Showing posts with label diabetes. Show all posts
Showing posts with label diabetes. Show all posts

Tuesday, March 12, 2013

The Old Perspective

Today was one of those days where I realized how old I am...which is not, this time, really a bad thing, just an observational thing.

First, I attended a nutrition class this afternoon, at Kaiser.   This was where they give you all sorts of written material and go over "food exchanges" for you and suggestions for how to keep carbohydrate intake in check.

The room was full (the last class I attended was just two of us).   Most were old farts like me and many seemed confused by the information they were being fed.  One woman, who glowered for the first 45 minutes and then stalked out of there, seemed to have no concept of taking glucose readings.  Others couldn't seem to get the idea that "1 exchange" didn't mean that was all you could eat, but that you had to combine it with everything else to figure out your ideal intake for the day.

I sat there half listening and wondering exactly how many times, in my lifetime, I have heard similar talks or read similar things on the various diets I have followed throughout my life, or at least the last 60 years (since I went on my first diet at age 10).  Food exchanges are the backbone of many of the versions of the Weight Watchers diets I've been on.  Other than getting the helpful written lists of exchanges, there was nothing new in this material for me, and I just kind of sat in amazement at how many people were having difficulty grasping the concept.

On the drive home, I was listening to NPR and heard that the latest craze among young people is cameras.  You remember cameras?  The non-digital kind.  The kind you put film in.  The kind where you can't see your pictures until it comes back from the corner drug store or wherever it is that you used the take film.  I thought it was impossible to get old time cameras and even more difficult to find somewhere that can develop film, but apparently not.  The radio announcer said this is not a nostalgia wave, but kind of an "everything old is new again," with teenagers who want the old time look that they can get on Instagram, but want the whole experience. Just when I'm so thrilled at the quality of digital photos!

INTERESTING ASIDE:  Also on NPR on the ride home, something which has nothing to do with my feeling old, but which I found fascinating.   Professor Randall Thompson of St. Luke's Mid American Heart Institute in Kansas City has been performing CT scans on mummies, over 4000 years old, from all over the world -- Alaska, the American Southwest, Peru and Egypt.  Of the 137 examined, 47 (34%) showed signs of atherosclerosis (clogged arteries). "The fact that we found similar levels of atherosclerosis in all of the different cultures we studied, all of whom had very different lifestyles and diets, suggests that atherosclerosis may have been far more common in the ancient world than previously thought," says Thompson.

Here we are, not smoking, following a sensible diet, avoiding fats, and exercising regularly to avoid atherosclerosis and it turns out that it may be inevitable in some people anyway!  Pass the McD's fries and the Sees Candy, please...

So, back to me feeling old.  I stopped at the supermarket to pick up a few things.  One thing I found was that I was mistaken about those $16 mushrooms.  They were apparently special ones which had been sold out when I took that picture.  Today the sign still there, but the mushrooms were the wide, flat-surfaced ones which were next to the ones I thought had had the humongous leap in price.  I feel better about that!

While I was wandering through the fresh produce aisle, I ran into Shelly and Ellen, with whom I had not visited in some time, so we stopped to chat. They told me that they had participated in a rally at the Galleria in Roseville last weekend.   A week ago, two men were evicted from the mall because they were holding hands and kissing.  

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Needless to say, the LGBTQ community was up in arms and decided to show the Galleria that this was not the kind of discrimination that they would take lying down.  No young heterosexual lovebirds have ever been evicted for showing affection.

Plans for a demonstration, first called a "kiss in" and then changed to (I think) "Love is Love" was organized.  Naturally Shelly and Ellen were there and they were amazed that over 300 people showed up.

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The organizers were disappointed at the "small" turnout; Shelly and Ellen were amazed at the large turnout.  They remember the days when they would invite 1,000 people to a demonstration and be happy if a dozen showed up.

Not only that,but the mall was totally in support of the demonstration, served the demonstrators hot chocolate with whipped cream and Mrs. Fields gave them cookies.  They had given sensitivity training to their employees.   They even flew in the guy who may have been the only gay guy in their upper echelons they could find, but they flew him in from Los Angeles to address the crowd and talk about himself and his boyfriend.  There was lots of support of "straight allies" and the press gave good coverage to the event.

The the three of us were kind of laughing about this thing when I asked them if ten years ago they could ever, in their wildest imagination picture what is happening now, with lots of states approving same sex marriage, the President encouraging the Supreme Court to overturn California's odious Prop 8, and even Clinton saying he was mistaken in signing the Defense of Marriage Act and saying that it should be overturned.

"Modern Family," which has a gay couple raising a child is the most popular comedy on television and has won lots of awards, including awards for its gay characters.  It's difficult to find a regular show on TV these days that does not have a gay character.  So far the horses have not run crazy in the streets.

The tide is turning and it seems impossible to realize how far the gay community has come in a short period of time.  It seems that things are snow balling now and there is a whole new set of problems about to come up...that being what happens if DOMA is overturned...that will open so many doors to so many different rights that it will take years to sort it all out.  

I hope that by the time Brianna is in high school, she won't understand what the fuss was ever about in the first place.

But I feel very old because I remember the Valentine's Day demonstrations at the County Recorder's office, when a handful of people showed up trying to get marriage licenses while the police had to hold hostile angry men at bay to protect the demonstrators and big buses sat outside trying to keep people from supporting the demonstration.

Now they serve the demonstrators snacks and fly gay representatives in to talk with them and give their employees sensitivity training. The old gay and lesbian activists are being replaced by new young enthusiastic people. Times they aren't just a-changing, they have a-changed!


In case you want to disprove the theory that a watched pot never boils, you might want to check out this web cam, a barn cam of KpM Horses, owned by my friend Karen Malcor-Chapman.  Nana, the mare in the upper right stall is past her due date and is scheduled to deliver any. minute. now.   I've been watching Nana for 3 days now and I'm sure that she will deliver while I'm at my mother's tomorrow and I'll miss the whole thing, but in the meantime, I keep watching her for suspicious activity.

Tuesday, December 11, 2012

The Numbers Game

I don't think I've ever written here about diabetes, but it's time.   I was diagnosed with Type II Diabetes over 10 years and 3 doctors ago.   Actually it was me who requested testing.  I asked my then-doctor (who, for obvious reasons, is no longer my doctor!) if he didn't think I should be tested.   My father had Type II diabetes, I said, and I pointed out that I was morbidly obese (weighing over 300 lbs at that time), and it seemed to me I should be tested.  The doctor looked kind of surprised and actually opened my file to check my weight to see if I was, indeed, morbidly obese.   Good grief...was he blind?

Anyway, surprise, surprise, the A1C came back showing that yes, I was not just pre-diabetic, but actually full blown Type II diabetic.  In all honesty, I can't remember getting any instruction from him other than to watch my eating and exercise more.  I was very dissatisfied with him as a primary care physician and when John, who had been a Sutter doctor and whose Internal Medicine office had been next to mine when I was managing Women's Health, joined the Kaiser staff, I requested a switch to him and promised to be a 100% compliant patient.

And I was.  John had me taking classes to learn about diabetes and I went to Weight Watchers and lost buckets of weight.  I took up biking.  I don't remember doing a lot of glucose testing, and I don't think John had me on any medication, but apparently I was doing all right.  I was working for Dr. G at the time and he told me if he were my doctor, he would have had me on insulin, but he could see that I was doing all the right things.

Well, John left Kaiser and started a high priced weight loss/obesity clinic and I was assigned another doctor.

In all honesty, I'm kind of neutral about this doctor, though she has been my doctor for years now.  She really knows very little about me and it seems to me that I am just a bunch of numbers to her.   She has never asked anything about my personal life (she has no idea I have two dead children, for example, compared to my gynecologist, who takes time to chat and ask me how things are going and who is well aware of Paul and David).  Dr. A and I never "chat," but she just checks the numbers and tries to get the medication, which she has put me on, dosage right.  But, to be fair, I haven't kept up my end of the bargain either.  I rarely followed through when she requested lab tests because I knew they were going to be bad.  I went for a few years without taking the meds at all, and doing no testing.  I lived in blissful ignorance.

But I had a scare recently (which turned out to be just a bladder infection) and it was kind of a wake up call.  I decided it was time to try to take charge of this diabetes thing. 
I went home from the appointment and did glucose testing for the first time in a few years.  You know what a slot machine looks like when you hit the jackpot?  All the lights go off and things to round and round and bells ring? If my glucose meter had sound and lights, that was what it would have looked like.  My blood sugar was so high (over 400) that the meter apparently didn't go up that high.  I just got a  dire warning to see my doctor NOW.

I started getting serious about the medication.  Within a couple of weeks, I had brought my numbers down to the low 200s, which, while still way too high, was at least heading in the right direction.  As for diet, well, some days were better than others, but more "less good" than "better."

By the time I saw the doctor again, All of my numbers were starting to look much better.  My cholesterol was OK, but the HDL (bad kind) was still too high.   My A1C, which measures the bood sugar over the past 3 months, which should be 7 and which had been 13 the last time it was measured, was now 8, still not where it should be, but definitely going in the right direction.  Of course Dr. A never gives me positive (or negative) reinforcement.  She just notices the numbers and suggests action, without editorial comment.

Dr. A set me up with Heather, who teaches a diabetes class.   There were only two of us in the class and one thing I learned was that each doctor has his or her own diabetes rep and that Heather was my doctor's rep, while the other woman had another rep, so at the end of the class, she gave the other woman the name of her rep and let her go, while she kept me another 30 minutes and I had a personal one-on-one session.

Heather has changed my life.  The answer?  Technology!   She reminded me that my glucose meter can be hooked up to my computer, which will download all the readings and put them in a graph form to help me see patterns and adjust diet accordingly. As I told her, I may have difficulty sticking with a program, but give me a computer thing and I'm there, Baby.  I ordered the cord that allowed me to connect with my computer.

I'm now testing my sugars several times a day...before breakfast, sometimes after breakfast, sometimes before lunch, always before dinner, and before bedtime (unless I forget).  The before dinner number is a great help because if it's high, I eat less.   My target range should be between 90 and 150.

I learned my lesson on the day when I woke up feeling so good because my sugar was 119, but then I snacked on Cheetos and when I tested before dinner, it was 277, the highest it's been since I got below 200!  I had a small dinner and brought it down to 156 by bedtime and then starting afresh at 113 the next morning.  Good me.   That day was so good my sugar was 116 at dinner and low at 73 before bedtime.  I had 1/2 cup of orange juice and brought it up to 93 before going to sleep.  This morning it was a nice respectable 110. 

For breakfast I had 1/2 cup of Grapenuts and 1/2 cup of blackberries with a bit of Splenda.  I tested an hour after eating and it was 234!  WTF? 

I wrote to Heather, who explained that testing 1 hour after meals (though somewhere I read that was recommended) is too soon, because food is still digesting, so she recommends only testing before meals to get a more accurate reading.   It's just great having someone available to answer questions more or less instantly.

I feel like my life has become numbers but, you know what?  It's actually fun figuring this all out.  It's a painless way to finally take control of my diabetes.  If I can begin to make sense of the pattern of what is causing the highs and lows!