Advice from astronauts: Living with a chronic illness (and thriving in isolation) during COVID-19

My job as a NASA flight controller — combined with my experience living with a chronic illness like type 1 diabetes (T1D) — has provided me with a unique vantage point during this COVID-19 pandemic.

For the most part, I can perform my office duties from home, but a few times a month I am "on-console" for a set of shifts in mission control. The setup is a little like being on a video call with the International Space Station (ISS) all day — the astronauts set up cameras inside the space station while they are awake, so we can help them during their scheduled activities. Virtually, of course.

NASA has studied prolonged isolation for decades, so in response to recent stay-at-home orders and social distancing guidelines, current and former astronauts have lent their voice, giving us their perspective on isolation coping mechanisms and best practices. I have folded their advice into my personal coping strategy, marrying their isolation experience with my years managing T1D.

Here are a few tips that you can use to deal with life in quarantine, and cope with a chronic condition that can complicate things.

Use the skills T1D instills

My favorite piece of advice for mentally coping in an isolated environment comes from astronaut Christina Koch. She broke the record for the longest single spaceflight by a woman at 328 days and said in a post-flight press conference that she kept a positive attitude by "always focusing on what I had and not the things I didn't have. Focusing on the unique aspects of my life that one day I would just wish I could have back."

While it may sound cliche, positive thinking really can be powerful. Just as you focus on the highlights of your life (instead of the moments you spent pricking your fingers and testing your blood sugars), it's important to look on the bright side and keep an optimistic outlook. Your T1D journey has likely taught you how to adapt to challenging situations and endure uncomfortable scenarios. Lean into your skills and abilities — and rest assured you'll get through this!

Stick to a routine

Several astronauts have highlighted the importance of routine. Chris Hadfield, a former Canadian astronaut, says, "You should always have objectives every single day." His advice is to "be your own taskmaster" and develop mini-missions to accomplish.

As individuals with T1D, we already know the value of routine. An algorithm based on routine is programmed into our insulin pumps or written down as part of our dosing equations. And blood sugar checks and continuous glucose monitor (CGM) calibrations are routine, of course. As the period of quarantine and social distancing stretches from weeks into months, a healthy diabetes routine can help you preserve precious mental space to work through the unique challenges of pandemic living.

In an op-ed to The New York Times, retired astronaut and year-long ISS resident Scott Kelly writes, "You will find maintaining a plan will help you and your family adjust to a different work and home life environment. When I returned to Earth, I missed the structure it provided and found it hard to live without."

Keep lines of communication open

Even without the added stress of a worldwide pandemic, communication is critical when living with a chronic illness. To cultivate healthy on-orbit habits, NASA astronauts and psychologists have developed a guide called "Expeditionary Behaviors." Astronaut Anne McClain even wrote a Twitter thread describing the "pro-tips." Communication is first on her list. She suggests "to talk so you are clearly understood. To listen, and question to understand. Share info/feelings freely. Talk about intentions before taking action."

In this period of pandemic living, communicating about diabetes is crucial. Identify and schedule sync points with your cohabitants, partners, children, relatives, friends, disease support groups and endocrinologist. All of your T1D team members can't help if they don't know you need it, and doctors can't be effective telehealth providers if you don't virtually show up. Strategize how to squeeze more communication into your routine.

"Scientists have found that isolation is damaging not only to our mental health, but to our physical health as well, especially our immune systems," Kelly explains. "Technology makes it easier than ever to keep in touch, so it's worth making time to connect with someone every day — it might actually help you fight off viruses."

Practice team care

The phrase "team care" is omnipresent at NASA. We practice it as members of the flight control team just as the astronauts do onboard ISS. The expeditionary behavior description of team care encourages astronauts to "demonstrate patience and respect. Encourage others. Volunteer for unpleasant tasks. Offer and accept help." This is advice most everyone can use!

Type 1 diabetes is a team effort. My T1D diagnosis at age 11 meant my family had to change their mindset. Meals and snacks became scheduled, measuring cups showed up on the table and everyone ate food that supported my carbohydrate requirements. Knowing the signs of low blood sugar was just part of being on my T1D team. Then, during pregnancy, I leaned on my endocrinologist and dietitian to guide me through foreign aspects of a condition I had lived with for nearly two decades. And now, my immediate diabetes team is my family. My husband often volunteers to help with pump site changes, but even my kids know the device's vibrations are an indication that I should check it. They all help me live my best life — don't be afraid to rely on your team.

As individuals living with a chronic illness, we are specially equipped to rise up when faced with a challenge. Living with T1D every day naturally bakes in many of the qualities that take astronauts and flight controllers years of training to perfect. If you ever need a quick break from the constant news cycle and statistics, watch a few minutes of the Earth from ISS. It may help you see that we are all in this together.

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