The Rambling Road: Plant-based

Posted on 3 January 2020 by dlhitzeman

Over the past several months, I’ve made a significant pivot in my diet toward eating more plants. This isn’t to suggest I’ve become a vegetarian because I still eat meat, but I do so less frequently and in less quantity when I do.

Making this pivot has been a mixed bag. On the positive side, I find I feel better most of the time, I am having an easier time maintaining my weight, my sleep is better, and I have more energy. On the negative side, I find I have a much harder time maintaining my glucose levels on any given day owing to the fact that plants are, by their nature, higher in carbohydrates.

Even with the glucose struggle, I think the benefits outweigh the downsides. Coupled with intermittent fasting and adequate exercise, I think the long term effect will be more weight loss and improved health. To that end, pursuing this course more aggressively is one of my singular goals for the coming year.

I will report back on how it is going.

DLH

The Rambling Road: Documenting Progress

Posted on 14 February 2019 by dlhitzeman

I had a medical appointment yesterday, which in itself is not remarkable, but that revealed a very good result.

I should back up a step and explain that, since about June of last year, I have altered my approach to managing my physical maladies, adopting a very low-carb diet(1) and following an intermittent fasting schedule(2) along with ramping up my physical activity. These changes flowed into the fact that I also started taking a pair of antidepressants in October that helped clear my head so I could focus better on what I am trying to do. Finally, in December I started taking Trulicity in addition to insulin and metformin

When I got out of the hospital a couple of years ago, my A1C was 8.5 and my blood glucose was running in the 450s mg/dL (yes, I am aware of how dangerously high that all is). At my last appointment, my A1C was 7.1 and my blood glucose average was around 180 mg/dL.

Fast forward to yesterday, and after about 9 months of focused effort, my A1C has dropped to 6.6 and my blood glucose average sits at around 161 mg/dL.

The moral of the story is that, if you are suffering from similar issues to mine, there are methods to overcome the obstacles those issues present. The right combination of medications, diet, and exercise can pay huge dividends in a short period of time and offer the promise of remission if not recovery.

DLH

(1) I try to keep my daily intake of all carbohydrates between 20 and 40 mg a day and do so by avoiding all sugars, modern grains (basically, anything containing wheat or rice), and manufactured foods. In general, I also try to keep the foods I consume in the low Glycemic Index range (below 55). Foods called Brassicas (broccoli, cauliflower, cabbage, and the like) are great for this.

Understand this kind of diet can be a huge adjustment, and if you decide to try it, there may be a period of transition where you experience symptoms similar to coming down with the flu. Also, if you have other health issues, be careful not to make them worse by following this diet. Be sure to consult your health care provider as you move forward.

(2) There are as many opinions on intermittent fasting as there are people who try it, and I don’t have a specific recommendation of where to start, but in general, the idea is to limit your calorie consumption to a narrow window once or twice a day. For me, this means usually eating one big meal between 2 and 4 and another smaller meal about an hour before bed (this helps level out overnight blood sugar spikes). These meals can vary somewhat based on my daily schedule, but in general results in there being at least 12 hours and as many as 16 hours between caloric intakes.

This method of eating helps encourage your body to take advantage of its already extant biological pathways that are part of the “feast and famine” experienced by our ancestors. Doing so helps our bodies use calories more effectively and, once you get into the habit, often results in eating less.

The Rambling Road: When excuses aren’t excuses

Posted on 13 December 2017 by dlhitzeman

A more bitter part of me wants to demand that, before anyone gives anyone with a chronic or enduring illness advice about what they should be doing, they should have to live through my past couple of weeks before giving it.

Now, before anyone panics, it’s just been a tough couple of weeks. I’ve been caught in what I call an “autoimmune loop,” first triggered by allergies, then flowing into everything from debilitating insomnia to blood sugar spikes and crashes. Good times…

I will grant, that having endured that, I’m particularly sensitive when people start throwing around, “Well, all you have to do is…” advice. I admit it. It pisses me off. After spending two weeks feeling like you’re a combination of drunk, high, coming down with the flu, and hopped up on way too much caffeine, that kind of advice hits wrong.

But I’m also listening, and in the course of listening, I have my own advice. I understand those of you trying to help people like me mean well. You sincerely want me to feel better. You believe you have answers, and the fact is that you do.

You’re also not listening.

Almost every conversation I’ve ever had with someone who believes they know how to fix me revolves around a single premise: everything I have to say about why their advice is a struggle is an excuse. I’m here to tell you, no, it’s not.

Yes, I can be doing more than I am. Yes, sometimes, I have to push through the terrible consequences of my current state of health in order to make it better than it is. That is true.

It is also true that, when my blood sugar crashes while I’m walking around the grocery store, so I have to cling to my cart like a lifeboat, and thank God my wife is with me to drive me home because I might not have made it otherwise, and I’m still shakey more than 24 hours later, it’s not an excuse. This stuff really happens. It really does limit what I am able to do. I have to keep in mind that every expenditure of effort I make comes with a cost I have to pay, sometimes for days. That’s not an excuse. It’s reality.

All I am asking you well meaning people to do is to understand that. Modify your expectations by the reality of the health I have right now. Not the theory of how healthy I could be. Not with a guilt trip about how I’m unhealthy because I did it to myself. With the fact that, right at this moment, what I’m experiencing is what is.

Help me with my reality. That will actually help.

DLH

The Rambling Road: A question of precision

Posted on 2 April 2017 by dlhitzeman

Having medical conditions often means medication, and taking medications often means a level of precision whether we realize it or not. Each medication has its own, often unique, requirements for administration that are often, in some way, in conflict with any others.

Add into this the human propensity for mistakes, and you have a recipe for disaster. In my case, this morning, it was a matter of injecting the wrong dose of my long-acting insulin, to the tune of 22 more units than I should have taken.

In isolation, this is not that big of a deal. I will have to keep extra track of my blood sugar throughout the day to make sure it does not drop too far, and because I can’t afford not to stay on track with my regular doses, I will have to make sure I eat enough calories tonight to see me through until morning.

That said, while I happened to notice this mistake and can compensate for it, I wonder how many times I may have made similar mistakes–taking a once a day pill twice or other instances of taking not enough or too much insulin–since this process began.

The fact is these mistakes pile up. Over time, we can’t help but to make them, and they start to have an effect on our health just as surely as the diseases we are treating. It’s an important thing for patients and medical professionals to consider for anyone battling disease.

As for me, I will redouble my efforts to pay attention. That’s the best I can do.

DLH

The Rambling Road: Thirty days

Posted on 17 February 2017 by dlhitzeman

I realized last night, as I finished my first vial of Lantus, that it’s been a month since I got out of the hospital. I’ll admit, it seems a lot longer, and I will also admit that I am frustrated to report that, even a month later, I am still recovering from those events.

That I am epically impatient is both well known and an understatement, but the fact is I can’t help but wonder if some of the things I’m experiencing now are in some way permanent or caused by some yet to be diagnosed condition. It’s always bad to borrow trouble, and I’m told I need to be patient, but I can’t help but think about the negatives.

That said, today it will be 60 degrees outside, which means a walk or even two. That’s not a bad way to celebrate a month out, even if it is with misgivings.

DLH

The Rambling Road: A pain in the…

Posted on 12 February 2017 by dlhitzeman

One of the things I had never considered about having a chronic condition like diabetes is that it is painful, not as much in the sense that the condition itself is painful, but in the sense that the treatment is.

I’ve already learned the lesson of ignoring it–or perhaps enduring it–but at least three times a day, I have to prick or stab myself to check my blood sugar or administer insulin. The fact is these events hurt, not a lot, but still, and I find that pain has an accumulative effect on one’s outlook on life. Now I understand a little better why the people with chronic illness act the way they do.

And it’s not just a matter of physical pain either. There’s further the metaphorical pain of paying for medication, the mental pain of having to be disciplined with diet and exercise even when you don’t want to, and the emotional pain of having to deal with the fact I’m sick with something that is, to a great degree, my fault.

This isn’t a troll for sympathy or a depressive mea culpa. Instead, it’s an acknowledgement this sucks and a warning to everyone who is not this way to avoid it if at all possible. This is preventable pain, but it takes some work and dedication to make sure it doesn’t happen to you. Because, the fact is, this is a pain in all the wrong places, and I don’t recommend it.

DLH

The Rambling Road: Keep your blood sugar in check. Seriously

Posted on 7 February 2017 by dlhitzeman

One of the more disconcerting experiences I’ve had in this journey so far is moments when my blood sugar has been out of check due to various factors ranging from the unknown to my own stupid behavior.

Now that I am on medication and insulin to regulate things, I can tell almost immediately when things go out of whack. When things get too low, I get weak and shaky quick, and when things get too high, I get bone-crushingly tired to the point I have to lay down or I’m going to just sleep where I am.

Unfortunately, this is a new normal for me, but one that has specific and enduring ramifications for anyone trying to be healthy. My own body’s reaction may be extreme, but you may recognize the symptoms in how your own body reacts to food and activity. Those reactions aren’t normal and I implore you to consider them carefully to avoid having to go what I have gone through.

I will be the first to acknowledge that better eating–the real key to blood sugar management and to avoiding a whole host of chronic illnesses–is time consuming, expensive, and sometimes downright boring. It is also one of the best choices you will ever make.

If I may be so bold, consider the following as a minimum: stop drinking sugared beverages of any kind and stop eating refined sugars. That change alone will pay dividends you can’t imagine. If you want to go beyond that, read food labels compulsively (there are plenty of websites out there that will help you learn to understand what’s making you sick) and eat vegetables like it’s your religion. If you want to go all the way, only eat food that you know who grew it. I promise. It will make a difference.

It will be worth it if you do. You don’t have to learn the hard lesson I have.

DLH

The Rambling Road: Experiments

Posted on 31 January 2017 by dlhitzeman

Last week, I learned the hard lesson of not eating too much at one time, something I hope I don’t soon forget. But, the experience got me to thinking about the side effects, especially as they relate to my blood sugar that I am monitoring twice a day.

When I went into the hospital, my numbers were dangerously high (along with apparently everything else being dangerously out of whack…), but a regular course of insulin injections brought them down to more manageable levels. Since I’ve been home, my numbers have still been high, but far better than they were.

What I wanted to find out is whether I could affect those numbers even more by changing my approach to what, how, and when I am eating, how much water I am drinking, when I am taking related medications, and how much physical activity I am getting.

Granted, those are a lot of variables to monkey with at once, but they all have a common component of metabolism, and metabolism is a key factor in my greatest risk factor, that being the fact that I am still well overweight.

As things stand now, I am waiting to eat until I am discernibly hungry, which means that I don’t have a regular meal time schedule as it is difficult to predict when I might be hungry. Further, I am consuming massive amounts of water, right now at least a gallon to a gallon and a half a day. I also increased the time between doses of my medication to spread it more evenly through the day. Finally, I am using a regime of “natural movement” exercises to increase my physical activity as I build up the stamina to do more.

I have been following this plan for about three days now, and the result is that my blood sugar number was in the “normal” ranger for the first time in quite a while yesterday afternoon and again tonight. Granted, this plan is not without cost, as I suspect some part of my fatigue is related to the change in quantity and timing of calorie intake, but my hope is that I can retrain by body to get used to the change and also lose weight in the process.

Presuming my numbers stay where they are supposed to be, I will continue this process for as long as it works or until I come up with something better.

DLH

Dennis L Hitzeman

Category Archives: diabetes