Stress, teaching and crazy highs

[devexity]

Hey all:

Looking for some advice on managing bg control in the classroom.

I'm in the middle of my first year of full-time teaching, and from the very start, my bg levels started to rise dramatically as soon as the first set of students piled in. By three months in, I started getting muddled thinking, dehydration, visual impairment and readings consistently in the 21+ range by the last lessons of the afternoon. I check throughout the day and administer corrective doses between lessons, but no amount of corrective insulin seems to do a thing. This morning, for example, it was 15.3 at ten, and 14.7 100 minutes and 3 units later. Occasionally, of course, just to be hilarious, it crashes out on me instead (then all the students want my glucose tablets, the swine...)

I can't see any other explanation but a hypersensitivity to adrenaline. Is that possible? Should I consider a pump? Take up meditation?

Thanks in advance for any suggestions or thoughts.

 

[Spiker]

This does sound like you are experiencing a long adrenalin reaction. It's odd that it's still happening three months after you started teaching.

If the blood sugar rise is really this predictable, you could try making your correction doses in advance, rather than after the event. Or just start the day with a whacking dose of Levemir, equal to all the correction doses you would take in a normal day. Just make sure you have hypo stuff at the ready and keep an eye on your blood sugar between lessons.

 

[Mrs Vimes]

This happens to me depending on the timetable. For example Thursday I have a number of challenging classes so I constantly corrected. What you need to do is contact to your DSN / consultant.
I ended up on a pump because of dawn phenomenon but I actually double my basal for the Thursday timetable. Corrections are for smaller spikes now. I won't waste my time telling you to chill - I found myself hitting 25 once correcting and teaching yr 11 at the same time. I didn't even feel stressed just very thirsty.
I love teaching but every day is different so you can't go on like this for the rest of your career. You must get advice.
Look after yourself,
Mrs Vimes xx


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[Patch13]

If you are getting consistently high levels then I would up your basal insulin. But don't forget to test regularly.
As other posters mentioned it is worth contacting your DN as well.

A pump could help as you can change the rates easily for term time / holiday time, but it is quite a commitment to set up so be sure you definitely are up for the challenge.

My basal rate when I am working is increased by 30% just because of stress.


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[devexity]

Thank you for the advice, everyone! Mrs Vimes - fabulous to hear from someone who understand my classroom pain, and really good to know that this is a fairly normal reaction to workplace stress. Have adjusted my basal upwards this evening and will discuss the endo with my GP this weekend. Cheers!

 

[noblehead]

Those levels are high and we should never underestimate what stress can do to bg levels. The only way of coping with it that I know is to inject extra insulin with your meals to counteract the high's, if you know your going to have a stressful experience in the classroom then bolus in advance, other than that see your gp and ask if he can give you some meds to calm your nerves.

 

[Spiker]

other than that see your gp and ask if he can give you some meds to calm your nerves.

I took beta blockers (propranolol) for my nerves. Unfortunately it totally blocked my hypo symptoms. A very strange and alarming experience. I wouldn't recommend it!

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[devexity]

Like Mrs Vimes said, most of the time I don't feel stressed at all: tranquilisers wouldn't help. Unfortunately (and fortunately: it's what makes it fun), the adrenaline-inducing aspect of teaching is unavoidable. Even at its smoothest, you're performing before a tough crowd for 5 to 6 hours at a time.

 

[Jaylee]

Like Mrs Vimes said, most of the time I don't feel stressed at all: tranquilisers wouldn't help. Unfortunately (and fortunately: it's what makes it fun), the adrenaline-inducing aspect of teaching is unavoidable. Even at its smoothest, you're performing before a tough crowd for 5 to 6 hours at a time.

Interesting thread.
Not unlike being in a rock band.. Lol Though in my case I tend not to eat a good 3 hours in advance of a gig..

 

[desidiabulum]

Like Mrs Vimes said, most of the time I don't feel stressed at all: tranquilisers wouldn't help. Unfortunately (and fortunately: it's what makes it fun), the adrenaline-inducing aspect of teaching is unavoidable. Even at its smoothest, you're performing before a tough crowd for 5 to 6 hours at a time.

This is exactly right. I've been teaching more than 20 years and it would be impossible without the adrenalin surge -- it's not nerves or stress as such, just means you are working at maximum efficiency, so the words and ideas come fizzing out. I'm sure that over time you will find the insulin combination that works for you -- there are plenty of T1 diabetic teachers out there -- but I would take the adrenalin as a given.

 

[devexity]

After all of your helpful feedback and a letter on Friday announcing that I'd developed background retinopathy, I went to the GP. He promptly signed me off for two weeks so I could sit at home and take the time to learn how my body works for the first time since I was diagnosed ten years ago.

On the one hand, that's a very good thing. My head of department has been lovely. The assistant head in charge of training has been lovely. Everyone keeps saying that my health comes first.

On the other hand, they also keep saying things like, 'Consider your priorities really seriously going forward' and 'Do you think you'll be able to be a teacher?' Or they begin sentences with phrases like, 'if you come back in a few weeks or months...'

I suppose my question is this: did I just destroy my career? It feels like I may have done.

 

[Bebo321]

Sorry you've had such a nasty piece of news.
Don't read too much into your colleague's comments - trying to put myself in their situation I wonder if I might not say something similar - only because no job is ever worth losing your health over.

Something to consider over the next couple of weeks - How about making plans to get properly 'tooled up'? - Pump and CGM? (I don't know if you have a budget to run to that, but it would seem the sensible thing to do)
Pump should give better control and CGM will tell you (and the entire class!) when your bloods go high, or fall low.

 

[Mrs Vimes]

Did you destroy your career- it is difficult to teach blind. Please don't think I'm being harsh I'm not. Nothing is worth sacrificing your health for. We just have the f@@@ing added complication of having to use our brain to be a pancreas which is a part time job in itself.
Non-diabetics must have so much room in their brains?

You must get advice, think about the pump. Unnatural as it seems to be hooked up, it has given me a much balanced life. It takes a lot of work at first but the feeling of being well from normal blood sugars gives you the energy to crack on.

Don't care what anyone thinks in work. You can bet as nice as they are/can be when they go home they are not worrying about your diabetes. And that is just being human and not nasty.

So, the only thing you should worried about is sorting yourself out.

I've known people completely balls up any chance of promotion in one school then move to another and leapfrog up the TLR scale.

And don't laugh at this next suggestion- I'm trying it to see if I can stop my liver dumping when I'm stressed - a technique called mindfulness. Concentrating on the moment (sort of meditating ) when you know you are starting to get stressed. Sounds a load of s&&t I know, but the science behind it makes sense. Apparently by doing this technique you move 'feelings' from the fight or flight part of the brain to the more 'chilled' out part. The more you do it the more you make neurones connect in a certain way and it helps to calm the stress response.

Ruby wax of all people has written a book it which was also entertaining. She has just gained a masters in psychology from Oxford.

Sorry if I have strangled the science.

Take care of yourself as you are allowed to put yourself first.

Mrs Vimes xxxx


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[Spiker]

After all of your helpful feedback and a letter on Friday announcing that I'd developed background retinopathy, I went to the GP. He promptly signed me off for two weeks so I could sit at home and take the time to learn how my body works for the first time since I was diagnosed ten years ago.

...

I suppose my question is this: did I just destroy my career? It feels like I may have done.

I think you just got control of your life and your future back. It's a huge win.

 

[Julie1471]

No you didn't destroy your career, you've got the time you need. I work in a school with those that have learning difficulties, I only do mid day meals, but switch departments so insulin needs vary due to departments, nursery easier than my main department, mo lumping tables around and I now do supply either before or after my mid day meal job, so needs vary again, thank god I'm on a pump, coped with MDI, not sure if I could cope with supply without my pump. I know I only do meals and nothing like you do everyday. But look after yourself..

 

[Bebo321]

How are you getting on devexity?
Hoping you've got more of a handle on your BGs now. Mrs Vimes made a good point about relaxation techniques - certainly worth persevering with.
Did you look into CGM at all? Just crossed my mind that you might be a good test case to get it funded. You could argue that you diabetes is impairing your ability to work.
Anyway, I just thought I would check how you're doing.