Take This Guarantee and Shove It!

If you are diabetic and have taken to the internet, then you know there is a TON of information out there. It also seems as if most diabetes websites have a “community” aspect to them where you can create your own profile, establish a blog, network with new friends and chat via message boards….. kind of like a diabetic Facebook! The sites are nothing short of a lifeline for both diabetic “rookies” and “lifers.” I troll through the many message boards observing the themes associated with the different stages of type 2 diabetes. I do occasionally comment with the intent to ask a question, answer a question, share a recipe, offer encouragement, etc. I do have 2 rules in the thoughts I put out there 1) no negativity and 2) no confrontations. Yesterday, I semi-broke #2.

I read a message board entry that stated that all diabetic will experience complications, especially if diagnosed young How do you NOT confront that statement? It is like it reached out of the computer and slapped me in the face. If that is true, why am I counting Weight Watchers Points, counting carbohydrates, pricking my find 4-5x/ day, exercising like a mad woman, and why is a blog like this even necessary? Well, I’ll tell you why…. because, despite what my precious 15 year old stepdaughter says, I AM young. I was 31 when I had borderline gestational diabetes and I was 33 when I was diagnosed with type II. I am young and I know diabetic complications are not guaranteed to be part of my future. And, young or old (aka young at heart), I want you to know that the same goes for you!

That statement, even in all its inaccuracy, did raise a few thoughts about the nature of diabetic complications and how we are instructed to prevent them. Many of us have WONDERFUL physicians, I personally have the BEST ; ). However, due to the nature of their job, they give us a glucometer and refer us to a class or individual nutritionist where we learn how many carbs to eat, what kind to eat, when to check our blood glucose and the recommended ranges for blood sugar. Many of us walk away with the assumption that managing our blood glucose is all we need to do to prevent diabetic complications, I know I did. Good thing I am married to a medical student!

Mr. Man, a 3rd year med student, attended a luncheon this week featuring a leading endocrinologist. This gentleman discussed how doctors must begin coaching their diabetic patients to do more than just manage blood sugar. The management of blood sugar is for 3 things in particular – preventing neuropathy, retinopathy and nephropathy. These are 3 very serious common complications of diabetes; but, there are many others and 2 biggies are heart disease and stroke. As a diabetic, preventing heart disease and stroke goes beyond just managing my blood sugar. I, personally, needed to lose 85 lbs (I have 35 more to go). I had to use both diet and exercise so that I would lower my cholesterol (now 150, down from 282 – without medication), lower my blood pressure (now 102/78 without medication), lower my A1c (now 6.1, down from 7.2 without medication) AND lose weight. I am lucky that I quit smoking 3 years ago or smoking cessation would have been added to my to-do list. Obesity, lack of exercise, hyperglycemia and smoking are huge risk factors for heart disease and stroke and managing blood glucose only addresses the hyperglycemia. The guest speaker’s point was received loud and clear: If an diabetic does not lose weight, lower their cholesterol, stop smoking, and/or start exercising they will die from a heart attack or stroke; but, hey, their blood sugar will be on target.

I was diagnosed 10 months ago and just learning to control my blood sugar was all I could handle. About 3 months in I began the weight loss and exercising. You have to start somewhere with baby steps, one at a time. Tackling it all at once would have left me feeling overwhelmed and frustrated…… 2 emotions that are not helpful in the world of managing diabetes and preventing its complications. This is a marathon, not a sprint, and it requires more than just monitoring your blood glucose. My suggestion is to create a timeline for your attack on diabetes. How many months will you focus on learning what foods you can eat and how they affect your blood sugar? When will you begin exercising (what kind, how often, etc)? Once you have that habit in place, when and how will you begin smoking cessation? Give yourself time to adjust to each new baby step and then take the next step. As you step in the ring to fight the good fight…. know there is hope; the proof is in the #’s….. 80% of diabetic complications are preventable! You will find many, many others at all stages of the marathon and most will want to help and encourage you; and, when you are ready to take the next step and add weight loss, exercise, and/or smoking cessation…… well, we will be here for that, too!

Yes, as diabetics we have to do so much more that just monitoring our BG to stay healthy and prevent complications…… but, the good news is that these complications, 80% of them, are preventable. I broke my #2 rule, no confontations regarding others’ posts….. but I felt the message was worth every word!

Have a wonderful weekend!

The Dishing Diabetic

Test Strip Tyranny

I am going to step out on a limb here and say that having type II diabetes means facing a number of obstacles – emotional, nutritional and physical.  Upon diagnosis, the barrage of  emotions – shock, confusion, denial, anger, grief – is staggering.  It is not a stretch to say that life as you knew it is a thing of the past.  You now have to learn how to eat, drink, exercise, test your blood and the most optimal times throughout the day to do those things.  Nutritionally, you must learn how everything – food, drink, exercise, medication – will affect your blood sugar and how to modify each of those things address blood glucose readings that are too high or too low.  Physically, you endure the side effects of your new diet and the addition of exercise to your routine.  For me, I struggled to find the time to have type II diabetes and be a med student’s wife, a mother, a stepmother, and an employee.  This thing literally comes at you from every direction.  There is one source of constant feedback that becomes your lifeline….. your glucometer and test strips.  The ability to “TEST, TEST, TEST” (you will see this mantra on almost all of the diabetes message boards) allows a type II diabetic to know how their diet and their exercise affects their blood glucose levels without any side effects (technology is so advanced now that most of us don’t even endure sore fingers!).

I am going to go out on another limb and say that those that test are those that have made managing their diabetes and preventing diabetic complications a priority in their daily life.  Although the diabetic benefits the most from these efforts, the general population benefits as well.  Just research the biggest contributors to escalating healthcare costs in this country.  You will see the rising obesity rates and the dramatic impact they have on healthcare’s “bottom line.”  Anywhere you see the term “obesity,” diabetes, heart disease and hypertension (bit of humor: my sweet friend who is a nurse calls this the Texas Trio) are sure to follow.  The cost of diabetic complications is exorbitant to the patient, those that care for them and the healthcare system.  When you consider the financial cost and that 80% of diabetic complications are preventable it becomes apparent how imperative prevention is for so many reasons.  Prevention can not be accomplished by new legislation, healthcare reform, or by those that love a diabetic.  Prevention is up to each type II diabetic and those that are at high risk for developing the disease (pre-diabetics). Daily blood glucose testing is central to successful prevention.  It is a simple and painless method to help manage diabetes; however, always having supplies on hand may not always be so simple.

I recently called my pharmacy to refill my test strips.  I was told that my insurance company did not approve the request because it was too “soon” since my last refill.  WHAT?  ARE YOU KIDDING ME?  We are talking about little pieces of plastic that collect my blood.  We are not talking about pills, syrups, or anything else that could be harmful if not controlled.  We are talking about test strips.  We are talking about blood glucose management.  We are talking about preventing diabetic complications.  We are talking about decreasing the costs of healthcare associated with the 80% of diabetic complications that are preventable.  This just absolutely amazes me.  These things should be passed out like candy to diabetics.  There should be test-strip-bowls in every endocrinologist’s office just like the lollipop bowls at the pediatrician’s.  Of all the obstacles diabetics face, obtaining test strips should NOT be one. Those that test are those that have made managing their diabetes and preventing diabetic complications a priority in their daily life.  Those that test are making a responsible decision that affects their life, the lives of those that love them and they are contributing – with every single pin prick – to the effort to reduce the cost of healthcare in this country.

So, until my doctor puts out a test-strip-bowl, I am left with 2 choices.  1) Test no more than 3 times a day OR 2) end up going whole days without testing until my insurance agency gives my pharmacy the green light to dispense me my little pieces of plastic. I can tell you that neither option agrees with me and, I am going to step out on another limb here, I am pretty sure the thousands of people on all of the wonderful diabetic message boards would agree.  From what I can tell from these amazing folks, we are all working to stay off medications, to take less or be taken off medication completely, to lose weight, the lower our blood glucose levels….. to PREVENT the diabetic complications that are guaranteed if we do not successfully manage are blood glucose.  This management begins when we “TEST, TEST, TEST” our blood glucose.

This was more of a venting, slightly political entry.  I apologize if I have offended anyone.  Have any of you faced this obstacle and found a way to overcome it?  If so, please share.

The Dishing Diabetic

The Weight Loss Willies

Have you ever had a case of the Weight Loss Willies?  They can take many forms and usually present themselves when you are contemplating the need to shed a few l-b’s. The WLW’s work tirelessly to remind you of every reason the task at hand is insurmountable.  The # is too big, not enough time, past efforts have not been successful, etc., etc., etc.  The Weight Loss Willies only serve to distract you from focusing your energy to accomplish your weight loss goals.

I received a message from a sweet friend today.   She was responding to having read my blog.  Her message and questions are simple and a clear case of the Weight Loss Willies.  I have attached her message below and and my response follows.  As I re-read my response before sending it, I thought I would share them with all of you.  Please share your thoughts, success stories and how you have exterminated the WLW’s in your own weight loss journey!

Dear The Dishing Diabetic,

I love your blog. Diabetes hasn’t struck…yet. But I am more interested in your weight loss through Weight Watchers. I have about 80 pounds to lose (gulp!) and I’m having trouble not thinking “Oh my gosh, there is no way! That is like an entire person” so I just go eat more ice cream. Any advice?

I get to see your sister this week…I’m very excited. Next time you’re here visiting it would be fun to see you too!

Love,

Sweet Friend

Dear my Sweet Friend,

Well, I would be the one to ask about weight loss seeing as I have had to do it twice now! ; ) Before getting pregnant, my doc said I needed to lose 100 lbs. I made it to 93 before I got pregnant. Then, I found myself facing needing to lose 80 lbs last August. I have lost 48 so far.

If you only knew how many times I quit because a 6,7,8 lb loss seemed insignificant when I realized I had, say, 94 more lbs to lose. At the beginning of the 93 lb weight loss I tried something that I really feel made a HUGE difference.
I had 100 lbs to lose….. so, I made a list of 10 “rewards for myself” – 1 for each 10lbs loss. They grew in expense…. went something like this… highlights for my hair, new workout clothes, new sunglasses, ipod, Lucky jeans,….. my last one – which I have not reached yet, but, girl, I WILL – is a Diane Von Furstenburg wrap dress (good thing I still have 36 lbs to go, it gives me some time to start saving!!). Notice, that none of the rewards are food, that was the one and only rule. I knew I had a problem with consolation and rewards always being food, so this is how I broke that habit.

The best part was when I hit that 1st 10lbs, I wasn’t staring down the barrel of another 90 lbs, I was only facing another 10….. which I knew I could do because I had just done it.

It took 18 months, Sweet Friend. Patience – that is the only other thing I changed when I started what was to be my 1st successful attempt at weight loss. I am not a patient person. But the saying “you didn’t gain it over night, you won’t lose it over night” is so true. You are a busy wife and mom, you have a life, be patient….. it will work!!

So, break it down and be patient. You can do this. I know you can do this. Do you know you can do this?

One more thing, Sweet Friend. Add health to the reasons you are doing this. I know this is going to sound weird, but, go get your cholesterol checked. Then get it checked again when you hit a 40lb loss and again at your goal. I know we all love to fit in our skinny jeans, see the # we want to see on the scale, etc….. but, you are the mom of 2 PRECIOUS angels. When you see that cholesterol level come down (mine went from 282 to 150), you will feel like you did this for the only people on earth more important to you than yourself…… your hubby and babies. It makes it something so much more than just being “skinny”.

As for Weight Watchers….. I will live and die by that program. I do it online now, but I went to meetings when I lost the 93 lbs. I needed the weekly support. Do what feels best for you. If you choose online, do NOT hestitate to ask me anything, anytime! Also, I will be your support. I weigh in (on my scale in my bathroom with my hubby) every Thurssday morning. If you want to join me, we can compare progress, challenges,etc.

If you only knew how many times my sister and I have talked about how absolutely DROP DEAD GORGEOUS you are!! You really are, Sweet Friend!! I’ve got your back, sista!! When you are ready, you can do this. You WILL do this. Go Sweet Friend, Go Sweet Friend, Go Sweet Friend!!!

Love you, sweet girl!!

The Dishing Diabetic

Soft Taco Success

Ok, the term success may be relative here; but, hey, every baby step counts when you are a BWWD2 (Busy Woman With Diabetes 2)!  So, my main battle (or should I say WAR?) is with my daily fasting glucose level.  I average in the 140’s.  According to my endocrinologist this just doesn’t cut the mustard.  His recommendation:  eat dinner early, exercise after dinner and no snacking before bed.  My recommendation: ask him to come over and feed the tot, do the dishes, do the laundry and pack for the following morning while I take care of that!  ; )  When possible I will always do as he says; however, when impossible, I will do as I can.

This morning’s fasting glucose reading – 126!  Can I get a Woo Hoo?  So here is what last night looked like: 55 minutes on the elliptical at 6:15pm (Mr. Man was at home and he fed the tot and got her ready for bed) 8:15 Dinner – Soft Tacos:

1 lb Ultra lean ground meat, 1 chopped white onion – cook onion and then add meat and brown.  Drain.  Add back to pan with taco seasoning (follow directions on seasoning package).  Make sure to check carbs on the seasoning pack!  Mine had 4 carbs per serving and one package had 6 servings.  The little boogers add up when you  aren’t looking!

Toppings:  1 small avocado sliced, Weight Watchers shredded cheese, Light Sour Cream, jalapenos, canned chopped green chiles and salsa

1 Mission Carb Balance White Tortilla (these are WONDERFUL.  12 carbs/7g fiber per tortilla): fill the tortilla with 1/4 c. meat, 1 serving (1/3 c.) cheese, 1 Tbsp light sour cream, 1/4 the avocado and salsa, jalapenos and green chiles to taste.

Yes, I had a second helping which was everything above in a bowl minus the tortilla.  Now, some BWWD2 can have that 2nd tortilla.  This is labor of experimentation.  I am an exceptionally sensitive BWWD2.  I can tolerate about 1/2 the carbs recommended per meal for people with diabetes 2.  This conclusion was reached after numerous blood testings 2 hours after eating.

Confession:  I had 1 tablespoon of Nerds for dessert (yes, the candy and yes, I actually measured them in and ate them right out of a measuring tablespoon!). This contained 14 g carbs and was pure heaven I might add!

I wonder what this morning’s reading would have been under my doctor’s directions?  Tonight’s challenge:  Mr. Man is on call today; so, I will be eating dinner early with the tot and then excercising before I go to bed.  Let’s see what difference that makes….  I’ll let you know in the morning!

Here’s to your soft taco success!!

The Dishing Diabetic