Happy Veterans Day & Diabetes Awareness Month

Veterans Day Happy Veterans Day & Diabetes Awareness Month

I borrowed this from the Lilly Pulitzer blog – it perfectly blends my love of all things bright and floral with my patriotic spirit!

Today I’d like to thank every member of the United States armed services for their service and sacrifice. Similarly, I would also like to acknowledge and thank the sacrifices made by the families of service members, too. (Believe me, they also serve.) Less than 1% of the families in this country have a member currently serving in the military. Less than 1%. Please take time every day to thank those in your life who put service ahead of self.

November is National Diabetes Awareness Month, the aim of which is to increase knowledge and understanding of this disease. Most of you know that I am diabetic, as are about 26 million other Americans. The type of diabetes that I have is called Type II – which used to be called “adult onset” until children under 18 began being diagnosed, too – and I am fortunate that my condition is currently well controlled with diet, exercise, and oral medication (Metformin). At the beginning of the year, I was injecting the maximum dose of long-acting insulin, a non-insulin injectible medication (Victoza), taking a pill to make my body produce more insulin on its own (Glipizide) plus a prescription-strength Omega-3 pill (Lovaza) and cholesterol medication (Tricor) to lower my triglycerides, AND double my current dose of Metformin – to absolutely no avail. I was a virtual walking pharmacy and none of it could get my numbers (blood sugar and triglycerides) into the recommended ranges.

I have made a lot of changes to my eating and exercise routines since then and have been fortunate to see drastic, positive changes in my health, but lifestyle changes such as the ones I’ve made this year don’t work for everyone – certainly not for Type I diabetics, who must inject insulin with every meal in order to allow their bodies to process the food that they eat – and so more must be done to spread awareness of ways to avoid diabetes as well as funding critical research to find new and better medical therapies for both Type I and Type II diabetics.

Last month, I was approached to participate in an online diabetes awareness-raising activity. The results of the project can be seen here and I’m very proud to be part of such a great group of bloggers with diabetes. Please take a moment to check it out and let me know if you have any questions about diabetes that I can help with. Knowledge is always powerful and it’s one of the best weapons against diabetes, too.

Doing my bit for Science

Having diabetes stinks. No really, it does. It’s not the dread Death Sentence some media outlets like to make it out to be but it definitely does stink.

(Did you know that insulin can make you gain weight? Insulin which most Type 2 diabetics will end up needing at some point in their lives? Basically, you need to lose weight to help control your blood sugar but the drug that you need to help you manage your blood sugar will make it tougher to lose weight. Just one of the special little gifts that come with your diabetes diagnosis – yay!)

Then you’ve got the stigma attached to being a person with Type 2 diabetes. Because one of the risk factors for Type 2 is being overweight, there’s a perception that we “deserve” this disease because we wouldn’t be here if we weren’t fat. Seriously, I’ve had people tell me that to my face. Whether that’s true or not, no one deserves diabetes and I wouldn’t wish it on my worst enemy. Three times yearly visits to the endocrinologist (diabetes doctor). Keeping track of what you eat versus your pre- and post-meal blood sugar readings so that you can try to figure out which foods don’t send your body into orbit with extra sugar. Finding it harder to lose weight even as your doctor tells you that you “really ought to” focus on losing some weight. Is it any wonder that so many diabetics also battle depression? And of course, depression can make getting out of bed a huge accomplishment, much less exercising and planning nutritious, low calorie meals. It’s all much easier with support from friends and family but the depression and shame can make it tough to reach out.

Enter Ginger.io, a company dedicated to using big data to help make new discoveries for treating chronic diseases like diabetes. I recently signed up for a pilot they are running to gather passive data about activity levels among Type 2 diabetics that can be used for several purposes.

sanofi landing page 122712 c 300x232 Doing my bit for Science

In essence, each of the participants downloads an application to their smart phone and then just goes about their daily business. Every day I receive a one-question survey about my mood the day prior, and once weekly I answer a survey about how I’m doing with my diabetes tasks and another about how my quality of life has been for the past week. Simple Simon. The application then tracks how active I’ve been – not with steps or calories burned or anything like that, but how many miles I’ve traveled, text messages I’ve sent, and phone calls I’ve made. Right now the application just gives me interesting tidbits about how my activity this week compares to what I did last week or today’s travels versus yesterday’s, but the plan is that in the future, if I specify people in my support circle, the application will track how I’m doing and alert those that I specify when my activity drops and my survey results show I’m not doing well.

Imagine that: I’m dealing with depression and struggling with my diabetes, and then TCB will just know as if by magic that I need help. Wow.

In addition to the selfish part of this exercise, the application is also gathering important behavioral information about a group of folks with Type II diabetes that can then be used to help create new methods for treating diabetes and those suffering from the disease.

If you or someone you know has been diagnosed with Type II diabetes and this program sounds like something you’d like to hear more about, click here to find out more or to sign up for the on-going pilot today.

…and then I had a completely crazy thought

Updates since last time:

  • Went to the gym all seven days last week
  • Tracked every morsel of food that went into my mouth using MyFitnessPal
  • Made it through a mild episode of depression without turning to food. I wanted to eat, I thought a lot about eating, but instead of eating I tried to figure out what it was that I really wanted and how to get there without food. Very interesting
  • I tested my blood sugar seven times in less than a week including my pre-breakfast blood sugars every day. I haven’t tested my blood sugar since I started on insulin injections and the readings were so high that they upset me, so I put my meter away. I committed to my Making Peace With Food group – all Type 1 and Type 2 diabetics – that I would test at least once before our next class, and then when the number wasn’t too bad, I just kept going. I’m treating it like an experiment: “if it’s this number now, what will it look like right after I finish on the treadmill?” or “I wonder what my blood sugar is this morning after I had more carbs for dinner than usual?”
129419999 1947747739 ...and then I had a completely crazy thought

Peonies by Linda N. via Flickr

So many good things are going on in my life right now and it’s wonderful but also scary. Scary because I remember what it feels like when it all goes sideways, so I’m putting in the effort now, while it’s all good, to learn how to be OK with not being 100% perfect all the time – basically learning to fail and bounce back.

Part of my strategy is to not let the scale be the sole determinant of whether or not I’m “successful”. I need to lose a LOT of weight just to be considered “overweight” (as opposed to Morbidly Obese, my current designation based on BMI) but I can’t focus on that because it’s too overwhelming, so I’m staying focused on what’s really important – my blood sugar. Good things are happening on that front, friends, and it’s very exciting! When I took my blood sugar for the first time in months last week it was 171 mg/dL which was about 40 points less than my fasting test last time I saw my endocrinologist two months ago. Target ranges for diabetics with good control are between 70 and 130 mg/dl before meals, and less than 180 two hours after starting a meal, so I knew I was a little high but was heading in the right direction. And I’ll be darned if my reading this morning before breakfast wasn’t 131 mg/dL – down 40 points in less than a week!

I also lost seven pounds this week.

And I had this crazy thought about what I can use for my long-term motivation but that will have to wait until next time. In the meantime, though, tell me how you deal with the “all or nothing”/”must be perfect in all ways” syndrome of healthy eating and exercise? Am I the only one who feels like there’s a light switch somewhere that controls my desire to eat well and exercise every day???  

Put One Foot In Front of the Other

Song PutOneFootInFront 300x228 Put One Foot In Front of the Other

(from Santa Claus is Coming to Town)

I don’t know what to think. I’ve gotten so used to failure and disappointment when it comes to making good choices about my eating and exercise habits that I’m scared. Scared because it’s all coming together so seemingly easily. And I remember when it used to be easy but then one day it wasn’t any more. So I don’t want to relax and enjoy the feeling because if I stop being scared maybe it will all evaporate and I’ll be back where I started, disappointed and sad. And hopeless.

But I have hope now – I’m letting myself feel just the faintest glimmer of hope again – and that is everything.

Little, tiny, baby steps

I started nightly injections of insulin a few days ago and have already had to increase the dose by 50% because the lowest dose isn’t effective. I could cry about that fact and beat myself up about my unwillingness to make the lifestyle changes that would make my own insulin effective enough to control my blood sugar, but the fact is that neither of those actions will take me in a positive direction. Once I find the right dosage, insulin will absolutely help get my blood sugar levels back where they belong and that’s just a simple truth.

At the appointment with my doctor where he prescribed the insulin, we talked about increasing my dosage of a non-insulin oral medication I’ve been taking for months, or going back to the Weight Loss clinic so they can prescribe a combo anti-seizure/amphetamine drug that’s supposed to make you forget to eat (the amphetamine option has already not worked for me), or changing up one of the six other medications I take on a daily basis. And a little voice inside my head started to scream, “Stop playing around with your health, Denise. Do what needs to be done and get on with it!” (It might have been my grandma’s voice I was hearing, to be honest, since that’s definitely what she would have told me had she been alive and in the room with me.) and so I stopped the doctor mid-sentence and told him that I’d like to start taking insulin.

5552023473 5ca5d3b410 z Little, tiny, baby steps

Wintersteps into the unknown by Stefán Freyr | Skyzography, on Flickr

Insulin isn’t the cure-all super-duper fixer-upper for my problems but it will get my blood sugar under control almost immediately (once I get to the right dosage) and that’s the big thing right now. Stop the damage that high blood sugar is doing to my body first then focus on making the rest of the changes that I need to make – eat better, exercise daily, control my stress.

As we sat in the car in the line at the pharmacy drive-through, I thought about what I need to do in order to get my diabetes under control: I just have to put my big girl panties on, take my insulin, and start making small changes for the better.

Small steps, people. Small steps.

Stuck

44863659 5dbfa1d48b Stuck

QUICKSAND!!! by Mickie Quick on Flickr

I feel so STUCK.

Every evening I tell myself that tomorrow will be better, that I’ll get some exercise and eat something with good nutritional value, but I don’t do it.

I get lots of really helpful advice from real-life friends, blog friends, doctors, parents, and random folks on the street. These are well-meaning people for the most part and their advice usually has at least a kernel of usefulness, but change isn’t happening.

Today I have an appointment with my endocrinologist (diabetes doctor, for those not in the know) and I will ask him to start me on an insulin regimen to get my blood sugar into acceptable ranges; I feel like such a waste of space.

Why don’t I control my eating? Why don’t I get any exercise at all??? I haven’t even made it on my yoga mat once and my 30 Days of Curvy Yoga class ends on Saturday. What will it take for me to change???

Eating well for diabetics: Six things NOT to eat

Just as there are guidelines about how to eat for diabetics, there are also recommendations about what not to eat if you’re diabetic. (I’d like to point out that non-diabetics probably wouldn’t be hurt by following these “don’t eat” commandments, too.) I found these from Everyday Health:

  1. Donuts.Whether glazed or jelly-filled, these little gems are full of saturated fat, tons of sugar, and not a single positive nutritional contribution to your diet. Just say no! Substitute a piece of low-glycemic fruit
    snacks to skip on diabetes diet 03 pg full 300x300 Eating well for diabetics: Six things NOT to eat

    My nemesis (from EverydayHealth.com)

    (apple slices, half a banana) with organic peanut butter.

  2. Cheese. Oh man, this one kills me! I love cheese so much that it hurts, but it’s just chock-full of saturated fat and we already know that’s a no-no. I don’t know of a really good substitute but the article mentions Greek yogurt which might work if you like Greek yogurt (it’s not a favorite of mine yet but I’m still trying).
  3. Anything breaded and fried, including chicken fingers and fish sticks. Not only are these saturated fat bombs, they generally have way too much salt, too, which can contribute to high blood pressure. Substitute an ounce of nuts, just be careful to portion it out because if you’re anything like me, nuts can lead to overindulging.
  4. Potato chips, crackers, and tortilla/corn chips. Wow, this is another tough one. I love chips and salsa SO MUCH. These nutritional miscreants not only raise your bad cholesterol and add too many calories to your diet, they are also a “gateway” to high fat dips or other enhancers. Le sigh. Substitute baked whole-grain crackers with salsa instead.
  5. Packaged baked goods, like cookies. High in sugar, fat, and calories, they also fall into the bucket of carbohydrate sources that are quickly converted to sugar because they have absolutely no fiber to slow digestion. Good substitutes include baked whole grain crackers or fruit. I sometimes find that a hot cup of tea with non-fat milk and sugar substitute will satiate my craving for sweet junk food, too!
  6. Processed cereals. I am lucky that I don’t like, and never eat, sugary cereals. As a matter of fact, I rarely eat cereal of any kind. These diet demons are packed so full of sugar that there’s no room for any fiber – a bad combination. A better option for breakfast would be non-fat Greek yogurt with fresh fruit and just a light sprinkling of a cereal that has whole grain listed as the first ingredient.

There are a few of my all-time favorites on that list, so I’d better get to the store tonight to stock up on some alternate snack ideas. I know what to do, now it’s time to actually do it.

What are some of your “no-no” food items and what strategies do you employ to avoid them? Or do you include them in your daily life in moderation? Do tell!

Five tips for better diabetic eating

I had an appointment with my endocrinologist (diabetes specialist) on Friday. We discussed several different options in terms of changing my medications to try to get a better handle on my diabetes, but ultimately the best thing I can do is eat less, of better quality foods. I wish this was something that came easily to me.

2914816320 85eef876fb 300x225 Five tips for better diabetic eating

Image by Atila Yumusakkaya on Flickr

The basic rules for healthy eating when you are diabetic are not really so different from those that apply to everyone. In a nutshell, here are the top five tips for better diabetic eating (with help from the American Diabetes Association’s website):

  1. Eat a good variety of foods. Include vegetables, fruit, whole grains, non-fat dairy products, healthy fats, and lean meats. Notice that candy, cookies, and white rice are not on the list? <Deep sigh.> The variety of food you eat is important not only because it keeps you from being bored with your meals but also so that you can get most of your necessary vitamins and minerals from what you eat instead of having to take a supplement.
  2. Don’t eat too much at one sitting or too much of any one type of food. For instance, binging on Girl Scout cookies is discouraged. Smaller portions are important because your body won’t have to work as hard if it only has to digest a small amount of food at a sitting rather than an enormous meal.
  3. Space your meals out throughout the day and don’t skip meals. Ideally you would eat reasonably sized meals every four hours so that your blood sugar never gets low. (Low blood sugar can make you ravenously hungry and less apt to make good food choices. See the bit about not binging on GS cookies in point #2 above.)
  4. Eat fish with your meals 2-3 times per week. Why does everyone keep talking about eating fish? It’s a lean protein option, with very little saturated fat. It’s also a great source of omega-3 fatty acids, which help lower cholesterol and triglycerides and might even lower your risk of certain types of cancer.
  5. Get your five daily servings of fruit and vegetables. For best glycemic control (defined as the measurement of how well your blood sugar is being managed), limit the amount of starchy vegetables – like potatoes, corn, peas, and winter squash, and choose fruit with lower glycemic index values like cantaloupe, apples, apricots, and plums. Again, a good variety of fruit and vegetable choices is important to make sure you’re getting the best nutritional bang for your (grocery) buck.

Of course, it’s one thing to know what to do and another thing entirely to make sure that you do it. I asked my endocrinologist for a referral to a nutritionist for help in putting together simple yet inviting meal plans for my whole family so that I can – gasp! – start eating mostly at home. While it’s certainly possible to eat well while eating out, it’s sure a lot easier when you prepare everything yourself so you know what’s going in the pot!

How do you make sure that you and your family are eating well and getting the nutrition you need? Any time and/or money saving tips you’d like to share?

Aftermath

It’s been a crazy few months. Travel. (Fun.) Holidays. (Mostly fun.) New volunteer opportunities. (Exhilarating, exhausting, and fun.) Making changes around here. (Fun. Scary, but fun.)

In the midst of all of that fun, it was also our busy season at work, which is not always fun but it’s required and I work with amazingly talented, dedicated people, so it’s not so bad. For better or worse, that part of our work year ended Tuesday night and now we’re all sort of hungover and want to find a dark, quiet place to nap. Once upon a time, a very LOOONG time ago, we would take at least a month off from doing anything significant, to recover from the insanity, but that practice is long gone and instead we’re jumping into next year’s development efforts with vigor. It’s a good thing because it’s how we stay on top of our games, but a day or two of rest wouldn’t go amiss.

I bring this up because I got a bit sidetracked – OK, it was more like a complete derailment – from Project HealthFirst, the healthy eating initiative intended to improve my diabetes outcomes. The backsliding must stop now and renewed focus and energy will be applied in the coming days to ensure I’m back on track as quickly with my health as I am with my work commitment. I wouldn’t slack off there and I can’t slack off when it comes to avoiding a heart attack or stroke due to high blood sugar!

6893721504 1672934fe1 Aftermath

I share this picture of me with my mum and dad earlier this month because it’s a reminder for me of what’s really important: friends, family, love, life. None of those things will be possible without my health, so it’s simply got to be a commitment for me  there are no other good options.