March 4, 2011

An Uncompliant Patient

Posted in diabetes, diet tagged , , , at 3:21 pm by sherisaid

Needles, needles, everywhere...

I started this blog in 2009 and abandoned it after only a few months. It has some pretty good stuff, so I decided to resurrect it today. I guess I should start with an update. For the last year or so, my condition (blood sugar and weight) has remained more or less unchanged. I have neither gained nor lost significant weight, and no diabetic complications have arisen. I’ve continued to eat a healthy diet without strictly monitoring every bite.

Except that my blood sugar has gone up. and up. and up. The most significant aspect of this struggle has been trying to find a doctor I can deal with. One who listens and at least pretends to care. One who gives me a straightforward version of truth I can trust. I want to hear “here’s what you have to do, and here’s what happens if you don’t.” No waffling, and no cookie-cutter answers. I need specific answers.

After the doctor I adored moved to Michigan a couple of years ago, I went to several specialists. For the first one, I prepared by meticulously tracking my diet for 6 weeks. She did not look at it when I handed it to her, just chucked it in my file and told me she’d be putting me on metformin and byetta. This was immediately after I told her that metformin makes me sick and does not lower my blood sugar, and actos is the only thing that has worked for me to date. And what’s this about Byetta? Turns out Byetta is to control food cravings. If you’re fat, you must be overeating, right? So I shrugged, and tried it. Unsurprisingly, it made zero difference in either my appetite or my weight. The Metformin made me sick and did not have an impact on my blood sugar. I stopped taking it after 2 months.

Then I went to see the dietitian in her office. I thought…finally, someone who will tell me what I’m doing wrong in my diet and help me fine-tune it. That did not happen. I gave her my diet and she chucked it in my file, then gave me a canned speech about the basics. One glance at my diet log and the detailed food analysis, and she’d have known that I’m way beyond the remedial class. I went to that office a total of 8 times for various appointments, educational classes and followups, and walked away without one shred of new knowledge. No one looked at my diet and said “I’ve taken a look at this, and here’s how I think you can improve.”

So I went to another doctor. He freaked out because my blood sugar was so high…I wrote about it in an old post somewhere. Anyway, I can’t deal with a doctor who brings that much drama into the room, so he was out right away. Then I tried another endocrinologist. She was fine, but getting an appointment, and getting anyone on the phone for any reason, was impossible. I had to reschedule my second appointment, and 10 phone calls later I was still unsuccessful, so forget it. But she wouldn’t have worked for me anyway. Her response to “Metformin makes me sick and doesn’t work for me” was “There’s a new form of metformin, a hybrid called Actos-plus-Met I want you to try.” It did not surprise me that it made me sick and didn’t work. Chalk up another doctor who wasn’t listening.

Last week, I went to Dr. Victor Roberts. He was calm, straightforward, and paid attention to what I had to say. I didn’t ask permission to not take metformin, I simply told him I would not. period. He was ok with that. He said I’d have to up my insulin because it is imperative to get my blood sugar down, and told me to take more if it spikes. You’d think some doctor and some time would have mentioned that before. None have. In a week, I’ve brought it down from an average of 350 to an average of 120. He also gave me a higher does of thyroid medication and zocor for cholesterol. AND he prescribed enough refills to last a year. The last 3 have prescribed short term prescriptions for things I have to take for the rest of my life, probably to force me to come back over and over. I have high hopes for this doctor. I’m not the most compliant patient in the world. I blindly follow nothing and no one. But if I see results, I’m on board. and so far, I do see results. I have so many tiny holes in my body I feel like a voodoo doll, but my blood sugar is down.

Since this blog is as much to help others struggling with similar issues as to document my struggles, here’s the takeaway: Don’t settle for a doctor, no matter who tells you how wonderful they are. Find one who will listen and respond. Diabetes is complicated and highly individualized. Standard solutions don’t always work.

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May 20, 2009

and now, a whole new category of suck.

Posted in diabetes, diet at 3:05 pm by sherisaid

I’ve lost 15 pounds since April 3. Great news, right? Sure. I mean, I’ve been trying to lose weight for years, and now, after just a few weeks of moderate walking, it’s falling off. The last time I tried a focused exercise program, I went to the gym 5 days a week for months…and lost nothing. That’s right. nothing. I worked much harder than I am now, and my exercise partner, whenever she could make it, was a personal trainer (who’s a friend).  So I was both ecstatic and bemused when I began to lose weight right away. 

Yesterday I went to the doctor. I had a blood test on Monday, and the results were not real good. In fact, the doctor used words like hospital, coma, and death. He said that he’d never seen a thyroid number so high. For those of you who understand A1c numbers, mine was 14.5. Normal is 6. This means that my blood sugars have averaged 400-500 for 3 months. I had lost my meter, but I follow such a great diet that, along with adding exercise, I expected my blood sugar to be down…certainly not WAY up. It was 10 last time, and that’s alarming. The doctor nearly blew a gasket. I think he was afraid I’d drop dead right there in his office…which is evidently possible. I’ve never seen any doctor so agitated. I have to go back next week.

Dammit, I feel fine. I’ve been a little tired, but no more than I consider normal for the amount of sleep I get (not nearly enough). I’m not having any symptoms aside from brittle hair (my hair is breaking off) and occasional headaches (which could be from excessive computer time).

So now I’m taking insulin, 2 shots a day. I’ve resisted it up till now, because it’s notorious for weight gain. But I found out recently that people gain weight because it makes you hungry and they overeat. I am not afraid of that because I know how to combat hunger…3 meals and 3 snacks a day, totaling about 1600 cals. If you eat every 2-3 hours, hunger isn’t a problem and neither are cravings and binge eating.

The shots don’t hurt. The needles are so fine that you don’t even feel them going in, as long as you pick the right area and alternate places. I haven’t had any side effects so far. My appetite is, if anything, suppressed. Breakfast was 2 & 1/2 hours ago, double-fiber oatmeal with peaches and walnuts, and I still feel full. 

So today I feel…weak, frail, mortal. It’s all in my head. I was told that I could have died and now my drama engine has gone into full production. I had to tell my son and his girlfriend that if they find me unresponsive to call an ambulance. Don’t just assume that I’m sleeping heavily, it may be a coma. Never thought I’d be having that discussion.

The doctor said not to worry, that the insulin should normalize my BG within a week, and I will probably be fine. I’m keeping close track of my meals and my BG. It’s time consuming, but definitely worth it.

I should probably note that I am under tremendous stress right now. My job bit the dust about 9 months ago and I’ve been struggling to make enough money and keep everything going, but some unexpected bills in the last few weeks have caused a major crash. I have been working for a new company for the last few weeks and it promises to be very lucrative, but right now it isn’t. My hub has lost some of his overtime hours due to the economy. His job isn’t in jeopardy, but his check is about $50 a week lighter. Between us, this means we’re operating on $1400 less every month, on average. I’m still making some money by freelancing – just not nearly enough.

May 16, 2009

Vanity

Posted in diet at 12:53 pm by sherisaid

 

I don’t consider myself vain. I used to be kind of a show-stopper, based on the amount of attention I constantly received, but I considered myself to be short, dark and a little pudgy.  And I was, all of those things. But in the days before plastic surgery and movie-star hair, I was a standout. I would not do well as a young woman today, I could never be slim enough to rate consideration. 

Since I gained such a ridiculous amount of weight, I make few concessions to beauty. My hair is usually in a ponytail because I can’t keep a style – it shoots out of my head like it’s in fast-forward. I do dye it, because I got my first gray strands about 14…thanks, Dad. He was 50% gray by 35, but on him, it looked cool. So I dye it my natural color, a medium brown. I’ve tried other shades, but I like this color. *shrugs*

I don’t wear makeup, or at least only rarely. My sister’s wedding, for example, which I’m coming to.

I needed a new av, so I looked through the pics from my sister’s wedding (taken nearly a year ago, they are my most recent pics). I found a family pic I could crop myself out of, but I found that I did not like being confronted by my bulgy neck. Just the other day I saw a cover of Kirstie Alley, fat again, poor woman, and it occurred to me that she is beautiful at any weight because her neck doesn’t get fat. 

Anyway, the neck fat thing bothered me so much that I fixed it. I took this picture:

 

neck rolls? ACK!

neck rolls? ACK!

and did this to it.
shadow is a wonderful thing

shadow is a wonderful thing

this was achieved mostly by manipulating shadow and contrast. If only I could do that to my actual neck.

Maybe I am a little vain. I did it for my twitter account and for my blog. But I think it should be said that I didn’t do it to be more attractive to other people, I did it so that looking at myself on every social page would not elicit a response of  “GAH! FAT!” If I am to win the battle of the bulge, I need to stay positive and not beat myself up constantly. So now I know what I will look like in about 50 pounds. I like it 🙂 It’s nowhere near my goal weight, but it makes me look younger and somehow friendlier. Definitely a goal worth reaching. Glad I have the graphic skills to pull it off. I like having something realistic to shoot for.

April 27, 2009

Weight Watchers

Posted in Uncategorized at 2:04 pm by sherisaid

I’ve decided not to go to Weight Watchers. I went to 2 meetings, and they were interesting enough but I didn’t learn anything. I began altering my diet about 8 years ago when I first learned I was diabetic. A healthy diet is a healthy diet, and Weight Watchers doesn’t espouse anything I haven’t been obsessively studying for years. That’s not to discourage anyone from going, mind you, it’s a great program. I just already know.

I thought the accountability factor would make a difference, and that’s why I decided to go. But I don’t have any connection with the people there. I think it would matter to me more if I gathered a group of friends and we met each week to toast our successes – plus kept close touch online. That’s what this process needs for me, some personal support. That’s also what the giant websites lack…so many people that every voice gets lost.  I need a local factor. I thought WW would provide that, but the discussion was a little too…structured? It just seemed dumbed down. Maybe I overthink things, but I’d rather have a round table of in-depth examination…a more intellectual approach. I want to interact with people who have the information and want to innovate new ideas, talk about new ways to look at problems.

Wish I had money to invest. Curves is great, but it has limitations (and a yearly committment, which I despise). WW is great, but it, too, is limited. I think some combination of the two is the answer. A specific weight-loss gym that combines circuit training and diet info/discussion/training. Incentives and prizes for meeting goals. Solid nutrition information, not just advice on avoiding the buffet at a birthday party. Plus a website with tools, profiles, local discussion groups…http://www.sparkpeople.com is so incredibly awesome, but the forums lack focus.

Another thing I think would be helpful is motivation coaches in a circuit workout situation. Maybe Curves has that, I don’t know. But what I do know is that pulling all of the aspects of weight loss – exercise, nutrition, psychology, motivation and accountability together is the answer.

If I win the lottery…it’s on.

April 26, 2009

Discipline without Documentation

Posted in Uncategorized at 3:14 pm by sherisaid

Yep, still dieting, exercising and losing, just not keeping track as well.  I really need to get a rechargeable battery for my camera so I can keep a photo record, because I really think I am on the way to success. If my home scale is to be believed, I’ve dropped about 8 pounds. I’ve been monitoring both morning and evening, to keep track of fluctuations (I weigh about 3 pounds more in the evening)

I’ve been walking, one way or another, every day. I go to the park for my mile walk about 3 times a week, and I’ve added a form of dog-walking to my day as well. We have a puppy less that 10 weeks old who is not yet leash trained. I take him into the back yard and walk around the pool…averaging about 4 circuits, 5 or 6 times a day. It’s only about a 5 minute walk, but everything adds up. I encourage Buddy to trot along beside me, and will soon add a leash element. Once he will walk on a leash, we’ll range farther afield.

Most of the time when I walk around the pool, I carry 5 pound weights and work my arms. My pool is a typical, kidneyish freeform shape, medium sized. It’s not a long walk. But from everything I’ve read, every step counts – and it’s easy and infinitely superior to spending every minute at my desk.

Once it warms up just a little more, I’ll swim, or at least exercise in the water. Maybe I’ll start that today 🙂 it’s nice and sunny.

BTW, if you’re reading, please comment. I don’t know if anyone is.

and you know,  i may start writing with an eye to publication.  It’s hard for people like me, with medical issues to overcome and few calories that can be cut.

April 11, 2009

The Evil Nature of Socks

Posted in diet, weight watchers at 3:38 pm by sherisaid

I found this post dated October 2006 on my Sparkpeople.com blog and it made me laugh so I decided to repost here (still true):

socksSocks are what kept me from exercising the first 20 times I got religion and decided to go to the gym. Socks are pure evil.

So there I am, full of determination, in my stretchy gym clothes with my water bottle, my headphones and my brand new Nike walkers. And my socks *narrows eyes* How to get them on my feet? My arms aren’t long enough to go for a straightforward over-the-buick approach, and my legs aren’t flexible to do a side manuever…so now what? It takes me almost as long to get my socks on as the exercise itself. No wonder I never did this before!

With practice  I finally conquered the putting on of the socks. It takes tremendous skill and precision, but I learned to manage. 

But wait, there’s more sock evilness afoot! Undaunted by my sartorial triumph, the socks continue their quest to bar me from exercise by disappearing. Somehow, all those lovely white socks I bought just for exercise have evaporated into thin air…what now? Do I make a lame nosock excuse and skip the gym? NAY I say! You’ll not defeat me so easily! I put on my sandals,  stop at target for new socks and head for the gym….ah but when I get there, what now? How do I get the new socks onto my unseen feet, so very far away, without my bed to do twisty leg gymnastics on? Can I put my foot on the console of my SUV? NO, I cannot! Still, I do not accept defeat. I pull out of my plum parking spot and find the most remote spot on the parking lot so as not to alarm passersby who might think I am having some sort of fit and call an ambulance. I get out of the car and put one foot on the running board, and voila! I have won the battle of the socks…for now. Who knows what evil plot they are hatching for next time.

Then I drive back to the plum parking spot, because I really am bone lazy at heart.

April 9, 2009

Exercise? Not Today.

Posted in Uncategorized at 2:20 pm by sherisaid

I did not want to walk today. Not. I am having a horrible allergy attack. My head’s been killing me since last night. and doesn’t respond to ibuprophen or sudafed. I’m achy all over. My nose is both stuffy and runny. My eyes are puffy, light-sensitive, and watering. And it feels like my ears have fluid in them, whch will probably result in ear infection. Doesn’t feel like a cold though, just allergies. yay spring.

I really did not want to walk. I’m too tired. I’m too achy. I can’t breathe. I feel as if I got no sleep, even though I went to sleep early. I got up late and didn’t have time to get dressed and get my shoes on. Getting socks on can be quite a challenge if you can’t even see your feet – much less reach them. 

Yesterday, I went to Weight Watchers and weighed in. I’d lost 2 pounds since Saturday. 5 days. 2 pounds.

You can credit Weight Watchers if you want to, but I’ve been on this same diet for 7 years. It’s a good diet, but I didn’t get it from WW. It’s just stone cold common sense. Eat good stuff. Don’t eat too much crap. So why did I lose weight? Well, the only significant difference is the 1 mile walk every morning.

I had every excuse not to walk today. I even almost passive-aggressive’d myself out of time to get dressed. Almost. Then I put my shoes on and went for my walk. 2 pounds. 5 days. I’d be crazy to start making excuses a week in.

oh, and this is me not eating the Krystal cheeseburgers my son was kind enough to leave in my fridge for me to find. Not a chance.

April 7, 2009

The Art of Hiding Veggies

Posted in Uncategorized at 12:16 am by sherisaid

How many??We all want to be healthy, and with all the info floating around the web, we all know what we have to do, it’s really pretty basic.  One of the things I hear most often is “how do I get 5-8 fruits and veggies in every day?”

I faced the same dilemma – only more so. Because I’m diabetic, everything is magnified. For me, it’s not a matter of feeling a little more energetic or looking better in my jeans. If I don’t lose weight and beat diabetes, they’ll eventually start hacking off body parts or hooking me up to some machiavellian device to clean my kidneys. Parts of me could freeze up and become useless. I’m not making this up. And I could go blind, which would totally suck. What would I do as a blind person? Frankly, my typing sucks with sight, and I am not the most tactile of people. Trust me, I do not have sufficient memory skills to learn braille. Besides, how would I then read each word obsessively 37 times before posting (and still miss the typos)?

I’m sure you can see where I’m going with this. I’m eating the damn veggies, ok? Here’s the thing. I like meat. No…I LOVE meat. I am an undisputed omnivore. What’s more, I love red meat. My favorite foods are things like meatloaf, cajun red beans and Andouille sausage, cuban picadillo with yellow rice and black beans & chicken pot pie. Basically, a mix of southern food, plus cajun and cuban. And italian.

There’s one other thing to note about how I eat. Some people are visually oriented and like pretty food. I’m not. The first time I made red beans and sausage, my hub remarked that it looked like legless boiled roaches with floating turds.  He refused to eat it. No problem. More for me. What’s most important to me? Taste and texture. I want different textures, smooth, creamy, crunchy…the gamut. And I like complicated flavors.

Fortunately, I discovered that I can satisfy my meat tooth, cut the fat, and get my veggies in one fell swoop.

Veggies can be hidden in almost anything. Tonight I made cabbage rolls, and they were delicious. Usually I’d fill these with meat and rice (yummy) but tonight, the filling consisted of one pound of lowfat ground beef (low fat means 10% or less) and cooked brown rice…plus about a cup of carrots, boiled till soft, and sauteed portobello mushrooms. I drained the carrots and added the mushrooms, then chopped them up really well, then added the rice, plus an egg, a little milk and about 1/4 cup of bread crumbs. I mixed that all together and then added the meat and spices. The bottom line? My meat mixture was only about 1/3 meat. But it tasted like meat and rice 🙂 It was delicious, filling and satisfying.

I make meatloaf in much the same way, only no rice. I’ve experimented with food processing beans to mush (works great), adding spinach, green and red peppers, carrots and parsnips. using the same idea, you can make any kind of casserole, sauced dish (like spaghetti) or loose meat dish like tacos. I’ve also taken to stuffing things.. pork chops, chicken breast, whatever. I put spinach in everything. I’ve convinced my family that it’s herbs. They would never voluntarily eat vegetables. you don’t even want to know what goes in my carrot cakes. (ok, carrots, parsnip and zuchini)

Pretty easy, huh? just cut the meat in half and sub in mushrooms (for bulk and meaty texture) and add assorted veggies…and you cut the fat in half (or more), satisfy even the most dedicated carnivore – and get in all those pesky veggies.

Oh, and for dessert…how about a yogurt with extra fiber poured over some peach slices and blueberries…with a little whipped cream on top and a sprinkle of nuts or granola?

Eating healthy does not have to be a sacrifice. You just have to think about things a little differently.

April 4, 2009

Weight Watchers – the adventure begins

Posted in Uncategorized at 6:33 pm by sherisaid

So today I went to a Weight Watcher’s meeting. The jury’s still out on whether I will stay with it. I have to see just how powerful the accountability issue is. This crowd didn’t seem as cohesive or enthusiastic as the group I went with the last time I was in WW, about 23 years ago…they were a lively crowd, but I suspect the enthusiasm is largely determined by the presenter.

I did like this presenter, she was very personable, she just didn’t stir the crowd. I remember the vivacious presenter from all those years ago…she’d lost more than a hundred pounds and she was really enthusiastic. Maybe I need to try a few different meeting times before finding the people I feel comfortable with…and an excitement level that will help.

One of my favorite twits, @kwidrick, is a lifetime member. I’m not sure how one becomes a lifetime member, but I do know she lost about 40 pounds..last year? Before I knew her. Anyway, she works in the Lake Mary WW on Monday nights, so I’ll try that meeting – it will give me an excuse to visit with Katy.

I’m still trying to figure out the points thing. People keep telling me it’s easy, but…it still involves figuring out the point system, so I don’t really see how it’s easier than tracking grams of fat, fiber and cals…and it doesn’t account for carbs, which I also like to monitor. But I guess as long as I’m eating whole grains and limiting potatoes and rice, that doesn’t really matter…all my carbs are from good sources.

I am not writing well today. Time for a snack, I think, and then a nap. It’s my  Saturday…and I’ll nap if I want to.

April 3, 2009

Motivation City

Posted in diet at 3:22 pm by sherisaid

Wow, motivation city! I got up this morning and after I dropped off the hub – and before breakfast – I went to my favorite park (Crane’s Roost, behind the Altamonte Mall) and walked a mile. At least, I think it’s a mile all the way around.

First thing, I pull into the area where I used to park when I used to walk, and lo and behold, there’s a sign that says business park only, your car will be towed.  What the hell? I guess when there is an event at the park, this is probably a pretty big issue, but on a glowering day like today, there are about 5 people in the park. So I decide to chance it.

Naturally, the minute I get out of the car, it begins to rain. Not that rain was a big surprise, the wall of black clouds seemed within touching distance. It’s supposed to clear up this afternoon, but frankly, I don’t trust myself. I have the most energy in the morning, and I think that’s going to be a key factor. So raindrops be damned, I forged ahead.

I love this park. Altamonte has put a great deal of effort into creating an upscale downtown sort of area (New Yorkers would say uptown). A lot of well-planned apartments have sprung up around the lake and it’s clean and lovely.  There’s a wide walkway all the way around with long bridges that span the ends of the oval, and the bridges have wide gazebo-like areas covered by big white hats and lined with benches. There will be pictures soon. There’s a band shell and concert area, a tower thingy with a sculpture on top, and lots of flowers and birds and such. Only problem is that during the rainy season, it’s prone to flooding over the bridges. But even then, I guess I can walk on one side…back and forth?

So about halfway in to my mile, which I am doing at just above a leisurely pace, I feel that familliar pull. It always happens. Same place, same problem. It’s the outside calf muscle of my left leg.  That muscle gives me issues all the time, and it never goes away, no matter how often I walk or what stretches I do.

But I ignored it and walked on. It rained a little more, and I walked on. I didn’t take a comfy seat under a white hat and watch the ducks. I didn’t dawdle at the cool tower thingy. I didn’t even stop to read the plaques. Nope. Kept walking.

It’s been a long time since I walked, and I won’t lie. My shoulders hurt and my left calf still feels fatigued. But it was ok. It was a good start. I’m thinking I can hit the park 3 times a week, monday, wednesday & friday.  Then do my 10 lb weight routine tues & thurs. and a full body weight routine with my hub coaching on saturday or sunday…and maybe even an hour in the pool here and there as well.

I feel tired, but I feel good. actually, I feel really good. Like I can do this.

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