Sunday, December 27, 2015

Focus: Taking Care

I remember a time when I had young children, a full time job and took night classes in business. There was rarely a day when I wasn’t busy doing something: cooking dinner, laundry and dishes, making lunches, helping with and doing homework, reading with my kids and putting in my 8 hours at work. Busy times. There was stress, of course, but most of my activities were positive and forward-looking. Raising great kids and furthering my career usually felt good and the stress was short-lived or minimal.

In hindsight, I didn’t always take the best care of myself. I ate too many processed foods and everyone else always came first. These days I rarely eat processed foods but one thing hasn’t changed: everyone else comes first and this has become a big problem for me.

I’ve mentioned my 97 year old mother in the past. I have been caring for her and my father in some capacity for at least 13 years. My father died in December of 2008 and Mom has needed increased care over the past 7 years. We hired caregivers to come into her apartment to care for her but they weren’t able to completely fill her schedule due to our remote location. That has meant that I have needed to step in and be her caregiver. On a good day I’m there once. Other days I’m there as much as 4 times per day. This means that Ray and I are pretty much glued to home. Mom fell a few weeks ago and has had other minor catastrophes that made it obvious that she could no longer stay in her apartment. We found a group assisted living home and we will be moving her there this week. It’s a nice place with nice people. She will have 6 roommates in the house but have her own room with her own furniture. She will be fine but this has been the most difficult decision I have ever made in my life. Worse even than the time I chose to cut my hair in a shag back in the 70s! (I had to lighten the mood a bit.)

During this time my diabetes has taken a back seat. Actually I think it’s been in the trunk under a blanket next to the tire iron. I just haven’t cared much. Ray and I started having a date night once per week just so we could have something to look forward to. I would order whatever sounded good and didn’t worry too much about carbs. Not the best choice but I needed to have something to enjoy! My fasting numbers have been anywhere from the low 130s to the mid 160s. Not grand. Apparently I’m still able to have some decent numbers through the middle of the day. I had an appointment with my PCP. It had been 6 months since I’d seen her because I had been “doing so well!!”. My previously rock-steady A1c had creeped up .3%. Big surprise. It’s close to my all-time high from years ago. I asked her about basal insulin to possibly help with my high morning numbers. Instead she recommended another injectable. I said I’d wait, thank you very much, to see if I can’t swing things back around. She just won’t consider insulin for me. I’m still “well controlled”. Sigh.

So here I sit after Christmas with some truly awful numbers due to stress and too many carby foods. (Interestingly, sweets are not in the least appealing, but those tamales…) I’m at a crossroads and it’s up to me to choose the best path.

I know that January is going to be a tough month for me. I’ll be dealing with guilt about Mom and trying to visit her (35 miles away) as often as I can. I will have to redefine my life and figure out what it will look like from now on. It might sound easy to just start living and doing all those things I’ve been unable to do but I know that there will be some emotional baggage that I will have to deal with. (Oh, and my son and his family just left yesterday to move 3 hours away. They, including my 4 grandsons, have always lived just down the block. I will miss them so much.) So how will I deal with this emotional baggage? Will I sit in the recliner, reading and eating stuff I shouldn’t? Will I tackle that bathroom spruce-up we’ve been putting off? Will I eat everything in sight or go back to watching my carb intake and actually caring about my own health? In reality, it will probably be a little bit of everything. I’m hopeful that my own self-care will take the lead. Once I get used to having some freedom to do whatever the hell I want, I am hopeful that my health will allow me to enjoy that freedom. Trips to see my grandsons! Hanging out with Laddie in Phoenix! Reading to Mom in her new home! Road trip with Ray in the late spring!

My Mom will be fine. My grandsons will thrive. I have much to look forward to and I need to take care of myself in order to make these things happen. I hope that writing this post will help me to take the correct path.

Sunday, November 8, 2015

People with type 2 diabetes can eat anything in moderation, or can they?

This subject, when discussed, can quickly turn into a heated argument. Many people with type 2 diabetes can currently control their blood glucose by adjusting their diet and adding exercise. Others do that and also take oral medications. Still others are using injected insulin to help control their blood glucose. Nearly all of the advice you can find online (or from a physician’s office) tells patients that they can continue to eat pretty much whatever they want, with some adjustments like whole grains vs white foods, etc. Moderation is the key. Well, as someone who can’t eat just anything she wants, I often take issue with this advice. I feel it leads patients to think that they’re ok if they just moderate and they often don’t test before and after a meal or snack to see what’s really going on inside their bodies.

Today, I did something incredibly stupid. Instead of just being mad at myself, I decided to use a bunch of test strips and do an experiment. I had a theory and I wanted to test that theory. You know… science stuff.

So what stupid thing did I do? Let me tell you.

I went to the grocery store at about 10 AM in the hopes of beating the crowd. I hadn’t eaten a thing (which, lately, isn’t all that unusual. I know, don’t judge me.) I had taken my meds with my daily concoction of psyllium husk (fiber) and warm water (homemade Metamucil without all the junk they add). I wasn’t hungry and my shopping list consisted of good things like veggies and stuff.  I needed to buy a loaf of bread for my mom so I found myself near the bakery and goodies. No worries, I had self-control. And then I saw it: a Hostess Lemon Pie. They never have lemon but today they did. Before you go “ewwww, why would you want that?” I need to explain that I am a whore for lemon. Lemon pie, lemon loaf from Starbucks, lemon cookies, lemon E V E R Y T H I N G!!!!! I used to eat these horrid things and I had a wave of nostalgia come over me. “Surely, one wouldn’t hurt me! ‘They’ say I can eat anything in moderation!” (Even though I know better.) I bought it. I inhaled it in the car. It was horrible. As I’m licking the disgusting sugar glaze off my fingers I realized what I had done and was ashamed. I felt like a drug addict in a back alley shooting up my Precious. Gawd, what an idiot.

After I got home with the groceries (and Ray helped me put them away. He’s a gem) I decided to check my blood glucose to see what damage I had done. It had been about 20 minutes since I had gorged. 124. What? I had started out with a 130 fasting reading. This can’t be right! Instead of gloating and thinking I had gotten away with something, I decided to continue to check at one hour intervals. Here are the results:

1 hour:  193
2 hours: 243 (began consuming mass quantities of water.)
3 hours: 201 (it’s coming down!!)
4 hours: 157 (I have a stomach ache.)
5 hours: 108 (YAY! Still have a stomach ache but I will eat dinner.)

I decided to stop checking after 5 hours, mostly because I saw such a great number on my meter. I had eaten nothing else all day other than a couple of spoon licks and cups of green tea. Someone out there is thinking, “Well your liver probably dumped because you didn’t eat, moron.” I beg to differ. Although I’m not a doctor or scientist I’m pretty sure my liver would realize that I was already dealing with way too much glucose in my system. Maybe not, but it really doesn’t matter. There is no way I felt like eating anything. Stomach ache, fuzzy head, guilt, remorse and I wanted to see what would happen.

So my theory was that the horrible, no-good, very bad thing I ate would eff up my blood sugar for hours and hours. My testing shows that my theory was pretty darned accurate. So why in the world am I confessing this STOOPID mistake to you? To educate.

When someone has diabetes and they don’t use insulin to control their blood glucose, they can’t necessarily eat whatever they want if they desire a longer and healthier life. One of the problems with type 2 is that we don’t always see immediate ramifications for our actions like our type 1 friends do. If we splurge or continue to eat in an unhealthy way, we don’t go into DKA or throw up or any of those other unpleasant results. We don’t realize that high blood glucose is coursing through our arteries, toasting our kidneys and eyes; ruining our nerves, unless we check. Unless we use our meters to learn what different foods do to our blood glucose. We can’t/shouldn’t wait 3 months to see what our A1c shows. It won’t show this awful high I had today because I will attempt to get back on track tomorrow and my lower readings will negate this high.

I was an idiot: a very human idiot who just impulsively ate something she shouldn’t. Will I eat a Hostess Lemon Pie again? HELL NO! (it was truly horrid) Will I ever eat something I “shouldn’t”? You bet I will. Will I do it all the time? Nope. I care enough about my future to attempt to control what I eat and whip the beast called diabetes into submission to the best of my ability.

I’m pleading with you now. Please, please, please think about what you’re eating on a daily basis and make adjustments as you can in order to try to control your blood glucose. I don’t care if you eat low carb, high fat, low fat, Vegan, vegetarian, Paleo or cinnamon-okra water. Just pay attention. Use your meter. Care enough about yourself to pay attention and learn. I was an idiot and, because of that, maybe you won’t be.

Wednesday, September 16, 2015

The Gym: A Like Affair

I have long known that strength training, or resistance training is beneficial to folks with type 2 diabetes. It causes your muscles to better utilize insulin, increases glucose uptake, reduces the risk of heart disease and assists you in losing weight. Score!! However, I have also long known that I am not suitable material to become a gym rat. I just couldn’t see myself in the midst of sweaty, grunting, muscle-bound men or lithe, midriff-baring cuties. No thanks. I decided that walking on my treadmill would be sufficient for added exercise, thank you very much.  Lately though, I’ve been thinking that I ought to step things up a bit and see if I couldn’t do more. (Besides, my husband decided he might like to try it and… well there you have it.) Here’s the stupid part: our health insurance will pay for the membership through the Silver Sneakers program. I can go to the local gym for free and I’m not doing it? Stupid.

We joined. My son, who is also a member, came along on our first foray to show us all the machines and how to use them. (I had no desire to be “that woman” at the gym who was using a machine backwards.) I will admit that it was a bit daunting but I figured I could ooze into it and there were a few options that intrigued me, like an Ab Roller thingy. I’d seen those commercials on tv for ab equipment where all you had to do was spend a bunch of money and, viola, you had a six-pack! I had a chance to use one for free!

That first day we just tried out the different options. A couple of days later we went “for real” and worked out for about 45 minutes. Warning: I’m about to use some technical gym jargon. There is the “crunch-your-thighs-together-from-a-ridiculous-splits-position” machine, the “leg-press-sled-that-will-crush-you-even-without-added-weight” monster and the “reach-up-really-high-and-pull-yourself-up-hahahaha” contraption. And, of course, free weights, treadmills, elliptical hell machines, kettle balls, resistance bands… yadda, yadda. It’s not a bad little gym. I stress the “little” part. We are a small community and the gym reflects that. That makes it much less intimidating. Besides, we have seen some folks there who are our age or older so that felt good… until that 70ish b…. showed up and proceeded to bench press more than should be possible for someone her size. Impressive.

Here’s the most amazing part; I like it. I don’t dread going to the gym, in fact I kinda look forward to it! So totally weird. We have 24/7 access, although I doubt I will ever be rolling my abs at 3 AM, but I could! This feels right. This feels good. I may not be a gym rat, but maybe a gym white mouse.

I have some limitations and I’m trying very hard to not overdo things. My left shoulder is “slushy” (not quite frozen) and it gives me some pain so I can’t do a lot of the arm stuff. I’m dealing with what may be fibromyalgia so I need to be gentle and not tax myself too much or I might spend a day in the recliner later in the week. I am NOT worrying about how much weight is on each machine, but focusing more on the motion for now. The elliptical machine is amazingly difficult for me. I can’t go more than 5 minutes before my legs are rubber (could be related to fibro) so my goal is to make it to 5 minutes without stopping… and then 10… etc. I don’t care that there are others there, in fact I like having others around. I don’t compare myself to them and I don’t care what they might be thinking. I’m doing this, dammit, and I’m proud. Yay me!

Strength/resistance training is something you can do at home. You don’t have to have a gym membership. Purchasing a few dumbbells of varying weights, resistance bands and a stability ball. You can even use your own weight for free! Use Google or Youtube to find exercises you can do at home. I really recommend trying this, without spending too much money at first. I was amazingly surprised at how good it makes me feel. If I can do it, you can at least try it. I don't love the gym, but I definitely like it.

Monday, June 29, 2015

It’s a mystery

**Edited 7/17/15 (at the bottom)

I have found the cure for type 2 diabetes. You heard that right…I’m cured. Here is “all you have to do” in order to be cured:

Contract a wicked summer cold, go tent camping for 3 nights, lose your voice and endure a couple of weeks of 90 degree weather…without air conditioning. Oh, and don’t forget to throw out your back! That’s all it takes to finally see consistent, near-normal readings on your meter. (That and 2,000 mg of Metformin daily.) Amazing, right? Why didn’t I do this sooner?

Yes, I’ve been enduring all of those things during the month of June. Is it over yet? I haven’t had much appetite for a while now but the incessant heat has made it impossible to think about eating. Just the bare minimum to get by. Now normally, not eating would cause my blood sugar to soar since my liver hates me. Not lately. I can go without eating for hours and my blood sugar just hangs out near 100.

It’s a mystery.

I’ve been struggling with high fasting readings for scores of months and yet my readings have hovered near 100 for a week now.

Unheard of!

It’s no secret that I’ve been eating a low carb diet, called Esther, for quite some time now. I’m certain that my level of carbs has been at the extreme low end during this month of “fun”. I honestly haven’t been paying much attention. The fact that there are very few processed carbs in the house and I haven’t had much energy to climb out of my recliner, let alone shop, means that what I have been eating is most likely a protein or a vegetable. I’ve eaten like this for more than a year and never saw these meter readings.
Scratching my head.

The normal reaction to illness is to see higher glucose readings, so why aren’t I seeing them?

Oh…I’ve lost 7 lbs. I’ve been trying to lose weight FOREVER with little to no success and now…it’s disappearing without effort. I’m not even exercising!!!
Call in the Mystery, Inc gang! Scooby, we’ve got a mystery to solve.

You know how frustrating it is when, no matter what you do, your blood sugar soars or dips or generally freaks out? You know the feeling of complete lack of control you get when you do the same thing every day and yet your blood sugar is all wonky and unpredictable? Yeah, well this feels just the same. I’m not complaining, believe me. It’s great to see these numbers and feel “skinny” for a change but I know it won’t last. The fact that I have NO idea what is causing this makes me fear that it will disappear; that I’ll go back to seeing 156 in the morning and the scale in the bathroom creep back in an upward trend.

The point of this post? It’s to remind you (and me) that all we can do is our best. All we can do is eat as healthfully as possible, exercise when we can and take our meds as directed. Diabetes is going to do what it’s going to do. It’s up to each of us to attempt to steer the ship the best we can and hold on during the storms. What I’m currently experiencing might feel as if I’m cured, but don’t be fooled. I’m not.

**Nope, not cured. (BIG surprise!!) Here it is halfway through July and my glucose readings are going back up, slowly. I haven't seen anything in the 150s in the AM but I have seen some 130s. I'm still not feeling 100% and am still eating on the lite side, but I have had a few munchie attacks and my meter has noticed. If I stay true to my food plan, my numbers are acceptable but we all know that there will be "those days" when I say, "what food plan?" :D In other words: back to business as usual!

Tuesday, June 16, 2015

It’s Just a Number, Right?

Yesterday, June 15, 2015, marked the 10th year I’ve been living with type 2 diabetes. Well, I’ve known about it for 10 years, I’ve definitely had it longer than that. I was diagnosed in June of 2005. I don’t know the exact date so I chose the 15th to mark the day. Many people with diabetes call it their diaversary and celebrate with a cupcake or some other treat. I woke up yesterday and said, “Huh”. No cupcake. No celebration. It was just another day.

Don’t get me wrong, I’m glad that I’ve managed to live with my diabetes for this long and not develop any complications. I’m thankful that I can deal with it, most of the time, without much struggle. But there are still “those days” when diabetes can take a flying leap as far as I’m concerned.

Things other than diabetes have stepped up to take the front seat in my life which has caused me to not pay close attention to my D. I try to pay attention to what I eat and since I’ve dramatically changed my diet it isn’t that difficult really. I still struggle with munching when I shouldn’t. I wouldn’t call those times binges but I always end up eating something that isn’t good for my blood sugar. Good old stress. I test, but usually only first thing in the morning and those numbers have crept up and up. It is obvious to me that my diabetes has progressed because I can no longer “get away” with eating processed carbs. I used to be able to handle them on occasion but now, when I do eat something carby, my numbers are atrocious.

I have a regular appointment with my HCP this morning. I won’t be shocked if my A1c is elevated but I’m not ready to make any medication changes yet. I’d like to attempt to rein in my food issues on my own; tame the beast in my head and corral the stress as best I can. If I can’t, then I’ll see what meds can do for me.

10 is just a number. My A1c is just a number. Diabetes is a reality in my life and it’s important that I stay vigilant, regardless of the hard stuff that pops up. Life has constant changes. Some are good and some aren’t but I can never let the bumps in the road throw me off track. I can do this. I can. So can you.