This is a report ofcourse from my experience and the experiences of people I talk to everyday- my patients. I have the privilege now to connect to them through online consultations and they allow me to understand their experiences. My personal experiences and the stories I hear of others have always influenced one another. Over the years, how I relate to other people’s experiences depends much on my capacity to feel and experience those emotions myself. In fact that’s true for any connection between two human beings. We hear and understand others through the filters of our own experiences. We can only understand that we are capable of feeling ourselves. If we have not experienced loss, we can’t understand how someone else will feel when they lose someone very close. Fear, loss, despair are very important experiences as a doctor for me.

The impact of lockdown is very different on different people. These differences are clearly apparent in people with diabetes, where the change in lifestyle impacts blood glucose levels.

The effect depends on the lifestyle pre lockdown. For people who were too busy to focus on their diet and exercise, lockdown has proved to be a boon. They have more time to exercise and eat a planned healthy meal. The glycemic control has improved with reduced travel and work stress in about 25% people in a city like Gurgaon.

For others, the circadian rhythm is affected and sleep pattern is disturbed. This leads to not being able to form an exercise schedule or meal schedule in 25%. This affects the glycemic control negatively. I have been advising yoga and meditation to these people but I am not sure what intervention will work best!

More than 50% people report eating more especially inbetween snacks consisting of bakery food and processed food. Atleast in the early days of lockdown, people were cooking and eating much more than before but now trying to discipline the routine better. Weight gain and increased blood glucose levels happened in these 50% people.

Yesterday we had a zoom meet for our type 1 diabetes group to know how everyone is doing. 60% had an increase in their insulin requirement by about 25% average, due to lack of exercise in some and unscheduled eating in others, especially at night if sleep is delayed. 30% reported no change because they are eating better, 10% reported reduced dose.

When patients ask me how to deal with stress and insomnia, changing rhythms, I reflect on how I have felt all these weeks. I look for answers from how I find myself dealing with it….

When the whole thing started, I was hooked to the news, closely reading the changing patterns of viral spread. The news gradually focused on and seemed to propagate conflicts causing a lot of churning of thoughts and emotions. This crisis made the social inequalities glare at our souls. The frustration and the desire to change things, but helplessness to do so, the optimism gradually changing to despair… In an attempt to defend myself from going into compassion fatigue, I had to disconnect myself. I have donated money to various groups hoping that maybe that will help. But it was overwhelming. There was also joy of being at home with family. The feelings varied over the day, sleep was some days very good, some days difficult and even interrupted by vivid dreams.

However through my periods of depression I have learnt that the first person we should help is ourselves. So amongst all the distress, it’s important for all of us to take care of ourselves first.

Use this time as an opportunity for- Sleeping well, eating healthy and exercising; cherishing each day of being alive, and all the others who lived through this day; celebrating life in the midst of disease and death, connecting with ourselves; being kind to ourselves and then extending that kindness to all!

To quote a beautiful poem by Mary Oliver-“One day you finally knew what you had to do, and began, though the voices around youkept shoutingtheir bad advice –though the whole house began to tremble and you felt the old tugat your ankles.”Mend my life!”each voice cried.But you didn’t stop.You knew what you had to do,though the wind pried with its stiff fingers at the very foundations,though their melancholy was terrible.It was already late enough, and a wild night,and the road full of fallen branches and stones.But little by little,as you left their voice behind,the stars began to burn through the sheets of clouds,and there was a new voicewhich you slowly recognised as your own,that kept you company as you strode deeper and deeper into the world,determined to do the only thing you could do –determined to save the only life that you could save.” Mary Oliver
The Journey