Desperate Times Call for Critical Transformations…

After a series of (mostly) positive transitions in the past few months, my body was left feeling spent and terrible. Sugars were at an all-time high, my energy bottomed out, my carpal tunnel syndrome raging in both hands, joint aching, and my moods more variable than the Oregon spring weather. Even good change is hard.

But then I got some terrible news about my Dad.

Dad has been in heart failure for the past couple of years – he’s 58. Heart failure is a fatal condition in which the heart simply doesn’t have the capacity to keep up with the rigors of running a body. Also a type-1 diabetic, Dad spent years neglecting his self-care and that neglect had serious consequences: heart disease, eye disease, kidney disease, you name it. He is now biologically much older than his actual age and his quality of life sucks.

There was some (though not much) hope that his quality of life and longevity could be spared through either a heart transplant or a less-invasive procedure, a heart pump. However, a few weeks ago, Dad got rejected for both procedures. His weakened state and history of high blood sugars made it unlikely that he could withstand the anti-rejection drug regimen that follows a heart transplant. His high risk of infection made him a bad candidate for the pump because there are components of the pump that exist outside of the body (think open wound). Without either of these procedures, Dad is destined for few remaining years, which will be of poor quality.

What does this have to do with my diet? 

It is now more important than ever that I get my diabetes and general health in order for two reasons: First, Dad wants to see me healthy and happy before he goes. He has been an amazing (ah-mazing!) source of emotional and logistical support in both my move to Oregon and my transition into private practice (yeah, still working on that – anyone need a lawyer?). He needs to know I’ll be alright, and it’s my responsibility to get there. And although I absolutely want this for my own reasons, be it performance, aesthetics, and quality of life, Dad’s circumstances have slapped me back into the reality of doing the hard work. Ladies and gentlemen, we have exigency. 

Second, Dad’s poor prognosis has shined a spotlight on my own health and the potential consequences of continued diabetes mismanagement. For those of you who don’t know, diabetes effects everything. From your eyesight to your hydration to your circulation. Everything. Dad serves as an unfortunate bad example of how I may end up if I don’t get my act together and figure out this diabetes thing. So yeah – the bad family news and my own poor health resulting from crippling stress served as a pretty legit wake-up call. And getting my act together starts with the food I eat.

It Starts With Food

Let thy food be thy medicine, and let thy medicine be thy food.  

~ Hippocrates, 460-377 BC

It is no mystery that our quality of life is deeply associated with the quality of our food. When I am stressed, I go straight for low-nutrition convenience foods. Needless to say, I’ve been feeling terrible – my 14-day BG averages have been hovering between 185-200. Yikes.

I conducted a little experiment: I switched over to an almost exclusively plant-based lifestyle with an emphasis on whole foods for two weeks. I have been flirting with the idea of going vegan for a little while now and it wasn’t a hard thing to do, given that I have been an on-and-off-again vegetarian for the past decade.

Why Plant-based?

There is a litany of reasons why I am choosing a plant-based diet. In short: proven health benefits, nutrient efficiency, respect for my animal neighbors, and to protect the environment. It also limits my food choices – when you’re vegan, you’re not burdened with a sort of decision overload with food.

The Results

I have gone from a 14-day average of 200 down to 160 in two weeks. I have more energy. I feel lighter. My moods are evening out. My sleep has improved. Can I attribute all of this to a plant-based lifestyle? Not quite sure yet because a lot has been going on lately and I’m only just starting to carve out my new routine.

Of course, I’m wondering as much as you are,“can I even pull this off?” There are scores of diabetic athletes, including members of Team Novo Nordisk, diabetic vegans such as Adrian Kiger and Melissa from Type1Vegan, and vegan athletes such as Rich Roll and Matt Frazier, the No Meat Athlete, but where are the diabetic vegan athletes? Those sound like unicorns.

Can I be that unicorn? Let’s find out.

Merry [Pump] Christmas!

merry christmas batman

After eleven stinking months of bitching at strangers on the phone, switching over to Oregon Health Plan (due to losing my job at the shitty, shitty restaurant), and fulfilling all of the compliance requirements in order to be approved for a pump by Kaiser’s weirdo DME committee….

I FINALLY HAVE A NEW PUMP!!!

Allow me to introduce you to Mister Plum, my brand-spanking new Medtronic Revel 523:

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What a handsome little fellow!  

This little monster is CGM-compatible and comes loaded with new, handy features (and complimentary gadgets) that will improve my diabetes management, including:

  • Post-meal BG reminder:  My A1c was recently rose back up to a dreadful 9.0, and my endocrinologist determined that a large part of the problem is my failure to test after meals. I simply forget. This function allows me to set my pump to squawk at me two hours after I eat, so forgetting is out of the question. The sooner I catch highs post-meal, the better I can control my overall sugars until I can determine what I’m doing wrong to get high post-meals in the first place. So stoked.
  • Capture Event function:  This function lets you capture certain moments in time that can be incorporated into your overall trends, such as BGs, exercise, insulin intake, and meals.
  • Missed Meal reminder:  If you have a problem forgetting to bolus with dinner, you can set a span of time to remind yourself to do so.  This is not as helpful for me at the moment because I do not eat at the same time every day.  Also, I generally do not forget to bolus with meals.
  • Bayer Contour Next Link blood glucose meter:  I *love* this thing:
    • The lancet device is less painful and the strips require much less blood than One Touch Ultras.
    • This meter is programmed to automatically ask you to categorize your reading as “Before Meal” and “After Meal” before you even see the reading itself.  This makes it easier to analyze whether you are off on your basal, carb-to-unit ratio, or are possibly in need of a carb-counting refresher.
    • Additionally, this meter has a built-in USB port, and communicates with your pump when plugged into the computer.  And now that CareLink has been upgraded to be more Mac-compatible, I will be able to get a better sense of my overall trends and behaviors.

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BG Reminder!

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The fancy Bayer Contour Next Link BG meter.  My new love. 

Lessons Learned

If you are in pump purgatory as I was, hang in there.  Be patient with the health administrators on the ground who are trying to get this done for you.  I promise you that they want to accommodate you, but because of the administrative hurdles instituted by top-down execs who mercilessly seek to cut costs, it will take time.  Try to humanize yourself to administrators to gain their sympathy (read: cooperation) and remind them why you are an excellent candidate for insulin pump therapy.  As an athlete, I argued that my dynamic and active lifestyle would be jeopardized by the constant eating you have to do while taking long-acting insulin* injections.  You can’t ramp down your insulin intake after you’ve taken a shot, so if you decide on an impromptu bike ride or random mountain climb, you have to eat beforehand or you’ll go low.  This makes weight management difficult, which in turn can affect how much insulin you require in the first place.  It’s a cycle, and remind them of that.  Keep your head up! 

Here’s to great control in the future with my new gadget!

Photo Credit: memecenter.com/keptinkurk

*Nota bene:  I am not full-scale attacking syringe-based insulin therapy.  Many respectable athletes use long-acting insulin.  I just believe that you have to be extremely regimented to make it work.  I am not.

Video: Get Sugar Smart

This is a wonderful video by Prevention Magazine that shows you the different amounts of added sugar in whole versus processed foods.

There is sugar hidden in pretty much all processed foods – even savory foods, which are then balanced out with copious amounts of salt. It is things like this, coupled with dubious advertising, that can make controlling your diet very complicated: As a young child, raisins were advertised as “Nature’s Candy,” a healthy alternative to sweets. However, based on the amount of sugar they contain, they are no different. Pulling ourselves out of this paradigm of life-long programming via advertisements is a challenge for us all.

The only way to effectively control your sugar intake is to eat as much of a whole foods diet as possible. Skip the processed juice, and go for the apple.

Sunday Stats: Week of March 16, 2014

Sunday, Bloody Sunday…. self-disclosure time!
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There is a lot of anecdotal evidence showing that people who track their fitness see more progress, likely because they know how they measure up against their goals. Now that I am starting to develop a fairly regular health and fitness routine, I’ll be publishing my stats every Sunday to track my progress. They’ll be pretty basic to start – weight and BG stats for now. Next week, I’ll start tracking the inches ((shudder)) and RHR. Also, I’ll be posting about my goals in the near future…

I have a quarterly appointment with my endocrinologist in April, after which I’ll publish many of the same stats I posted in my Baseline Assessment. I would loooovvveee to see my a1c below 7. Fingers crossed.

WEIGHT: 152 ((sigh))

DIABETIC STATS:
     7-day BG average: 181
     14-day BG average: 190
     30-day BG average: 216

     Before Meal 7-day average: 131
     Before Meal 14-day average: 146
     Before Meal 30-day average: 178

     After Meal 7-day average: 241
     After Meal 14-day average: 254
     After Meal 30-day average: 282

     Lowest BG of the week: 40
     Highest BG of the week: 344

THOUGHTS
I’m liking the overall downward trend of my diabetic stats, particularly my pre-meal BGs. I’m down 15 points for my baseline 7-day average of 196. Unfortunately, this was the only stat I took down from my meter to establish my baseline – I’m excited to see what my 14-day and 30-day averages are going to look like next week!

I clearly need some improvement in the After Meal category, as this seems to be the major source of my high BGs. This could be an issue with carb-counting, my carb-to-unit ratio (currently 1 unit of insulin for every 12 grams of carbohydrates), or a little of both. I suspect the most likely culprit is carb counting. It is not even remotely an exact science, and I am in need of a major refresher. Luckily, my endocrinologist referred me to Kaiser Permanente’s nutrition department, and I will be setting up an appointment soon.

Nota bene: A lot of my lows are going unreported. When I was without health care, I had to severely cut back on my blood sugar testing to conserve test strips, so I was taught not to test for lows because I don’t need a meter to know when I’m low (hot neck, cranky, sweaty, disoriented, HANGRY).

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I will be getting in the habit of testing for lows to show that trend to both my readers and my endocrinologist. While we’re on the topic of evil, evil lows, I’ve been having at least one hypo a day for the past four or five days, and I am not a fan of this trend. Lows feel like shit on a stick.

Anything else you guys think I should be tracking on a weekly basis? Chime in and leave a comment!

Photo Credits: ideasmile and http://efficientawesomeness.com/

Assessment: Establishing My Baseline

“You can’t know where you’re going until you know where you’ve been….”  ~ Someone Marginally Intelligent 

Thus, I commence my journey back into being an athlete.

But, before I set my fitness and health goals, I think it’s important to establish a baseline for both health and fitness. This is the health portion of that assessment.  As I learn more about what it means to truly self-assess (read: not beat up on myself), I will incorporate more information (for example, a postural assessment).

Without further ado and in my science-y style, I give you my deplorable health stats:

General Physical Stats:
Overall Weight: ~150 lbs. ((sigh))
Height: 5 feet 3.75 inches
Body Mass Index: 25.7*

*Thoughts: Many people believe that BMI is a flawed measurement.  For example it does not account for the relative density of individuals with differing percentages of fat and lean tissue. I tend to agree. According to the BMI, I am technically overweight. I am not – I am a short woman with dense, muscular legs (for the record, I am a size 6, considered to be pretty average).  That being said, Furr.is.out.of.shape.  But Furr will win. 

Measurements:
Bust:  35.5 inches
Waist:  32 inches
Hips:  42 inches
Thighs:  25 inches ((thunder clap))
Arms:  12 inches

Thoughts: Nothing to see here, folks, move along ((thunder clap)).  I will be taking a “before” picture of myself – this is essentially that “before” on paper, so that I may track my progress in terms of shrinkage, of which I don’t plan on doing much of.  However, I will not be posting such a picture until I have made some visible progress, for insecurity’s sake. 

Aerobic Stats:
Resting Heart Rate (RHR):  84 bpm (beats per minute)
Maximum Heart Rate (MHR):  (220-age) 190 bpm
Lower Range of HR (50%):  0.50(MHR – RHR) + RHR = 137 bpm
Upper Range of HR (85%):  0.85(MHR – RHR) + RHR = 174.1 bpm

Thoughts: I don’t know much about the meaning of these numbers quite yet.  It does appear that my RHR is higher than most.  I’m not sure if this is a good or a bad thing. 

Diabetic, Metabolic, and other Medical Stats:
Hemoglobin a1c:  9.3
Average Blood Glucose (BG) This Week:  196 
Highest BG:  432
Lowest Recorded BG:  68

Thoughts:  Plain and simple, these numbers SUCK.  

Thyroid:  3.12
Cholesterol:  207
HDL Cholesterol:  65
LDL Cholesterol:  144
Triglycerides:  85

Thoughts:  One of the few happy revelations that came out of my [first] endocrinologist appointment [in four years] is that it appears I do not need to be on thyroid medication.  Good times!  Otherwise, all of these levels are normal, but on the higher end of the range.  My goal will be to reduce them generally.  Interestingly enough, my triglycerides are closely connected with BG levels, so I hope to see a quick reduction there. 

There you have it.  My health on paper.  These should be updated quarterly, and I’m excited to see what my new lifestyle will do change these numbers for the positive.

Namaste, suckas.