My battle with the needle and diabetes

Let me start with some history first. Everyone in my family whose medical history I know has diabetes, heart disease, high blood pressure or sleep apnea.

Several years ago, in my early 40's, my sister and I were in Texas and found out that we'd had a half sister that was only 5 years older than me. Notice that's past tense, she'd died at the age of 45 from complications related to diabetes. My paternal grandmother died from complications related to diabetes. My mother died from complications related to diabetes. My father died from complications related probably to high blood pressure and sleep apnea (he's had a heart attack some 20 years earlier) - which I found out was assumed from the very intensive and thorough testing and history I did when I was diagnosed with sleep apnea.

So, diabetes, high blood pressure, heart disease and of course the sleep apnea are the main concerns I have relating to my health and are all assumed to be hereditary. All are killers. All are related to each other or impacted by each other and all can be managed or prevented by diet.

I've been monitoring my blood sugar daily off and on for 10 years. I've been making sure that I had a fasting blood test or A1C at least a couple of times a year until the last several years - I now do it every quarter.

Monitoring is essential to me, now. That way I can see trends and changes immediately and take evasive action.

In August, 2004, I suddenly ended up in the emergency room with my blood sugar at 493! The truth is it was only suddenly because I'd stopped monitoring. I'd seen my blood sugar start creeping up several months earlier and had gotten tired of dealing with it and went into a state of denial.

I'd been floating with a diagnosis of 'pre-diabetic' for years. I was now diagnosed as a full blown diabetic on insulin! I could very well have ended up in a coma!

They started me on 15 units twice a day and I was to call in with my numbers every day until they were satisfied that I was managing my dosages and my blood sugar.

The doctor increased my insulin every day until I was at 45 units 2 times a day. And that barely worked.

The following week after the ER incident I went in for a pre-op appointment I'd had scheduled for an unrelated problem and my surgeon flat out refused to proceed. What I found out was that if you're diabetic - and particularly if it's not controlled - your risk of dying under anesthesia increase by 60%! She wouldn't put me on the table because the likelihood was, I wouldn't wake up from it.

60%!!!! Think about what that means if you were to have an accident or something happens where you don't have a choice about being treated! Those are high stakes!

I knew I had to get this back in control. I was just scared!

I knew that one of the things that worked for me short term was a high carb diet. But I also knew I couldn't stay on it for long. So I did a lot of reading - which is what I do anyway about everything. I had to find something I could live with.

So what are carbs? The Encarta Dictionary says: "A carbohydrate or a high-carbohydrate food." Not very helpful. Under carbohydrate is says: "any food containing carbohydrates, for example, bread, pasta, or potatoes." Also not very helpful for me.

Carbs are much more than that. There are simple carbs and complex carbs and processed carbs. Knowing the difference is everything for a diabetic. I have Nutrition for Dummies and The Idiot's Guide to Supplements next to my bed and use them all the time. Whatever resources work for you are the ones that you can use and feel comfortable with.

So where to start. I started ages ago with the American Diabetes Association (ADA) Exchange Diet which you can find out about at: http://www.diabetes.org/nutrition-and-recipes/nutrition/exchangelist.jsp. You can probably get a free book from your doctor's office on this.

The American Diabetes Association website says:

"A healthy diet is a way of eating that that reduces risk for complications such as heart disease and stroke. Healthy eating includes eating a wide variety of foods including vegetables, whole grains, fruits, non-fat dairy products, beans, and lean meats, poultry and fish. There is no one perfect food so including a variety of different foods and watching portion sizes is key to a healthy diet. Also, make sure your choices from each food group provide the highest quality nutrients you can find. In other words, pick foods rich in vitamins, minerals and fiber over those that are processed."

I knew from experience and monitoring what my body responded badly to. Sugar. Baked goods. Anything made with flour basically. So that's where I started. By removing these things as much as possible from my diet. I saw pretty much immediate results.

I increased the bulkier vegetables especially dark green vegetables: broccoli, brussel sprouts, spinach, greens, anything salad, cucumbers, etc.

I was off insulin in about a month and a half after being put on it and they were watching my numbers to see if they needed to give me oral medication.

I still had work to do. I didn't want to count calories or carbs and the ADA exchange is good for that because really all you're doing is keeping track of your servings and exchanges. It still wasn't working for me in the sense that over the years I'd also gained a lot of weight and it just was not getting me the results I needed in that area.

The ADA also publishes a great set of books which I have and love: the Month of Meal Series (you can find it at: http://store.diabetes.org/products/product_category.jsp?JSESSIONID=Dj20TmQJXvJ122uetmzxnUe82PeE1tieHm6NeyGjCh9O9W0uwDmY!-527711336!-1407451110!7005!8005&FOLDERfolder_id=2534374302023956&bmUID=1138996853164). I discovered this series at the Take Care Store at Group Health which also carries several other ADA approved cook books. These books usually have a good description of the Exchange diet and information on planning. The Month of Meals books have easy meals in a mix and match format with 30 breakfasts, lunches and dinners and a chapter on snacks that can be flipped back and forth to mix and match.

I still had problems planning and sticking with anything for an extended period of time.

I looked for a good nutritionist that would work with me regularly - I couldn't really find one that would work on a plan and help me with accountability. I knew what I needed was a way to plan my meals better, an exercise plan that I could work into my schedule easily, and accountability. I just do much better with someone to check in with.

So I was still looking. I knew what I needed at this point and was doing it sporadically, enough to bring my sugar down so the doctors were leaving me alone about that. My blood pressure was still up and I was convinced that the weight and exercise was the next hurdle.

At this point, my basic guidelines were:

• 5-6 meals a day.
• Meals that focused on lean proteins and vegetables with little in the way of starches.
• Work to remove all added sugar.

 

This made a huge difference but my sugar only was coming just so far down like this. And I wasn't really exercising yet.

I hate to admit that what finally has worked for me is something I found in an infomercial. Michael Thurmond is that guy on ABC's show Extreme Makeover that works with people to reshape their bodies and change their diet. He has an infomercial for the 6 Week Body Makeover (http://www.bodymakeover.com/6wk_howitworks1.aspx?mid=2&sid=73ec633085ab4081868fe39aec542a08). This is what I'm doing now. I thought at first it was going to be crazy, but basically, what I do now is:

• I plan all my meals, period. Nothing goes in my mouth without preplanning anymore.
• I log my food in a journal - every day, every meal.
• I eat every 2-3 hours - I've set an alarm on my cell phone to remind me. I even took it to with me to keep track of when I was supposed to eat.
• I eat several small meals a day.
• My main meals are basically protein, vegetables and a serving of a high fiber carbohydrate (i.e.: baked potato with skin, yam, jicama, something like that -- sometimes rice, but less often).
• My snacks in between the main meals are small.
• No added fat.
• No added salt.
• No added sugar.
• No dairy.
• I exercise 4-6 days a week (4-5 sessions of some kind of cardio and 2-4 sessions of resistance).

My blood sugar hasn't been above 100 more than twice since I started in October 2005 and as of Monday, January 30, 2006 I've lost 37 pounds! And my blood pressure is improving.

This is just how my body responds. Yours might respond differently. The most important thing is to listen to what your body tells you and pay attention to your monitoring. For instance, I know now that if I get lazy at night and decide it's okay to have a couple of egg whites, oatmeal and veggies for dinner, my sugar is going to be higher in the morning. Technically, that's still within the parameters of my program, but it doesn't work for me.

I cook for the week on the weekend now. I do several dishes with skinless, boneless, chicken breasts including throwing a batch of herbs, spices onion in meat in the food processor for sausages (this travels well and can be cooked into 2 ounces patties and grabbed for last minute needs) and a pot of oatmeal. The oatmeal gets portioned out into ½ cup servings in baggies and I just pack up the breasts in containers or baggies. Then every night, when I'm fixing my fresh veggies and potato for dinner and warming up my meat for dinner, I throw together 2 snacks and lunch to be ready to grab and go in the morning. I thought this would be about spending all of my time eating or thinking about food or cooking food, but in the long run, it's less time than I spent before on food and I'm not obsessing at all about what to eat.

I am still on meds for my high blood pressure, hopefully that will change as my weight changes. I'm not on anything for diabetes! In fact, at my last doctor's appointment I was told that I may no longer sustain the diagnosis! I didn't even know that was possible. It's amazing to me that you can turn your health around to such a degree that you're no longer a diabetic. I don't know yet what that means in terms of the possible damage I may have done to my body by getting to that point in the first place.

I was starting to have some signs of mild neuropathy - numbness in my hands and feet - hopefully that will improve. I know that I've drastically reduced my risk should I have to have surgery again. I know that some of the damage to your heart, kidney and other organs can be reduced or reversed. And I've drastically reduced my risk of having diabetes related blindness. Those are the things that basically 'scared me straight.'