Tag Archive | health

It’s not a food allergy & other misconceptions about diabetes

I run into this one all the time...

I run into this one all the time…

Since my diagnosis , whenever a planned visit to my mother’s approaches I start getting texts from Mom with various food questions. “I forget, can you eat pineapple?” “I know you can’t eat regular bread, but what about biscuits?” And so forth. And each time I have to explain, yet again, that I can eat anything.1 It isn’t about what kinds of food I can and can’t eat, it’s about how much carbohydrate is in each food, and how much I’ve already eaten.

Once when I vented about this misconception on line, someone replied that their mother kept thinking that his wife’s need to eat gluten free meant always having a vegetarian option.

My mom isn’t the only person who buys into this myth that diabetics can never ever eat this, that, or the other. I’ve met plenty of diabetics (and a doctor or two) who also buy into it. I’ve seen plenty of people who take it the other way: since they’ve been told they can “never” eat anything they think is good, they just say “screw it” and eat themselves to death.2

So, for instance, most mornings I have a cookie or nice piece of chocolate. We’re supposed to eat a small snack each time we take our insulin, and I have found my blood sugar is most stable if I eat something with less than 10 grams of carbs for that first snack of the day. And there are lots of snack foods which are NOT sugar-free where a single serving falls in that range.

Everyone’s body varies, but I’ve found that as long as my total carbs for the day stay under 150 grams and no single meal has more than about 40, (and I take my meds on time) my blood sugar readings stays in the desired range. That’s true whether those carbs come from things like lentil soup, tangerines, and icelandic yogurt or chocolate, Dry soda, and beef stroganoff with noodles.

Keeping track of the carbs takes work, I get that. People keep asking me if I have an app the tells me how many carbs are in things and I reply, “Safari!” Yes, the defalt web browser on my iphone. I can just type “how many carbs in french fries” and get a useful answer–a serving of this size contains this many carbohydrates, that much fibre, et cetera. I’ve been doing it long enough that I don’t have to look up a bunch foods, because the numbers and serving sizes have started to stick in my memory. I can eyeball a lot of servings and come up with a good guess.4

I’m just enough of a creature of habit with a bit of obsessive compulsive leanings that once the behavior was established, making a not of how many carbs I’m eating happens almost without thinking. But there is time and effort involved. And let’s be honest, eating healthy isn’t cheap. Our society has gotten really good at serving massive amount of calories cheaply in forms that are almost tailor-made to make you fat. Finding health alternatives, that are easily to keep with you, easy to store, won’t spoil before you can eat them all, and so forth is more expensive the just grabbing the reasonably priced pre-packaged foods, or a cheap (and delicious) meal from a food truck or whatever.

Another myth I hear a lot is, “You can eat all the fruit you want!” in various forms. I can’t tell you how many times I’ve had a conversation that includes the claim, “But fruit doesn’t have sugar!” and when it’s pointed out that fruit contains a lot of sugar, “Well, but it’s nature sugar, so it’s good for you!” I’ve had engineers who I know had to pass basic chemistry to get their degrees insist that the naturally occurring sugar in fruit doesn’t elevate your blood sugar reading, because it “isn’t the bad stuff.”

News flash: all sugar is natural. Really. That beautiful white crystalline power you buy at the store and put in sugar bowls is natural sugar. It’s simply squeezed out of plants, such as sugar cane, or beets. The science is very clear that nothing about the process of extracting it and purifying it makes it any more or less dangerous than the sugars you ingest if you take a bite of an apple or a banana. At all.5 This is really just the flip side of the myth I opened with: you can never have certain foods, others are always good for you, no matter what.

So, no, just because it’s “healthy” doesn’t mean I can eat as much as I want.

The biggest adult-onset diabetes myth I keep running into is the notion that being obese causes diabetes. For decades people (and doctors) said that because there was a strong correlation. But try as they might, no medical study could ever establish the causal link. Not only that, as options other than just injecting insulin became available, a lot of people started noticing that diabetic patients who had been struggling to lose weight (and failing), starting losing weight easily once they were on the correct medicine for them. Turned out there was a reason for both of those facts: for several types of diabetes, it isn’t the obesity that caused the diabetes, it’s the underlying genetic issue that will eventually turn into diabetes that is causing the obesity.

There is a relationship. Being obese makes many of the other symptoms of diabetes worse. But a huge number of studies have shown that the old way of treating the disease: basically fat-shaming the pre-diabetics and refusing to start them on medication until their blood sugar levels were so out of control that permanent damage had accrued in the liver, kidneys, and other internal organs–wasn’t helping anyone. Whereas starting patients on medication early, and focusing on diet, exercise, and the results of blood tests rather than worrying about weight, often leads to the patient losing weight, and sometimes bringing function back to the pancreas.

While we’re on that. There’s another related myth. For a long time when treating patients who were developing adult-onset diabetes, doctors put off starting the patient on insulin for as long as they could. The reasoning was a combination of the obesity-causation myth and the anecdotal experience of watching adult-onset diabetics’ health decline sharply after starting the insulin. The problem was the waiting, not the insulin.

There’s a number that is generated from the routine blood tests, your A1C. You don’t need to know what that means to understand what I’m about to explain. The average healthy person’s A1C will be about 4. If it’s over about 5.7 you’re considered pre-diabetic. If it’s over 6.5 you’re considered diabetic. In the old days, doctors would wait until an adult patients’ A1C was over 12 before starting them on insulin. The problem is that when the A1C is greater than 7, internal organ damage starts happening. So waiting until a patient is consistently at an A1C of 12 means the body is already so damaged that the patient was already dying. So it created this mass of anecdotal evidence that people were associating with the insulin.

That’s why the guidance now is to start medications early. Try the various meds that can be taken as pills when a patient is in the upper end of pre-diabetic stage, but don’t wait so long. Again, lots of studies are available on this.

Anyway, besides just trying to reduce the number of people who argue with us about what we’re eating, I hope that this will encourage you to think about how the body works and how many of medical and biological facts you’ve absorbed over your life are actually just widely believed myths. Everyone should have a basic understanding of how human bodies work, in my opinion.


Footnotes:
1. Well, except almonds, but that’s an actual allergy I’ve had forever.

2. One reason I asked my doctor for a nutritionist referral when I was diagnosed pre-diabetic 17 years ago was watching my Dad,3 some uncles, and cousins who didn’t take care of their illness lose their eyesight or toes or entire lower legs along with their swiftly declining health. Contrasted with a great-uncle who had watched his diet and took his meds faithfully since his diagnosis at age forty who lived to the age of 99, spry enough to play nine holes of golf with some younger buddies just a few days before he dropped dead.

3. I should mention that Dad wasn’t diagnosed until 13 years after the divorce, so my Mom has never lived with someone with this particular disorder.

4. Usually. Sometimes I realize partway through eating something that it is sweeter than I expected, and I can stop at half a portion. Other times I didn’t realize there were hidden extra carbs in something until later, when I start feeling that high sugar buzz, then check my blood sugar and confirm that it’s shot up a lot higher than it should have if what I’d eaten a bit ago had been what I thought.

5. And all sorts of natural substances are poison, while lots of manufactured substances are life-saving medicines. Stop assuming that natural somehow means magically healing or whatever.

Finding a new equilibrium: writing, life, and more

Cat with a manual typewriter.We’re still in the process of unpacking. My husband told me that when he mentioned our unpacking activities to some friends, someone commented that if you get all the boxes opened within 5 years you’ve done a good job. When I told people we were moving, I had had a couple different co-workers and other acquaintances tell me things of how many years it’s been since they moved to their current place and how many boxes still haven’t been unboxed.

I found none of these comments either inspiring nor comforting.

The number of boxes we have left to unpack is pretty small, and there are little stacks of artwork and framed photos all around the house waiting to be hung up. My goal at the moment is to have the living room, library, dining room, and kitchen free of any unpacked boxes or other moving detritus by the 15th of this month–when we are hosting the monthly writers’ meeting at our place.

One thing that has been worrying me about the move is my exercise level and related health issues. For most of the previous 20 years I bused in to work each day and walked home (the walk taking a bit over an hour). That long walk was an important source of exercise. I learned a long time ago that exercise of its own sake (such as going to a gym) is just not something I can motivate myself to do. But walk somewhere instead of taking the bus or driving? That I’ll do.

The new place is much further from downtown, so walking isn’t practical. The nearest bus stop is only three-tenths of a mile from the office. The next closest is only five-tenths of a mile… and then because the bus is an express, the next is a mile further out but up on a highway overpass and not really a pleasant place to walk to. On the other hand, the first couple blocks of any walk to those bus stops is up a very steep hill (extremely steep, even), so I get my heart up to a respectable rate no matter what.

I’ve been experimenting since we started staying at the new place, and I now walk up that steep hill, and then keep walking up the less steep next four blocks, going past the nearest bus stop until I reach the place where normal streets merged with highway, then I turn and do a semi-random serpentine for several blocks winding my way back to the bus stop I walked by earlier. I say semi-random because I decide which way to go at several intersections based on the cross-walk signs. I can fairly easily get in a mile of walking this way (using the fitness app on my watch to keep track) before I get to the bus stop.

According to the fitness app (which uses a combination of how much you seem to be moving and your heart rate to determine how much exercise you’re getting) the entire 20-ish minutes this takes (no matter what I do there is time spent waiting to cross several streets) counts as good exercise. Which is funny, because my old route home, which was mostly flat (or at least such a shallow hill that it might as well have been flat) even though it took a bit over an hour to walk, the app usually only counted about 20 minutes of it as exercise. Clearly the early steep hill climb getting my heart rate up is a better start.

Anyway, while I hoped this was a good replacement for the longer walk, I wasn’t entirely certain I believed the watch app. I got some reassurance this weekend. I had a two-day visit with my mom and other relatives, and thus took a limited amount of clothes with me. I kept trying to tighten the belt I was wearing Saturday. It took me a few times before I realized that the reason I couldn’t get it snug was because I’d run out of notches on that belt.

I’ve been slowly losing weight for the last two years. I’d been exercising and trying to follow the prescribed diet for years without success on the weight front. Then once I was on new meds for my diabetes, suddenly weight starting melting away on its own. I’ve been being conservative. When I noticed pants were getting baggy the first time, I didn’t run out and buy all new stuff. I bought a couple of new, smaller pairs, and tossed the two older pairs that looked most worn. Then then I lost some more, I bought a couple more pairs and replaced a few more of the larger. I started buying smaller shirts as well. Then downsized another bit on the pants and so forth. The upshot is that I have several sets of clothes in the current size and one size larger at any time.

Anyway, I had another belt at the house that was shorter than the one I’d taken on the trip, and I can get is snug. But at this rate, in a couple months it will be too big, too. Clearly time to get a few more items of clothing the next size down and to get rid of some of the larger ones. So the weird walk to the bus seems to be providing an adequate amount of exercise.

During the intense parts of the move, I was often really low on energy during those few times I had time to sit and work on either writing or editing. I still got some done, but my productivity was way down. And it still is. There’s something about the new bus route that makes it harder for me to open up an editor on my phone and get some writing in during the ride. That writing time seldom produced huge amounts of work, in part because the old bus ride wasn’t really long. I had thought the new longer route would make writing easier. It hasn’t. I don’t know why. As soon as I open the app and start at the phone, I find myself looking away and not able to focus on any word-making.

To be fair, it’s only been about a month since the really exhausting part of moving and cleaning the old place and such ended. And then we immediately hit rush mode on our main project at work and I started working a lot more long hours than usual. So it’s possible that I just need a week or two of more normal job workload and more manageable home workload before I can get back into the swing of things.

We’ll see. Wish me luck!

Confessions of a guy who likes the rain

Cat with coffee mug

I’ll be fine if you just give me my coffee… and my snacks… and my allergy meds… and… and… and…

So one of my co-workers had been working for the same employer in an office on the east coast, and decided to move to Seattle and work in our group. She’s been here since mid-summer, and it’s been quite an experience trying to explain Seattle weather to her. Yesterday she was asking why summer hasn’t already started, because a daytime high of 48ºF with lots of drizzling and some rain with sun breaks in April seems absurd to her. I hadn’t realized that each of the times she had come out to work in our office for several days over the last few years had always been in August. I tried to explain how our summer doesn’t really start until about July 12, and so forth, which seemed to astound her. I think maybe she thinks we’re all pulling her leg or something. I mentioned that I like the rain, and really don’t like our typical August weather at all.

My walk home later that day was fun and weird. It was raining, but the sun was also out, so I had to put on my sunglasses. When I got to the corner, where our office building was no longer acting as a wind break, I found out it was really windy. At the next corner I swear a whirlwind touched down on me and threatened to sweep me away. The rain got much more intense as I walked the third block… and then it turned to sleet. I had sleet for about three blocks, with the wind buffeting me from many directions. The wind is particularly weird now because of my new hat, which has a much broader brim than my old broad-brimmed hat. So the amount of lift it was putting on my head was disturbing.

And I should mention that even when the rain and sleet were coming down hardest, the sun was still shining right in my eyes, since it was close to the horizon and there were blue skies visible there.

The sleet let up to just a light drizzle by the time I was at about the 11th block of my walk, and the wind shifted to a fairly steady breeze coming straight out of the north—right in my face.

The rest of the walk home (about 4 miles total) was breezy with occasional drizzles. The sun was just dipping below the horizon (but the sky was still lit nicely) when I got to the house.

The new hat, by the way, didn’t let any water reach my head. Some of my previous hats would have been soaked and my head would have at least been damp by then.

Seattle weather is like that a lot—by which I mean, weird mixes of things that change quickly throughout the day or that just change from one neighborhood to the next. One of the consequences of this is that I own several different coats and jackets. This was another part of the co-worker’s disbelief: she’s used to owning one heavy coat for winter, and a light jacket for the fall. She was freaked out at how many different types of raincoat she tried (and returned) before she found one she liked last fall. And now neither of her three coats work, because it will be too cold for the light coat or rain coat when she leaves the house in the morning, but too warm for the heavy coat when she goes out for lunch in the middle of the day. I and several co-workers said (almost simultaneously) “That’s why everyone in Seattle wears layers.”

I have several coats. My heavy winter coat, which is leather and has a hood and that I waterproof regularly (and also has a removable extra liner) gets me through several months from the late fall through winter. I start wearing it without the liner mid-fall, add the liner about a month later, then take out the liner around the end of January. Then I have a medium jacket, which is puffy and insulated and looks like it might be for colder weather than the coat, but because it only covers my torso is inadequate for winter. Well, not totally. It gets worn on weekends a lot during the winter when I’m only out of the house to go shopping or visit friends and mostly driving rather than walking and busing. The jacket works for part of fall and a bit of spring. Then I have a lighter jacket that still has some insulation. It tends to take over around April and is the jacket I wear until about June. And then there is a light windbreaker style jacket with a hood that gets carried around in my backpack starting in late May or June and usually through September because you often need a jacket for part of the day during those months.

When we were out looking at apartments (again) on Saturday, I wore the medium coat, and regretted it because it was too heavy for how warm it was. So I switched to the lighter coat Sunday, when I ran out to buy a money order because the property manager of the apartment we put in an application for called and asked us to bring the deposit the next day. Finding a place to sell me a money order using a debit card on a Sunday was more of an adventure than I expected, in part because of that switch in coats. When I switched, I wasn’t diligent about moving things from the medium jacket to the light one, so my emergency granola bar I always carry in case I have a glycemic crash wasn’t in my pocket. Because I’m on timed-released or long acting insulin, I have to have small snacks of meals every couple of hours, or my blood sugar drops too low and I have a glycemic crash.

For me, glycemic crashes mean my mood gets weird, I usually get a headache, and my brain just doesn’t work right. The problem is that the low blood sugar headache feels just like a hay fever headache, so if I don’t realize it’s been longer since my last snack or meal then I think, or notice that my fingers are trembling if I hold my hand up, I don’t realize what’s going on.

I won’t go into all the details of finding out I couldn’t get a money order from debit at the first place I went, or the rude customer in line in front of me, and so on. But what should have been a clue was that once I had the money order in hand, there at a counter at the second place, with my wallet in my other hand, I had this thought that I shouldn’t put the money order in the wallet because I might lose it if I didn’t keep my eye on it. So I walked out to the car clutching the money order very tightly in my hand, and only when I was inside the car and needed both hands to operate the vehicle, did I decide I should put the money order in a pocket or something. All of the pockets seemed like a bad idea, and I finally remembered I could put it in the wallet. Which I did.

When I’d left the house, Michael had asked me to pick up a very specific brand of juice. Instead of stopping at the grocery store on my way back with the money order, I drove right past it and was just pulling up in front of the house when I remembered the juice. So I went back to the store, parked in the garage under the store, grabbed a shopping bag from the bag of the car, and ran upstairs. It was while I was having trouble finding the juice that I finally realize that I was in the middle of a glycemic crash, so once I found the juice, I grabbed a cold bottle of thai iced coffee, which would give me both caffeine and some much needed carbs, and headed to the front of the store.

All of the registers were open except the express line, and they all had really long lines. So I ran down to the self serve checkout. I’d scanned my items and was feeling around in my pockets for my wallet. Which wasn’t there. I had to cancel my transaction, which meant the clerk monitoring the whole section had to scan her card in and authorize the cancelation. I told her that I seemed to have left my wallet in the car. She said, “It happens to everyone. You want me to keep these up here for you?” I thanked her and ran down to the car.

And I couldn’t find the wallet.

The wallet with all my usual wallet things plus, today, a very large money order. I was trying not to panic. I pulled out my phone to fire up the Tile app and ping my wallet, hoping that it had just fallen on the floor of the car and rolled under a seat or something. I hadn’t quite gotten the app up when, because I was leaning into the car slightly differently, I saw where the wallet had bounced when, apparently, I had tossed it at the passenger seat after putting the money order in it. I hadn’t slipped it back into my pocket because by that point I had strapped myself in (don’t ask me why after pulling the wallet from my pocket while sitting in the car but before I put it back I had decided to put my seat belt on, making the pocket inaccessible; my brain wasn’t working right, see above). I grabbed the wallet, ran back upstairs and only when I got to the clerk did I realize I’d left my shopping bag behind.

I paid for my purchases and was on my way out when I saw another clerk who had helped me earlier and I had seen dealing with an unreasonable customer, and I stopped to thank her for her help before and hoped she was having a better day.

Back at the car I drank down the coffee drink so I would start to get my blood sugar back where it ought to be. I strapped in, turned on the car, checked all my mirrors, looked over both shoulder, and put the car into gear. I heard an immediate crash and the car jolted funny. I stomp on the brake, put the car back in park, and looked around. There was no other vehicle. No sign of anything that I had hit or had hit me. I turned off the car, suddenly remembering that I had seen someone walking by as I was starting the vehicle, and had a complete panic that I had actually hit a person who was currently trapped under the car.

So I jumped out and ran around the car.

Nothing.

I took a deep breath and squatted down to get a better view under the car. I slowly circled the car again, looking under at several locations. Nothing and no one was under the car, thanks goodness. I circled again looking for scratches or dents on the fenders and such. Still nothing.

I took another deep breath and held up my hands. My fingers were still trembling, but not as badly, so my blood sugar was coming back up. I climbed into the car. I opened up my Breathe app on my Apple Watch and went through a cycle with it. Half of the reason was to just not move for a minute and let my blood sugar keep improving. I started the car, foot firmly on the brake. I looked carefully around. And then I hurt the crash again. I turned up the volume on the stereo. We keep an old iPod (really old) in the car plugged into the car stereo set to random play. It is loaded with a bunch of my music and a bunch of Michael’s music. There’s a particular They Might Be Giant’s track that has a lot of these dramatic orchestral blasts that sound a lot like a crash.

I remembered that sometimes, if I take the Subaru out of Park and let my foot slip from the brake before it gets all the way to reverse, that the transmission does this little thing that makes the car wiggle just a bit, once. I had apparently managed to set off the wiggle at exactly the same moment that one of the musical crashes happened, when the stereo was turned down so that I could hear only some of the music, and not realize what was happening. So I hadn’t run over anyone or hit something.

I drove home. I told my hubby of my misadventures while he had juice and I ate a yogurt. When gathered things up, I swapped laundry loads, I tested my blood sugar and made certain I had a granola bar in the jacket pocket.

And then we headed out to pay our deposit and get on with the day.

I didn’t make as many runs to Value Village as I would like, but otherwise, the rest of Sunday was great.

Weekend Update 3/25/2017: Fake healthcare, fake dealmaker

A demonstrator holds a sign reading "Trumpcare - Fake Healthcare" during a health care rally at Thomas Paine Plaza on February 25, 2017 in Philadelphia, Pennsylvania.  Rallies are being held across the country in support of the Affordable Health Care Act.  (Photo by Mark Makela/Getty Images)

A demonstrator holds a sign reading “Trumpcare – Fake Healthcare” during a health care rally at Thomas Paine Plaza on February 25, 2017 in Philadelphia, Pennsylvania. Rallies are being held across the country in support of the Affordable Health Care Act. (Photo by Mark Makela/Getty Images)

It was always unlikely to pass both houses of congress, but the extent to which Donald and the Republicans bungled this should be that big a surprise. Since election day slowly many of Donald’s supporters have come to understand that the Affordable Care Act that they love because it gave millions of them coverage and Obamacare which they hate for reasons are one and the same. Not all of his voters, by any means, but a lot of them. There are a lot of articles out there trying to explain why Trumpcare failed, if you want more of the details. Or here for a a good bit of analysis: How disastrous for Trump is healthcare collapse?

But I really love this local news site’s take: Congresswoman Pramila Jayapal on Trumpcare Fail: “It Was Such a Sweet Moment To See”.

President Trump today blamed Democrats for bungling internal party negotiations on a piece of legislation that they’ve been campaigning on for over seven years the bill’s demise, to which Jayapal replied, “Hahahahahahah.”

They have a majority of both houses. They don’t need a single Democratic vote to pass anything. And we didn’t even get to the Senate and any attempt to filibuster, so there isn’t any way to put this on Democrats. Except that they will, and a certain number of their voters will believe it. Of course, they had a majority in both houses for most of Obama’s presidency, and they never managed to repeal Obamacare then, either. The ugly truth that they were keeping from themselves is that they only reason any of the votes to repeal passed in the house was because several factions within the Republican ranks knew it was a meaningless vote. Complete repeal wouldn’t pass in the Senate, and President Obama was ready to veto it if they did.

Newt goes from anticipating victory to trying to pretend he understood it's a lost cause in just 7 hours.

Newt goes from anticipating victory to trying to pretend he understood it’s a lost cause in just 7 hours.

Even pro-Republican news sites were reporting earlier in the week Only 17% of Americans support ‘Trumpcare’, yet just hours before the rescheduled vote, folks like Newt Gingrich were tweeting and bragging about how Obamacare was going down. I mention Newt because just 7 hours later, Newt had changed his tune to “Why would you even schedule a vote?”

One reason it failed is that, yes, thousands of constituents called their Republican congresspeople and urged them to vote no. But don’t forget that another reason it failed was because there exists a group in Congress who want the replacement to hurt even more poor people: TrumpCare Postponed: Too Horrible for Moderate Republicans, Not Horrible Enough for Freedom Caucus. Even when Donald tried to negotiate directly with this small group, they couldn’t get them. And each concession Donald and the Speaker of the House offered the Freedom Caucus drove more of the moderate Republicans into the no camp. Obamacare is seen favorably by 57% of voters, making it far more popular than the replacement, our so-called president, or congress itself. And the provisions that the Freedom Caucus want to remove enjoy a walloping 90% approval from voters (as mentioned in that article), which makes if really hard for me to see how, even if they got this thing through the House, how it would have passed in the Senate.

But that doesn’t mean we should relax!

I didn’t think I was this sick…

Kitten in a blanket.

I just want to stay under the covers.

The only reason I even saw the doctor today was because I already had a follow-up appointment for another matter scheduled. If that appointment hadn’t been on the schedule, I would have just muddled through another day. But I’m getting ahead of myself. I should tell things in order. I’ll try not to let it turn into a “what I had for breakfast” post.

So, if you want to know more, click through…
Read More…

Normal is an illusion

Myth: “People with mental health problems are different than normal people.” Fact: “We all have mental health, just as we all have physical health.”

Myth: “People with mental health problems are different than normal people.” Fact: “We all have mental health, just as we all have physical health.”

The first time I experienced mental health therapy was under duress. I was in middle school, and one of the many times I was bullied that year had resulted in me being injured to a degree that the school nurse said I needed to be taken to the hospital. This ultimately led to the administration deciding that the only logical response to how often I was being bullied by other students was to threaten me, the victim, with expulsion unless I got therapy. And my ability to remain enrolled was contingent on the therapist reporting that I was making adequate progress. Whatever that meant.

The therapist spent all of our time together making me describe and then analyze specific incidents of bullying, trying to identify which of my behaviors had provoked the bully, then trying to teach me to act like a normal boy. I don’t think she ever used the phrase “normal” to my face, but she certainly did when explaining things to my parents. Just as school officials and teachers repeatedly told my parents in parent-teacher conferences and the like that these incidents would surely stop if I would just learn to act more like the other boys.

This experience did not instill much confidence that therapy was meant to help me.

Throughout my teens I was dragged into therapy several more times for various reasons. There was concern for a while that my migraines might have a psychological cause, for instance. Another time, I got into an argument with one of my Aunts because I refused to agree with her that I felt traumatized by my parents’ divorce, which eventually led to an ultimatum from Mom to start seeing a therapist. So I saw this guy once a week for a few months, though what the therapist wanted to talk about was very confusing and didn’t seem to have much to do with my feelings about my parents’ divorce (I was thrilled to no longer be living with a physically abusive man). It was many years later that I learned that my mom’s insistence that I see the therapist was related to the secret prayer meetings she was having with other church ladies because she was afraid I was gay.

Again, not an experience to inspire me with confidence.

Then there had been the continuing spectacle of watching my sister being diagnosed with various contradictory mental illnesses, going in and out of mental health facilities over decades. One of the early rounds for my sister happened while I was still a teen living at home, and Mom decided that we needed full family counseling. At least that therapist told Mom after a few sessions that it would be better use of the limited amount of time Mom and her insurance could afford to focus on my sister’s issues.

Many years later I sought out therapy on my own, and that time I found it helpful. Of course, it was the first time I had a therapist who didn’t treat either my being gay nor my love of science fiction/fantasy as a symptom (seriously—but that’s a story for another day). That alone was a big improvement. And it was the first time I had made the decision to seek help. I sought help because I was concerned I was turning into an abusive person, like my dad. I didn’t want to become him.

But it also helped me get over the lingering sense of distrust I had for the idea of mental health treatment. My bad experiences weren’t proof that mental health treatment is hooey, they were proof that prejudice and bias can happen anywhere, even in a profession that thinks of itself as objective.

No two people will experience the same illness the same way. What works for one person won’t necessarily work for another. Even more important, what works for a person for a few months or years, may not work as well later. We just have to do our best, try to adapt, and most importantly, try not to beat ourselves up over things.

Having lived with, loved, and otherwise been close to people with various mental health issues, I am very aware of the importance of getting treatment, getting the right treatment, and getting support and affirmation from your friends, family, and community. It’s hard to know, sometimes, how to be supportive. There isn’t a simple, one size fits all approach.

Try to be there. Listen if they want to talk. Don’t push. Let them know you care. Be willing to give them space. And take care of yourself: if you get stressed out and frazzled on their behalf, you aren’t actually helping.

Love them. Love yourself.

I love walking

Siberian Lynx © San Diego Zoo.

Siberian Lynx © San Diego Zoo.

I was first diagnosed as pre-diabetic about 14 years ago. Having seen so many relatives (mostly on Dad’s side of the family) develop adult-onset diabetes, and particularly seeing what happened to some of them who never took the diagnosis seriously, I’ve been obsessing about carbohydrates, blood sugar, and calorie-burning ever since. Now that I’m at the point where I’m actually testing my blood-sugar directly several times a day, I’ve learned that a lot of the advice my general practitioner and the nutritionist he sent me to is… well, let’s just say the advice was not based on the latest research, nor does it match what’s happening in my body day-to-day… Read More…

Why I hate hay fever reason #6273

icanhascheeseburger.come

…and a cold cloth for my head, please.

I’ve written before of my frustration at being unable to distinguish a really bad hay fever day from the early stages of a head cold. Because we had such a mild winter, this was one of the years where I never got a break from hay fever. My frustration and confusion have been exacerbated by the fact that I was more or less continually sick from early January until (I hope) a bit over a week ago. What I think happened was this: I caught the virus that was going around this year making people very sick for a week or so with flu-like symptoms, then lingering for many weeks after with low key (but still annoying) symptoms. And while my immune system was bogged down fighting the virus, I got a bacterial infection in my throat, that was spreading to my sinuses by the time I went in to see the doctor and got the first prescription for an antibiotic. I got slightly better while on the antibiotic, but the throat infection surged back as soon as the pills ended, and spread to my ears before I went back to the doctor, who took more swabs to culture and put me on another, longer round of antibiotics

At the end of the second round, the sore throat came back along with a new, keep-me-up-half-the-night cough. The doctor didn’t like how my lungs sounded, so I got chest and sinus x-rays along with more swabs before the next round of a different antibiotic. And so on.

And each time I was on antibiotics, I felt better, but never completely well. Which both I and my doctor figure was probably because the original viral infection was still lingering. Except during that three month period, at least two other bouts of some sort of cold seemed to run through my office. So it’s possible that it wasn’t one long lingering viral infection, but really three or four unrelated viral infections that each hit me one after the other.

But we have also had a lot of high pollen/allergy alert days during that time. Coincidentally, some of the highest pollen count days happened to occur right after the end of each of the first two rounds of antibiotics. So each time that the sore throat and sinus symptoms started to re-occur, I told myself it was probably just allergies, and didn’t call my doctor right away.

Regardless, it’s been ten days since the end of the last round of antibiotics, with so far no sore throat and no ear ache. I think that means that the bacterial infection is finally gone. And while I’ve been having sore sinuses, congestion, and itchy eyes throughout for that entire time, nothing that isn’t very typical hay fever symptoms have shown up.

So far.

But I’m still feeling paranoid. So when I woke up feeling overheated and more congested than usual, I panicked a little. Until I remembered that because of the work being done on the exterior of the house, we’ve closed up all the windows and disabled the air-conditioning vent in the bedroom. It merely took opening the front door when I took out the garbage minutes after waking up to make me feel much more normal.

Though I had pollen alerts on my phone from both a weather app and my pollen tracker, and I see we’re going to be in the red all week. So this congestion and itchy eyes and sinus headache are probably here for the long haul.

Dang it!

Anyway, could you pass me that box of tissue, please?

The Incredibly Slowly Shrinking Writer

img_0019I’ve never had the kind of body anyone would call heroic. Even back in middle school when I was active (and generally not terribly good) in various sports. Back then I was usually short for my age (other than a brief exception in 7th grade when I shot up to what would turn out to be my full adult height, but within two years all but two of my classmates were taller than me, again), and was usually painfully scrawny. Then, in my twenties, Still the same height I’d been since the age of 14, I started gaining weight and generally started to look like many generations of short, round, bald, hairy men on my Dad’s side of the family. Yes, bald. my hairline starting receding around the age of 15.

Despite having more than a bit of a belly, for most of my thirties and forties I had excellent blood pressure and more than excellent cholesterol numbers. That was probably helped by the fact that for most of my adult life I’ve walked, a lot. I currently live about five miles from the location of my office, and most nights after work I walk home, rather than take the bus. Even when I’m feeling sick, I walk a couple of miles to get to a bus stop along the way.

Every male descendant of my paternal great-grandfather with whom I am in contact developed adult onset diabetes by their mid-forties. A few in their thirties. And some of them didn’t follow doctor’s advice when diagnosed, and suffered various awful complications. So fifteen years ago (at age 41) when I received the official pre-diabetic diagnosis, I vowed to take it seriously. I went to the nutritionist my doctor recommended. I mostly followed the diet—for fourteen years. We got so used to following it, that recently when the new consult changed it, my hubby and I keep forgetting we’re allowed to buy beef, now.

About ten months ago, my blood sugar went really bad, after hanging in the “higher than optimal, but still not diabetic” range, and I finally gave in and let the doctor start me on insulin. At least I made the it into my mid-fifties before it fully hit! The initial treatment is to start at a very low dose and start edging up as you get used to checking your blood sugar regularly and learn how your body reacts. Standard procedure is to see the doctor two weeks after starting to get evaluated.

Now, after only two days on insulin, both I and my husband noticed that I was much more energetic. I hadn’t noticed a long slow drag to my overall energy level and feeling of well-being over the previous few years. The most dramatic discovery though happened at that first follow-up visit. I had lost about 11 pounds in two weeks.

My regular pharmacist had been telling me during the previous couple of years while we tried various non-insulin medications, that in her experience, when the patient found the right treatment, lots of things improved, including the patient’s weight. I hadn’t believed her.

In the months since, I have been steadily having, at odd intervals, to tighten my belt another notch. My work slacks got so baggy I gave in a few months ago and bought a couple pairs of smaller pants. I’ve even had to adjust the wrist band for the iPod Nano that I wear as a watch. I never thought I had fat wrists, but apparently there was some to lose there, too. I had to change which finger I wear my grandfather’s ring on, because it fell off the old finger. My wedding ring, which was a very tight fit for the last few years, isn’t in that danger, yet, but it slides off without much effort now.

Make no mistake, I have a lot of weight still to use. When I look  in the mirror, I still look just as fat to my own eyes as ever. But I hit another milestone today: I am on the last notch on this belt. Counting from the dent in the leather from the spot I was at for years, I’ve tightened this belt five times, now. It may be time to buy some smaller pants, again.

My new diet is still low carb, but I’m no longer doing the glycemic load calculation, where I get to have more carbs if I eat high fiber foods. Because doing that doesn’t keep my blood sugar down. The other change is that I’m allowed to eat fat again. I’m eating a much higher fat diet than I did for fourteen years, and only now am I losing weight. Also, my cholesterol never got bad, but it had left the unbelievably good range during that time I was pre-diabetic. But now that I’m on insulin, my cholesterol numbers are back to incredibly good. And remember, I’m eating more fat, now.

I’ve been feeling down a lot for the last two months because of these flu- and cold-like symptoms that would never completely go away. Yesterday, after another ten days on antibiotics (for the opportunistic bacterial ear-nose-throat infection on top of whatever the viral thing is) I finally felt better than “meh” after longer than I care to admit. I’m not feeling great, just okay.

But realizing this morning, when I tried to tighten my belt that I was actually having to pull it slightly past the last notch before it felt tight, that certainly was a great feeling!

What a difference no pain makes

Screen-shot-2013-06-26-at-3.16.19-PMI haven’t been posting much for a variety of reasons. NaNoWriMo is eating a lot of my time, for one. But the last two weeks there’s also been near constant pain.

It started a couple of Fridays ago when one of my big toes swelled up with gout. For the next eight days, every morning I woke up with a different toe on one of the feet swollen. The worse was one night when the pain woke me in the middle of the night, and I needed to go to the bathroom, but when I tried to stand up, I nearly collapsed. I literally crawled part of the way to the bathroom. I eventually hobbled downstairs where my cane was, but even with the cane the thought of going back upstairs was too daunting. So I put a heating pad on my feet and sat in the recliner until my husband woke up.

Most of the days that week I worked from home. When I did go in, I had to use the cane to get around, and since the temperatures outside were 10-15 degrees colder than usual for this time of year, and since cold tends to make gout worse, it wasn’t fun. The next week was better. Several mornings my feet were feeling close enough to normal that I almost left the cane at home. By the end of the day Monday, Tuesday, and Wednesday I was really glad that I had taken it with me, because one joint was slightly swollen and in pain by the end of the day.

Thursday was the first evening I didn’t actually need the cane at the end of the day.

Friday was the only day I worked from home last week, and it was the first day that I felt like myself again. Usually on my work from home day, when I break for lunch, I start some soup cooking, and while it’s heating up, I’ll do a little housework. Unload and load the dishwasher, put away laundry, or some other task like that. It’s a nice way to stay away from the computer for a little bit and not think about work, right? But during all of my days working from home the previous week, I just didn’t have the energy. I didn’t have much energy for writing, either. I got writing done, but not at the rate I had been the previous couple of weeks.

It shouldn’t be a surprise, but it really felt weird and wonderful that day not to have at least one of my feet in pain. And it was the first day that I wanted to do housework. I didn’t just want to do it, I enjoyed doing it. Being about to move, to stand, the walk around without constantly bracing for how much the next step was going to hurt was almost enough to make me giddy.

So for the last few days I’ve been really grateful for the simple act of being able to walk without pain.

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