New Numbers!

I just came back from dinner with my in-laws.  Okay, is that blog worthy?  Probably not.  But I never, ever thought I would spend a meal talking about doctors, lab tests and other medical odds and ends.  Never in my wildest imagination (and I can imagine a lot!) did  I ever see myself talking about medical issues during dinner.  But, we did and it seemed okay to do so.  In fact, there were several times when we laughed pretty hard. 

Did you notice my great segue into lab work and medical stuff, there?  Should I repeat it so you can enjoy it again?  Don't worry, I won't do it.

I have just gone through my semi-annual lab work and my report card came back.  I won't bore you with cholesterol numbers, because you don't really care about those.  But, in the spirit of transparency I will tell you two numbers.

Blood pressure is 114/81.  And, A1c is 6.1.  That A1c is not great by a lot of diabetic's standards, but it means I am managing the disease pretty well.  Can I get a bit lower?  Yes - my goal during the next six months is 5.8.  I am developing a plan to meet it and will share it with you when I have the plan finished. 

I mention this because I consistently see room for improvement in what I do and how I do it.  And, if I can do it, I know you can, too.   It's a matter of setting a goal and making a plan to achieve that goal.  The steps are pretty simple.  In fact, you probably already know what to do.

1. Set a realistic goal.  
2. Develop a plan to achieve that goal. 
3. Then, follow your plan. 
4. Monitor your progress.

Simple, huh?  It really is and can lead to your triumph over diabetes.  You can, and will, win the war.  Does it get any better than that?  Not in my little world.  I want everyone to know they can win the war and control diabetes.

In the next blog I will take a look at these steps.  Tune in tomorrow for the exciting conclusion to New Numbers!

And, as always, thank you for reading.

Diabetes Week Two

I made it through the first week of diabetes.  My life changed in the same way you turn a light on - within a moment.  Was I still scared?  Oh, yeah.  In fact today, almost three years later I am still scared of diabetes if I was being completely honest.  I have a deep and abiding respect for what the disease can do if not managed and controlled.

The good news is that it can be controlled with a bit of effort which was my big "AHA!" during Week Two.

Anyway, back at Week Two.  I had begun to take my meds - Metformin twice a day 1.000 mg each time.  Pretty standard starting treatment.  And, it was just the Metformin.  I know many may have two pills to take, which for some proves to be very effective.  It's kind of like a one-two punch and when you are in a war with diabetes, you want to throw as many punches as possible to get your glucose, and subsequently your A1c, down somewhere in normal range.  If you need to see the a chart for A1c values and how they compare to your blood glucose readings, look here for a pretty easy to read chart.

Remember not to use one reading, but look at your average reading.  Even then, it depends on when you take it.  More on that at some point in the near future.

Again I got a bit side tracked.  Week Two - I had begun my walking.  Every evening for 30 minutes.  I know I have written here before I don't like exercise, but we were talking about my life here.  So, that walk became one of my best friends.  I didn't try to walk fast or go very far at first.  I used shoes that were about five or six years old and just walked.  One foot in front of another.  For 30 minutes - which seemed like forever the frist few days, but by the time Week Two started, the time seemed to go a little faster, but not much.

And, I was getting more ideas of what I could and could not eat.  Think about it, we get near immediate feedback with our glucose readings.  If it's not the right food, up it goes.  If it is the right food, it dips a little bit.  Take your readings twice a day, more often if your doctor will authorize it, so you will know what your blood sugar (glucose) is doing.  You should be on a steady downward trend.  And, keep a record of your readings as well as diet (everything you eat and when) in a food diary.  You will really learn what is working and will be able to spot trends faster.  If you spot the trend, you can make adjustments.

Me?  I just liked seeing the numbers go down.  I started with seeing glucose numbers of 300+.  It was an exciting morning when I hit 297.  During the second week I saw it get down to 275.  I was making progress!  Fear was gone because I was taking action.  I knew the meds would not make me go too low - fat chance when you are in the high 200's.  Things were beginning to work and I felt empowered; that I could get this disease under control. Hey, I even found I lost my first couple of pounds during Week Two,

What was I doing?

Meds.  Diet.  Walking.  Testing.  Recording.  If I was really bright, I'd come up with some sort of catchy acronym, but alas and alack, I am not that bright.  I am open to ideas, though.  You know what my meds were.  I was on a low carb diet.  I was walking 30 minutes a day, six days per week.  And, I kept records.  All of this really began to come together during the second week.

You can do this.  It's all about little steps that collectively make a journey.  You can take the small steps without fear - a lot of folks have gone before you.

Prediabetes - What Does It Really Mean?

I wish I had taken control of my diet and exercise when the doctor told me I had 'Prediabetes.'  I equated it to Pre-Algebra and nothing to really be worried about.  Was I wrong!

I clearly remember not worrying when I was told by my doctor that I had prediabetes.  I didn't think it was anything to worry about and that it would just go away while I gained another 10 or 15 pounds.  I was warned and didn't even get the warning; I was clueless and plain STUPID.

So, what is prediabetes?  My strictly non-medical definition is that it means you are a likely candidate for full-blown diabetes if you don't make some changes.  I know that now - a bit too late.  In more of a medical definition it means that you have elevated A1c levels.  Elevated?  Yes, it means that when you had that wonderful blood test for which you had to fast, the results came back with your A1c being between 6.0 and 6.4.  Some scales even go as low as 5.7 and include that and higher as prediabetes!!!  While those numbers are considered high, they are still more or less normal. But the closer you get to 6.5, the more damage that can be done to your body.

Want to know more about prediabetes?  You can read about it here, here, and here.  As always I have gone to the best sources I can find.

Most measurements indicate full blown diabetes at an A1c of 6.5, or higher.  I went big, and when I was diagnosed, I was at 13.1.  But, if you have been reading this blog, you already know that.

So, don't be like me and ignore it when you are told that you have prediabetes.  Make the changes - losing weight, exercise, diet - that will prevent full-flown diabetes from developing.  By the way, the changes you should make are pretty much what I have written about in this blog.  And, will write more about in future entries.

So, take control and make the changes if you have prediabetes.  You really do make the decision as to what will happen.  Are the Big Macs, Shakes, Fries, Pies, Cakes, Fried Foods and on and on worth it?  Are they worth losing a limb over?  Or, blindness?  I am not trying to scare you, just letting you know the possible consequences.  Are they worth a life-time on medication? 

For me, I wish the answer had been no.  You really can do something about it - so please, please make the necessary changes.  Change to a low-carb diet or diet that will work for you; find time to sxercise; and lose weight, if you need to.

As always - thank you for time and for reading.

The First Day...I Do Remember

I know I have referred to the first day my doctor told me I had diabetes.  Fear.  Fear.  Fear.  I was afraid of everything from what could happen to me with diabetes (I have a vivid imagination) to the fear of changing my diet (and to what?) to the fear of medication (what if it took my sugar down too low...vivid imagination kicks in, once again).

At this point some folks just freeze and don't do anything hoping it will all go away.  News Flash - it's not going to go away.  Changes have to take place.

So, my biggest fear was the damage diabetes can do.  I won't go into it.  Chances are you already know, but in the event you don't, read about it here.

First things first.  Get the medication.  For me it was 1,000 mg of metformin twice a day.  I was also changing the way I ate - I have referred to that in a previous blog.  If you want more details, all you have to do is ask.  And, I started testing as soon as I could as much as I could.  It happened that I could test up to like 3 times a day.  In the beginning I tested four times a day.  I wanted to know exactly what was happening.  How fast was my glucose going down? Was it getting dangerously low?  Because I was testing so often, I knew exactly what was going on.  I began to gain some confidence in the process of diet, medication and exercise.  And, being a bit anal, I kept some records.

In case you don't know, your glucose meter keeps records, too.  It probably can go back at least 90 days to give you averages, and might be able to go back seven days for specific readings including date and time of day.

Remember, it's just your first day...things are going ot be changing - a lot will be changing!  Make the dietary changes, take your medication religiously (NEVER, EVER MISS A DOSE), make a few life style changes, and test, test, test the first few weeks if you have enough test strips to do so.  If you don't, ask your insurance company and doctor if you can get more.  You aren't going to need extras forever, just a few months as you learn you can control diabetes.

Because of all of my testing and record keeping I know within 10 to 20 points, or so, where my glucose is at any given time.  The last time I went in to see my doctor we got into a discussion about my current reading.  It was about 4:00 in the afternoon and I told him it would be about 80.  He said that wasn't possible.  It should be around 90 or 100.  I just said, "Test me."  He did and what was the reading?  78.  He lowered my medication, which caused me to change my diet a bit (he wanted me to lose about 7 pounds, anyway - but that's another story) and increase my exercise a bit to compensate for the lower medication.

You see, I like lower numbers.  It means that I probably won't have the side effects of diabetes. But, remember I have been testing and working through managing and controlling diabetes for about three years - knowing about where you are won't come over night.

So, you see, there is good news.  If you are a bit diligent you can control this disease.  I am here to assist you in anyway I can.

Thanks for reading.

Diet and Exercise - General Routine

A question about my general diet and exercise was asked and I thought this would be a good time to introduce the topic.  I will go into more detail in future posts.

Diet and Exercise are the two of the most important ways for you to control your blood sugar, cholesterol and general well being.  For a diabetic there is only one more important item - TAKE YOUR MEDS AS PRESCRIBED!

The exercise part is the easier one to answer.  I walk.  I walk 5 or 6 days a week for about 30 minutes.  Sometimes it's 35 or 40 minutes because I decide to walk a bit farther.  I walk because it's something I can do easily and gives me a time to consider life in general, see the neighborhood and at least say hi to folks I see.  Once I start my walk, I do not stop. 

I walked for the first 2 1/2 years in old shoes that my wife wanted me to throw away. Yes, my shins ached a bit, but I would rather have a little ache than have a high A1c.  The first day I walked maybe 3/4 of a mile in 30 minutes, but the important thing was that I was doing something.  Over time my pace increased, so I go much farther in 30 minutes now.  My normal 'walk' pace is 120 paces per minute; I have several areas of my walk where it increases to 132 paces per minute.  My walk is done on level ground.

Do you know the most important reason I walk?  I hate the idea of going to a gym and I think I might dislike the idea of actually running almost as much.  Now, you know.

Don't worry about the 'right' shoes, by the way.  Just get out and start walking.

I think my next blog entry is going to be on diet, at least where I began, which is not where I am today.  I stay to about 45 or 50 carbs for breakfast - whole grain cereals, hard boiled eggs (no more than four per week), toast (whole wheat and high fiber - found a great brand that does not taste like cardboard), blue berries and black berries mixed (a little over 1/2 cup each), very low carb yogurt like stuff and coffee with a splash of milk.  Now, understand I do not have all of that at the same time!  I mix and match to get to a carb count.

Lunch is a sandwich of turkey (not my favorite), left-over roast, peanut butter (watch the portion size), ramen like noodles (watch the carb count), maybe low carb yogurt stuff, fruit, fresh raw vegetables, and iced tea to drink (unsweetened).  I will have the occasional hamburger (but they normally come in at 55 carbs by themselves).  Again, I mix and match to get to 50 + or - carbs.

Dinner is a taco type salad with a piece of bread or corn tortilla, roast, salad, broiled or rotisserie chicken, fish, fish tacos (2 and I use corn tortillas) and iced tea to drink.  Again, I use 50 carbs as the magic number. 

For snacks I use low carb yogurt stuff, low carb granola bars (that really are good), fruit, half of a peanut butter sandwich, fresh raw vegetables.  Most snacks I try to keep to 15 cards, more or less.

When I drink milk, which I love, I use 2%.

If it would assist you, I would be glad to use Twitter to list what I eat for a specific meal, or meals.  I would record and send out everything I eat.  I don't claim to be an expert, but I have found what works for me to keep my A1c and weight where they should be.  If I can help you, I'd like to.  I would also let you know when I found a great food or product that would help you.

Again, thank you for reading.

"The best years of your life are the ones in which you decide your problems are your own. You do not blame them on your mother, the ecology or the president. You realize that you control your own destiny."  Albert Ellis

First Steps

Well, I had just found out I had diabetes that morning.  Not one of my better mornings.  I was afraid, but was determined not to be a victim of the disease.  I might (no might about it with my A1c) have diabetes, but diabetes did not have me.  It was important for me to make that distinction and statement.

The first marching orders from my doctor: Get the medication started because he wanted to get the A1c down as soon as possible, and lose a little weight.  I am so glad he did not tell me I had to lose 60 pounds.  I am not sure I would have been so aggressive in getting the weight off.  A 'little weight' is so much easier to lose!  Of course, I heard 'just a little more' for quite a few months.

Obvious foods were out for me.  You know what they are - sugar in just about any form, a lot of starches, no rice (I loved rice), white breads, etc.  Load up on vegetables (didn't know that I liked that idea).  So, no more cookies - and I have never met a cookie I didn't like.  And, of course, pies, cakes, ice cream, etc. were off the menu permanently.

The simple fact of life is that I had to change the way I ate.  So, I decided one of my first steps was to start and maintain a food log or diary.  EVERYTHING I ate got recorded.  I found an unused 'scratch' pad around the house and started writing down what I ate.  I used a simple format: Breakfast, Snack, Lunch, Snack, Dinner, Snack (B, S, L, S, D, S).  I wrote down every little thing and I put a carb count next to each meal

What? Carb count?  Yep, I am one of those who counts carbs - still do.  In the beginning I allowed myself about 60 carbs per meal and 15 carbs per snack.  Each day had a maximum possible of 225 carbs.  Where did I get this idea?  I think I eventually got it from a on-on-one with a dietician - unfortunately I can't accurately recall. (Sounds like I am answering a question during a Senate Investigation.)  Where ever I got it, it worked for me.

You have to remember where I was coming from.  100 or 150 carb meals were the norm.  I ate what I wanted when I wanted.  You might be coming from the same place.  Pizza.  Pastas. Breads of any sort. And, potatoes.  It doesn't take much for me to accurately imagine a baked potato with butter, lots of butter on it.  So, from 150 carbs per meal to only 225 for the day.  I really, really, really wanted to re-think this approach, but knew in my heart I didn't have any alternative.

In fact, I reduced the total number of carbs consumed daily (now, that really does sound like a label on a product) over the next few weeks to between 190 and 200.  But, I knew what I was eating and where I could reduce.  Why?  Because I kept my food diary.

By the way, at the top of every page, I put my morning glucose reading.  I knew the general goal was to see it go down to below 120.  I started with something over 300, but between the medication and the change in what I ate, I saw it go down everyday which served as a reinforcement for my eating.  Seeing the glucose number helped me be more successful.  It became a game for me!

So, please get your food diary started.  Even now when I need to make an adjustment - like lose a few pounds (more on that later), I start keeping a diary and I can immediately see where I need to make adjustments.

Now, most of my meals are aorund 50 to 55 carbs and my snacks are about 12 to 15 carbs.  I only know that it works for me.  As an alternative you might want to try six small meals at about 30 carbs each.

Want to know carb counts on some basic foods?  Look here.

You can do this!  Diabetes is the enemy and you ARE going to vanquish it with a bit of time and planning.

"Life is 10% what happens to you and 90% how you react to it." Charles R. Swindoll

Welcome!

Thank you for coming to this blog.  I have been thinking about it for weeks before posing my first entry.  You see, by starting this blog, I think I have a responsibility to continue to write and I take that seriously.  My hope is that you will find some value to what I write.

Three things happened recently to propel me to write this blog:

1. My diabetes nurse (part of my Treatment Team) told me I should think about being a Diabetes Trainer because I have been successful, in her mind, at managing diabetes.  
2. I was asked what I would do differently if I had a million dollars.  I don't have that kind of money, but it really caused me to ask myself what I would like to do.  The answer: Make a difference in people's lives.
3. I was talking with a client who told me one of his folks was out with a leg infection.  Of course, I thought diabetes - which I later found out was correct.  After asking about the prognosis, I thought it was totally avoidable - it did not have to happen.  I began to think about ways I could reach out to others to let them know they did not have to be victims.  And, a blog was born. (If you have any ideas on how to get folks to take a look at it, if you find it valuable, I will gladly take the help.)

So, I hope you get a bit of encouragement.  Smile once in a while.  And, comment when you want to.


A bit about me.  I am a diabetic.  I was diagnosed about three years ago when after a routine (what I thought was routine) series of blood tests.  My doctor's office called and told me I needed to come in.  They told me it had to do with the test results.  Well, I had a few days of rampant, raging fear not having any idea what was going on.

After I got into the doctor's office, he came directly to the point.  I had an HBA1c of about 13.1.  I remember looking at him and wondering what that meant.  He said it was a 'bit high' and that I had diabetes and that I would probably have to take pills the rest of my life.  I don't know what the rest of you thought when you heard the news you had diabetes, but I thought of all of the horror stories of lost feet, legs, blindness and organ failure.  To say I was scared is an understatement.

My doctor started me on good ol' Metformin and told me to return in several weeks after another blood test.  He also said that I had to 'lose a little weight.'  I came back and he changed the medication to Janumet - my A1c was not dropping fast enough for him, and I was scared, again.  Two months later my A1c was down to around 7.  He changed my medication back to Metformin and my numbers continued to drop.  My A1c seems to have stabilized around 6 - and sometimes under.

What have I done?  I changed my diet immediately.  I began to exercise.  I looked at the American Diabetes Association website.  Learned about BMI's.  And all sorts of stuff that I was clueless about.

This blog is about my journey toward diabetes management.