low-carb desert to be waiting for you? 

One thing at a time. Baby steps.

Of course, if you don’t have the patience for this, you always have the option of ditching your family altogether, rather than trading them in or refurbishing them. Am I talking about staying home alone with a Swanson Turkey TV Dinner? No, I was thinking more along the lines of volunteering for the day at the local homeless shelter. It’s a socially acceptable way to ditch your family. They’ll see you as a hero rather than a bum, you’ll be doing something good for the day, and you may find it not only directly rewarding, but it may help you with thankfulness perspective when you see so many who are so much worse off than you are. 

Or you can get married. Then you’ll have two families to choose from each holiday season. Ask your doctor if a spouse is right for you. 

Now, you also mentioned travel and time zone stress. There’s no easy cure for that either, but I do have a pair of vaccines to offer. For travel stress: If you can manage it, travel a day or two earlier and leave a day or two later. Sure, you might have more hotel expenses, and you’ll lose some work time, but you’ll avoid the largest crush of traffic in the airways and on the highways. That will reduce your stress, and the extra time will also reduce worry about missing connections due to weather and the like.

The time zone vaccine entails choosing flight times based on what’s most convenient, not on the best price. Most of us chose flights based on the cheapest ticket. But there’s a saying in business that time is money. Similarly, time is health. Getting up at 3am to catch the red eye and save seventy-two bucks is going to screw with your blood sugar.

It’s really not worth it. 

Spend a little more money, save a lot of health. Find flight times that work for your normal body rhythms and you’ll feel better. You can also prepare your body by changing your meds—especially basal insulin timing—to the time zone you’re traveling to several days in advance, while you’re still at home. The goal is to avoid having too many changes happening all at once.

OK, on to carbs, carbs, carbs, carbs. Granted, we have stuffing and sweet potatoes, bread rolls, jellied cranberry and gravy, and pies to deal with -- and damn, am I ever getting hungry writing this! But the star attraction of a typical T-day meal is about as low-carb as you can get: a big, steaming plate of protein. Yep. Turkey has been scientifically proven to have bupkes effect on blood sugar levels. The cream cheese-filled celery sticks are largely harmless too, and the green beans—unless they are soaked in a creamy soup and covered with yummy French fried onions—have an equally low carb count.

Yes, I realize that there’s no way in hell that Auntie Betty is going to stop making her famous green bean casserole, but you can refurbish her to the extent of having her set aside a serving or two of the plain green beans for you during the assembly process. Asking for a side salad is hardly an inconvenience either, or you can slip into the kitchen and make yourself some cauliflower “mashed potatoes” while the turkey is in the oven.

Does it take will power to eat low-carb while those around you pig out on carbolicious goodies? Yes. Of course. But are we not strong? And you will be thankful for a happy blood sugar, both Thanksgiving night and the next day. You can do it. After all, lots of low-carb options are there, right on the Thanksgiving Day table. It’s not like going to a pasta convention where there are no low-carb options to be found.

Another arrow in the quiver that works for some D-folks is the micro portion. If you take very small portions of the high-carb offerings, along with very large portions of the zero-carb options, you can savor the variety of the banquet with a drastically reduced carb count, at least compared to what other people around the table are consuming. The risk is that one taste of gravy can have a narcotic-like effect on the taste buds and willpower that can lead to an unrestricted carb-fueled feeding frenzy. Personally, I find it takes more willpower to micro portion than to just eat low-carb while everyone else is passing the stuffing and sweet potatoes. But that’s just me. Your willpower may vary. 

And that’s it for this year. I want to close by saying that I’m thankful for all of you, my readers. If my math is right (and I’m pretty sure it is because I was able to do it on my fingers) this is my eighth T-day column here at DiabetesMine. That’s right, eight years. Thank you and keep the great questions coming!

 

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.