Wednesday, March 27, 2013

Learning curve steepens

I have made some important discoveries as I've begun the journey of facing type 2 diabetes head on. Pretty radical stuff, actually.  (Typed with tongue firmly implanted in cheek.)

1.  Having not felt true empty stomach gnawing hunger much at all in the last 10 years or so, I've discovered that it can feel downright uncomfortable. In my previous bursts of "doing good" with weight loss efforts since I started the blog in 2009, an occasional bout of real hunger felt righteous, even good. Over the last couple of weeks as I've experienced HUNGER a lot, there have been times where I've done millions of things to distract myself from "the hungry", including filling up with water, starting a work project, etc..., and finally determined that I must be "low" (blood sugar wise) if I'm feeling that hungry.

Low is really anything below 70.  Well, the lowest I've seen yet is 98.  I'm not putting myself in danger by feeling hungry.  My body and my mind are just totally unaccustomed to sitting through uncomfortable moments.

2.  Having a sane, legal, low-carb snack in a sane, legal, low-carb amount, like one cheese stick or a 100 cal. pack of almonds, doesn't take "the hungry" away immediately.  BUT it DOES work in a little while - 10 minutes or whatever.  Turns out I don't need to eat uncontrollably in order for a reasonable snack to do the trick.  I may want to, but I don't need to.

3.  Allowing myself to sit quietly and feeeeeel the pangs, trying to "be one" with them, embrace them...isn't very interesting.  My monkey mind has many other things to throw at my consciousness.  I've been trying to really focus on and feel the hunger and try to go deeper and see what it is I'm hungry for (besides food, in psychobabble).  Turns out when I'm not binge eating and consuming huge amounts of highly processed carbs and sugars, hunger is actually physiological, NOT psychological.

4.  The discoveries in #3 in no way make it easier to not eat when I WANT TO despite not really being hungry, which is how I most always have eaten.  But the discoveries in #3 DO make it seem tolerable and actually doable, to not eat when I can recognize that I am truly NOT hungry.  Does that make sense?  Thankfully it does to me, which is all that matters since it's my journey.

5.  I thought I'd have this type 2 all wrapped up pretty quickly, given the brisk response of my blood sugars in the first couple of weeks.  I'm staying normal through the days, but so far, the lowest I've gotten my fasting sugar in the morning is 109!  Damn - MY goal is under 100, and preferably lower.  Apparently this is going to take time, and paying close attention to what I eat, when I eat, etc.  It's a process, not a one time event from which I'll graduate.

I've been doing tons of reading up on type 2, recommended food plans, etc.  I see for myself that low carb eating is going to be the way to go for me.  Really low carb, but not as radical as Atkins Induction.  There are so many resources out there now for this condition that I feel lucky, because I've already gotten some great menu and meal ideas, and lots of good recipes.  And I've barely scraped the surface, both on information gathering as well as finding my bliss point.  But I'm grateful to be in the process, and I feel more clear headed and calm than I have in ages.  Maybe I really can say goodbye to "the whites" (sugar, flour, simple high glycemic carbs), and from there anything seems possible.

Monday, March 18, 2013

Don't even get me started

I was all set to write this morning but have had a work day where all hell broke lose early and is just now settling down.  Oh well, they call it Monday for a reason...

I don't have a whole lot today other than to say I'm still checking my blood sugar and have gotten my fastings down to 101, except for this morning when I couldn't test because I ran out of strips.  Now before all the naysayers rally to accuse me of not being prepared and not owning my truth, I can honestly say running out of test strips was not my fault.  I got my glucometer last Wednesday afternoon at my primary care doc's office.  It came with 10 lancets and 10 test strips.

The nurse practitioner gave me scripts for full bottles of testing strips and for the lancets with which one pricks one's finger to obtain one's blood specimen for testing.  (And yes, you may assume from my increasingly crisp verbiage I am in a snit over this episode...)  Saturday morning I took the Rxs to the drug store.  When I went to pick up the stuff, the pharmacy tech asked, "You just had the one prescription??"  I answered that it was really 2, with the strips and the lancets.  Well.  The pharmacist stepped over and told me that they couldn't fill the testing strips until they were precertified by my insurance company.  Are you kidding me?  They're more than happy to pay for the lancets to get the blood, but not the strips to test the blood?

I'm not lying - the pharmacist said this happens all the time.  The strips are expensive - the lancets aren't, so they (the insurance companies) give the patient the runaround and add to the bullshit nonsense busy-work for the busy primary care practice to have to call in and get a precert. for the strips.  In a million years it wouldn't have occurred to me that there would be any problem at all getting test strips for blood sugar.  This is such an example of the absolute shambles in which our country is regarding access to basic healthcare and such.

Had I known there would be drama getting my test strips, I'd have brought home my glucometer from work again, but being a rational sentient being, I assumed it would be a non-issue for a type 2 diabetic to get blood sugar test strips.  So until my precert "comes in", I will be using my work meter for the morning fastings.

It's almost time for me to go home from work and I have errands to do, so I'll stop for now.  But I have a lot of thoughts about being almost 2 full weeks in to fully acknowledging and accepting and OWNING my type 2 and dealing with it.  And also some observations of how I'm feeling physically as I clean up my food and other aspects of my act!

Thursday, March 14, 2013

Leslie's life class ensues

Happy Little Friday (a hopeful term coined by a friend of mine to bridge the gap between hump day and the ever popular Real Friday, aka Thursday), blog friends.  I took a day off from blogging yesterday and am eager to get back here.  The accountability in this arena is so important to me and is seeming to yield some good karma at this juncture in my life.

Wednesday morning I woke feeling amazing.  Brain fog continues to subside which makes my head feel so much clearer.  This has always happened when I've given up sugar and it's various relatives.  Why I have known that for years and continue to crawl back to the dark side is baffling.

My FBS was 109 again, 2nd day in a row.  I felt ridiculously good about myself for showing up at both my appointments on Tuesday  (more on that in a sec...).  I returned to work to discover that a couple of suggestions I'd made regarding 2 of our "consumers" had been followed, which was gratifying.

What was different yesterday was that I was in such a big hurry in the morning, in order to get to my 7 a.m. A.A. meeting before work, that I didn't have a lunch prepared.  I grabbed some things to throw together for a salad in my office, but by the time lunch rolled around, I didn't feel like making the salad.  I ate some chicken that was to go into said salad, and had a handful of almonds.  Cue warning music from offstage.  I've been trying to eat VERY low carb, as in Atkins Induction phase.  That plan reliably shuts off my cravings for junk within a day, so I felt fine and satisfied.

As the day wore on, I started thinking about what to fix for dinner that fit the plan (tossing in a potato or something for hubby) and realized nothing sounded good.  But by late afternoon, I started feeling empty stomach hunger pangs that are not present ever when I'm in my addictive crazy eating all day mode.  Obviously.  And still nothing sounded good.  I've noticed this a few times this week, which is a good thing.  But my new education about Type 2 is revealing to me that I need to not get too uncomfortably hungry because my blood sugar can also go too low.  It is just now dawning on me that the next time I experience that feeling, I will check the number, but it didn't dawn on me at the time.

In trying to stay on the almost no/very low carb level, I got some more almonds, and then more.  Then I had a piece of ham and a slice of cheese, and felt fine.  Turns out hubby a church thing to attend, and was happy to fix himself a PB&J sandwich.  He was out of the house by 6:45, at which time I cooked up some turkey burgers to have for lunch the rest of the week.  I had one burger, but after I wanted something else.
I ended up having popcorn - not microwave, but not air-popped either.  I probably had about 5 cups, and that was the last thing I ate for the night.  I figured that might not be a great choice, but it wasn't sugary or sweet, and it satisfied me.

Blood sugar this morning:  118.  Still much better than it had been, but up 9 points from the last 2 days.  This tells me several things.
1.  This is a learning process.  It will take time for me to figure out my body and its tendencies, especially considering how long I've ignored her.
2.  Getting my blood sugar to a normal level is not a one walk dog.  It is a dynamic process that will change continually.
3.  The Atkins induction plan is no longer sustainable for me over more than a few days.  I start feeling deprived quickly of fruit, some vegetables (like carrots), and just getting too focused on eliminating every possible source of even healthy carbs.  I believe low carbing to be a sound way for me to eat, but nothing extreme.
4.  This is a learning process. (yes, repeat of #1)  Emotionally as well as physically.  Even mentally - I tend to black and white thinking - I'm either all good or all bad when it comes to eating.  This has always been a set up for binges, overeating, and bad choices.  Moderation and reasonability are highly coveted states for me, and I know I can get there.

There's more, but that's enough for now.  I just got a wonderful book that is already a good resource, Diabetes Weight Loss Week by Week, written by an RD and Certified Diabetes Educator.  I am at the beginning of this journey (even though almost 4 years in) due to the fact I ignored it for so long.  I'm hungry for information, and ready for success.

The doc appointments went fine.  Especially good was with my Primary's Nurse Practitioner, who said that I don't need medication at this time, given my blood work, because I'm still at levels where I can reverse the course with diet and exercise and education.  She agrees that the classes would be too elementary for me and prescribed a few sessions with a diabetes dietician and educator.  Whether or not my insurance pays, I'm doing that.  She wants me to get bloodwork rechecked in 3 months, which will be early June, to see what's doing.  (translation:  what I'm doing!)  And at the suggestion of Vickie, I did say that my goal was to cure this, not just control it, and the NP agreed that is a doable goal. 

I'm on my way.  Sorry for this long post, but I needed to process some of what went on for me yesterday.  Stay tuned!

Tuesday, March 12, 2013

My new bestie

FBS this morning - 109!  Woot! 

No work today.  Doctor appointments 10:30 and 3.  The glucometer, my worst enemy for several years and thereby relegated to my INACTIVE file has moved to BFF status.  Afterall, don't real friends support and encourage, steadfastly hang in when we stray, and always care enough to tell us the truth, even when it hurts? 

Happy Tuesday, all!

Monday, March 11, 2013

Who is this person?

No long post from me today after my weekend writing marathon.  I mainly want to document that my blood sugar this morning was 128.  Down 4 more points.  I'll take it.  Rome wasn't built in a day, and Leslie isn't going to reverse the clinical evidence of Type 2 and 4 years of ignoring my truth overnight.  I'm off to a good start, though.

When my eyes popped open at 4:45 this morning, I immediately jumped up to go prick my finger and check the number, eagerly anticipating the freedom that coming out of hiding from reality brings.  I'm actually excited for that doctor appointment tomorrow afternoon to discuss all this and get an official plan.  I'm willing to go to any lengths to get better, and to do whatever they suggest to bring it about. 

In the meantime, I'm omitting sugar and staying very low carb in my food choices.  Yesterday afternoon I had a headache that smacked of sugar withdrawal, but a walk in the gorgeous tease of spring we've had this weekend helped, and Vitamin I(buprofen) was NOT needed!  Last night I saw Life of Pi with some friends from AA and it was stunning.  Couldn't get through the book when I tried, but now I'm going to give it another shot. 

All in all, a great weekend, and my Monday starts with a mammogram at 7:45.  My year of Self Care continues.

Sunday, March 10, 2013

Shift happens

Good morning!  It's now 8 a.m. Sunday morning.  Yesterday at this time it was 7 a.m.  Doesn't take much to change things substantially.  We'll all really get this annual reminder when it's broad daylight at 7 tonight!  Sorry for the continuation of my morning musings on time change, but as noted in my last post, it fascinates me...the notion of times changing are very relevant in my life now.

And so back to our story from Saturday...the unintended cliffhanger that happened because the day started moving before I had a chance to finish the saga.  Actually this saga will be unfolding over time for the long haul, but on to the next chapter for now...

The blood was drawn Wednesday.  Thursday around 1:15 I was at work, blithely eating my lunch when my cell phone rang, and the number that appeared was that of my doctor's office.  In keeping with my oft-reported neurotic nature, wisps of adrenalin puffed into my solar plexus.  It was the office receptionist who said that my results were in and the doctor wanted me to come in to discuss them.

Knowing full well she couldn't say much, I said I'd make the appointment, but asked she fax me a copy of them.  She replied that the doc didn't like doing that until the results were discussed with the patient.  So I asked to talk to someone.  She put me on hold.

After about a minute, she came back and said that the Nurse Practitioner, who I see as often as the doc,   fully trust and believe to be extremely competent, said to tell me it was to discuss diabetes management and treatment options.  Aha.  Just as I expected.  I scheduled the appointment for this coming Tuesday, hung up, and exhaled deeply.

It was almost a sense of relief to me that this issue was "out in the open", and I knew that a subtle shift had happened inside where I was no longer going to ignore this truth that's been present for close to 4 years.  No more hiding it, no more euphemistic descriptions of my "borderline" status.  I have it.  It's gotten worse over the years.  Turns out ignoring a problem is not a useful strategy.  Magical thinking doesn't exact change.  Not like setting a clock to a different time and calling it a day.

Having not had the doc appointment yet, I haven't found out the particular numbers of my fasting blood sugar and HbA1C, which are the initial 2 indicators of diabetic status.  I haven't been instructed to check my fasting blood sugar daily, or been given diet guidelines.  I haven't been told that I need to go on medication.  Yet.

Shortly after I hung up from talking to the receptionist, I got my work glucometer out and checked my blood sugar.  It was a dumb time to check it, because I'd just eaten lunch (albeit a healthy low carb one) and knew the number would be high.  But how high?  My nursing knowledge is helpful, but it can also be a distinct hurdle in rational action on my own behalf.  I know normal ranges for fasting, but not related to mealtimes, etc.  I thought it could be in the 200s, which would not be good.  It was 167, which is high, but not so bad just after a meal.  2 hours later would have told a different story, but I let it go, just feeling good that I'd had the nerve to check it.

I brought the meter home for the weekend.  Friday night, hubby brought home dinner from his golf club (where we have to spend a certain amount in their dining room quarterly), and from where we usually get outrageously delicious dessert.  I told him in no uncertain terms NOT to get me a dessert, but when he got home, one of the containers had 2 desserts.  I shrieked at him, and he said he'd told them just the one dessert.  He was surprised, and I can assure all of you that he would not attempt to sabotage me.  It was a fluke.  Guess what I did?  I ate it.  And once that sugar was on board, I opened a bag of candy that I was going to send to my son in the Republic of Georgia, and ate that too.  Insane.

Armed with my glucometer, I checked my fasting blood sugar yesterday morning.  Normal value would be less than 100.  Mine was 152.  It was that value and my reaction to it that prompted me to begin writing all this yesterday morning.  I saw it and didn't freak out.  What came was a steely determination and resolve to change it.  Get it down.  It was visceral, real.  That high blood sugar empowered me through the day yesterday, including a baby shower with a full dinner, cake, avoid the simple carbs and sugar.  Also to take in healthy nourishing meals.

This morning my blood sugar was 132.  Still high.  Down 20 points.  Coinkydink?  I think not.  Can I get it lower?  I believe I can.

The awareness is still fresh, almost astonishing as it continues to wash over me.  The facts of my condition, out in the open, motivate me.  Reality vs. wishing and hoping.  A measurable indicator of my  status can help me rather than scare me.  There are many things I cannot control.  But I am not powerless over what I put in my mouth.  Once certain things enter my body (like booze, sugar, highly processed crap), my judgement is impaired.  The person I am before I put in certain substances is different from the one after I ingest them.  That is my biochemical addictive nature.  If I ignore it, all bets are off as to my ability to act on my own behalf.

So - that's where I am at this point.  I am going to test my FastingBloodSugar (FBS) every day now, whether the doc says to or not.  But he will.  I'm not afraid of it anymore.  I'm afraid NOT to do it.  That's a big change.

Saturday, March 9, 2013

The times, they are a-changin'

It's 6:15 Saturday morning.  Tomorrow at this time it will be 7:15.  It always fascinates me to think of this related to time change.  Simply change the clock setting, and voila!  Instant new normal, albeit a less drastic one than many.   

Like most other folks at this seasonal juncture, I'm beyond ready for any harbinger of spring to emerge, and daylight savings time is a biggie.  The purple shocks of crocus against winter brown rain/snow dampened earth have been wooing for a few weeks, but repeated storms and last gasp winter onslaughts have kept them from fully flourishing.  But time change...even mother nature can't mess with that.  It immediately and literally brings new light into every moment from dawn to dark.

I generally don't post on a weekend (and no cracks about how I generally don't post much at all these days), but I want to reflect and write out my thoughts this morning.  Recall my Wednesday post about beginning to pay attention to my health, by scheduling appointments, having blood drawn, etc.  Today's musings evolve from there.

Let me note that denial has never been a river in Egypt in my world, but magical thinking with a big dose of ignoring reality have often figured prominently in my operating system.  Before I got sober, I knew my drinking wasn't "normal", but I was having too much fun to worry about it.  Until I wasn't, and even then - armed with the knowledge that I was an alcoholic, I kept doing what I was doing, thinking that eventually I'd stop, or "get over it".  

I determined to quit a million times and meant it with all my heart every time.  But eventually (in a few days, or a few weeks) I'd go back, or rather, pick up the drink.  And I never picked up planning to moderate.  I never wanted a civilized glass of wine with dinner.  I wanted obliteration, but without those pesky blackouts and fights with the husband.  

That is how it's been with my eating and food struggles.  While the consequences in my daily life have been less drastic in the social sense (I have a zillion friends, wonderful family, good job, love and feel loved) than those wreaked by alcohol, they have been painful in my inner life, and increasingly serious to my physical being.  

I've ignored Type 2 diabetes for several years.  It started out around 2009 with warnings that I was showing signs of it (borderline values).  My doctor told me "You can cure yourself", and sent me to a Diabetes Educator/Dietician for food guidelines and menu planning.  I went a few times, began losing weight and my lab values flipped back to normal quickly.  So I figured I could control this thing, and lapsed back to eating what and when I wanted.  My borderline status quickly turned to teetering-on-the- brink, and my doctor gently warned me.  

At one point about 18 months ago, the office nurse called and said that the doc wanted me to take the Diabetes Education classes offered at the local hospital, and I (know it all nurse and pain in the ass patient) said to her, "I'm not going to do that.  I know what to do, and I could probably teach the class myself."  It won't shock you to know that was the last time I had blood drawn, until this past Wednesday.  I had an office visit for a muscle spasm in September of 2012, and the doc gave me a slip for blood work that I hung onto, vowing to self (HAH!) that once I got a "good month of sane eating" under my belt, I'd have it done.

If I waited for that month, I'd likely never get stuck with a needle again.  A moment of clarity, a deep fear, finally wanting to stop NOT WANTING to see family who aren't close by...something I can't explain jolted me into just getting the blood tests done.  

And then the wait for the phone call from the doc's office.  

It didn't take long.  24 hours.

Wednesday, March 6, 2013

Atta girl, Leslie

I'm high-5ing myself today and daring to be optimistic about some miniscule progress related to my last post.  This morning, as scheduled, I went and had my routine blood work drawn that I've put off for months.  My blood is out there in the ether to be looked at and to reveal the general status of my health.  In the past, I used to play drama queen (to myself only) after walking out of a lab, thinking, "well, the die is cast", with emphasis on the "die"!  Brother - I'm really getting tired of myself with that stuff and see that I can make a choice to be optimistic or pessimistic.  Whatever is, IS.  Not knowing not only doesn't help or change anything, it fuels my anxiety.  The long-held fear dates back to my childhood, and while I know from where it stems, it's very hard to navigate at times.  But the only way through is through.

Upon getting to work, I also scheduled my mammogram for this Monday.  It's late as well, because I'd cancelled one back in October and never got around to rescheduling.  I got an appointment early in the morning, which is my best and brightest time of day, and I'm highly unlikely to chicken out or be "too busy".  I'll have it done and be able to get to work early.  While I don't love these boob-flattening fests, they don't breed dread and fear in me the way having my blood drawn does.

Finally, I go to a fancy schmancy practice GYN care.  The woman gyn. doc I see is no longer accepting new clients, and you have to schedule your annual exam as you leave from your current one, or you might have to wait for well over a year.  I also cancelled that appointment last summer, and never rescheduled.  This morning I called to do so, figuring it would probably be late fall before I'd get in, and by some miracle was told that my doc had a cancellation for this Tuesday at 10:30, so I grabbed it!  I'll just take the day off since it's in the middle of the day.  This also doesn't get me too worked up, though I know she'll gently mention my weight, as always.  Maybe at next year's app't, that won't be an issue!  It could, and should, happen.

Seems like the universe is opening up a sliver for me to take better care of myself, both in having ideal time slots available for what I need, and suspending some of my resistance and fear about health issues.  For someone who's been very healthy my whole life, it's strange that I hate these routine procedures.  But I also know how good it feels to know things are well, and if they aren't, that I am following through on my own behalf.  Details to follow.

Oh - and my food and eating have improved for the last few days.  That helps for sure.

Monday, March 4, 2013

The first day of something

Today is the proverbial first day of the rest of my life.  The day (actually the 2nd day, as I was stellar yesterday) I start back on track with moving toward weight loss, improved fitness, and denial-free attention to my physical well-being.  Mondays are good first-days-of-the-rest-of-my-life.  I should know.  I've had a zillion of them in my 59+ years, yet here I still sit, about 40 pounds overweight, in denial about my borderline (hopefully still borderline) type 2 diabetes, hypertension controlled by medication, and who knows what other weight related issues.  Confession:  initially I wrote "obesity related issues", but it sounded so harsh and ugly that I changed it to the kinder and gentler "weight-related".  This runs deep.

I'm going to spit out some major baggage here - I might as well use this blog for an outlet, since it isn't panning out to be a springboard to writing fame.  I'm too cheap to go to therapy again - been there, done that.  It won't get me skinny or give me any new insights into my demons.  I have to have somewhere to say some of this shit out loud.  Judge me or not.  Something's gotta give if I'm ever to find freedom from a very destructive relationship with food and eating.

I've been blogging since summer of 2009, and it was really only in the first 6 months that I lost a chunk of weight (~25 pounds) that I have of course re-found.  I'm still not as high as I was at the very beginning, but I'm as far from a success story as Obama is from getting Congressional republicans to agree with any words that come out of his mouth.  Truth be told, the reason I stop blogging for long periods (often) is that I get tired of not having anything positive to report.  I always get so much support and kindness here, and yet I feel ashamed about that because I don't deserve it.

I've written before about one of my favorite sayings in AA - "if nothing changes, nothing changes".  I am the poster child for that little nugget of truth.  Many things HAVE changed in my life over the years, and those changes have bore much fruit and richness.  But with the eating, the food, the weight - status quo breeds status quo.  I want to be honest about a few facts of my life.  These won't be new to anyone who has read me for awhile.  They provide good examples of the saying in the paragraph above.

1)  I love my Atlanta in-law family.  They love me.  I'd like to visit more often.  But I dread going, always, because I'm fat.  Still fat.
2)  My beautiful daughter is still living in the Dominican Republic with her wonderful boyfriend and soon to be official fiance.  I love spending time with them both.  We have only been to visit once while she's been there, though she comes home as often as possible.  They are dying for us to come down soon so we can meet Cesar's parents, and visit their beach condo up on a stunningly beautiful tiny penisula off the northeastern coast of the island.  I want to go, but I don't want to go fat.  I can't wear long sleeves and capris on a tropical Caribbean beach.  And I definitely can't wear a bathing suit.  Or meet the parents.
3)  I should have had basic blood work drawn about 7 months ago, and have put it off until I get some "sane eating time" under my belt".  I'm afraid of the type 2.  I'm afraid something horrible and terminal will show up.  I'm afraid of my shadow, I think.   (And whenever I walk with friends, my shadow is always the biggest.  Admittedly I have lean friends, but still...)  I'm afraid of literally everything.  I'm phobic about minor symptoms, in me or my family members.  And I keep this all at bay, inside, so as not to appear as nuts as I feel.  A neurotic mess on the inside.  Cool, wise, AA sponsor/friend/nurse/mom/counselor on the outside.  Let me tell you - it takes a lot of food to keep this all zipped up.

There is a lot more I could say, but my work day is winding down, and I think enough is enough.  Maybe I'll write again soon.  I hope so, but my willful bad self, driven by a million forms of self-centered fear, can call the shots if I'm having a bad day.

Acceptance and the Serenity prayer are my current strategies right now.  There is much I cannot change.  There is much I can.  I even claim wisdom to know the difference between the two.  But action is what matters.  One planned action is that I have an appointment at 8 a.m. on Wednesday morning to have that blood work done.  If it shows I'm gonna croak - so be it.  I'm having it done.  It's a start.  And I'm going to try and resist any sugar, other than fruit, for the rest of the day.  I did that yesterday and it was ridiculously hard, arguing constantly with the voice in my head coaxing me to have just one ___________ that someone brought to a meeting.  I got through the day.  I'd like for a rerun of that today.