Thursday, February 25, 2010, 03:58 PM CST
[General]
I Am Will's Balancing Act
The thing that is really hard, and really amazing, is giving up on being perfect and beginning to work on becoming yourself. - Anna Quindlen
Surrendering to My Joy
I have not been posting a much lately. I have been working on finding that quiet place inside me where I can center and cultivate a new attitude. I have been more concerned with catching all the Olympic curling games I can before the four year drought on American television starts. It amazes me that since I have moved my diabetes to second focus in my life my numbers keep improving. My daily average is now 98 mg/dL (5.4 mmol/L) and standard deviation of 10.
R.I.P. Überpatient Viva Me!
I have always been a type A personality, I am trying to change that part of me. When I was diagnosed with diabetes my body became my new battlefield. I hit the problem hard I was convinced that to beat this crisis I needed to be the Überpatient. To feel like I was merely in control was not good enough. My arrogance told me that “I was better than that, MY goal should be perfection.” It is a trap we can all fall in. We panic and set up high standards. When we fail to live up to the standards we set many feel guilt and despair. It is the classic saint or sinner trap. The problem with unrealistic goals is they are difficult to sustain. We are human and not perfect we never were, we never will be.
Walking the Tightrope Without a Net
My hard-won control of my condition has become a routine matter. The fantasy of being perfect is passing and I have been finding how to lead a life where I balance good control with some of the spontaneity I have sorely missed. It is a high-wire act that you have to practice to get right. Too much control and life gets grim, too little control and you slip and fall to the pavement. I am glad I have finally started to listen to my care team to live a more freewheeling life. I know I still have to control my condition, but I now have the confidence to do it in a more simple and transparent manner than before. There is always room for improvement, and it is something that will happen slowly and surely. I may not be perfect but I am happy and healthy. What more can I ask for than that? Besides for more curling year round.
Till we meet again, live your life with passion, live it with joy, and wonder. Try to be good to yourself, and do something good for others. Remember this in those human moments where we feel like we have failed to meet out goals that sometimes it is better to be happy than perfect.
Saturday, February 13, 2010, 03:24 PM CST
[General]
I am Will's Hunger for Knowledge
First say to yourself what you would be; and then do what you have to do. -- Epictetus
Thoughts on Writing a User's Manual for My own Body
A word of explanation is in order. Back in mid October I began working on a new project. It is for lack of a better term my personal “Diabetes for Dummies” book. I keep working on it and putting it on the back burner as events have goaded me into writing on other issues. It has been my own albatross round my neck. Time has made me see that it will become too big to post in one large chunk of words so I am breaking it up into smaller easily digestible portions. Besides the room for procrastination it will give me I get a chance to wrestle with upcoming sections. That way I can make it say what I mean and mean what I say. Please forgive me if I sound a bit Pedantic, I wrote this as a lecture to myself. No egos were harmed in the creation of this article. So here is part one of my extended rant:
Bad News Always Travels Fast
When we are first diagnosed we feel lost and clueless. Our minds race as we try to come to terms with how we will learn to live with this new constant companion called Diabetes. Who can I turn to for advice and support? What do I do now? When did I become diabetic? Where do I go for help? Why is this happening to me? These are the same W's that a reporter has to ask when writing a news story, and we just got the news and it all seems bleak at best. We are faced with two options, we dig and answer these questions. Or we go into deep denial and our life and health begins an ever accelerating downward spiral. The bad news is we have to work hard to find the answers. The good news is that for the most part the answers are just basic simple common sense principles that apply to all of us whether we are dealing with diabetes or not.
Avoiding Some Pot Holes Along the Way to Understanding
Keeping it Real
Along the way on our fact finding mission we will see many claims and ideas that at first appear appealing. We focus on hoping against hope. Looking for a quick fix, a magic bullet. Something, anything that holds out hope that our condition is merely a temporary state of being. Eventually we see them for what they are. Bedtime stories we read to our self to let us sleep at night. If you read claims using the words, amazing, miracle, secret and they seem to good to be true. Most likely they are not. Knowledge is power and we need all the good information we can find to be empowered to meet the challenges we all face.
Keeping it Simple
There is no need to give into temptation to over think and over complicate your plan for management. Make a list of changes you feel are important to your health. The easier your plan is to follow the easier it will be to stick to it and achieve your goals. There is a temptation to tackle every issue at once. Try not to spread yourself too thin. Pick your battles carefully. Solve the easy issues that will aid you in the more difficult goals first. Build a firm foundation one step at a time, one day at a time. Each success will make the next one that much easier.
Keeping it Honest
There is an old saying: Know yourself and to yourself be true. To live a full and balanced life and maintain good diabetes control we need to be honest with oneself. That means you need to know your body, part of this is a simple numbers game. How much do you weigh? How tall are you? What is your BMI? What is your blood pressure, temperature? What are your blood values, including your cholesterol (both LDL and HDL), triglycerides, glucose levels and A1c number? How many minutes a day have you exercised and how hard did you exert yourself? How many carbohydrates have you eaten and when did you eat them? The answers to these questions will be your guideposts to a healthier life. Never lie to yourself, being honest will let you plan well.
Take Charge
Diabetes is an extremely personal condition. There is no one size fits all solution to the riddle of control. You have your diabetes and I have mine. The key is being proactive and accepting responsibility for your own care. Doctors can prescribe and refer you to specialists, but the final word on treatment is yours. The better your control the more a doctor becomes a spectator in the process. When you become informed and a doctor is not actively working on your personal plan speak up loud and clear. You are paying them to do what you want and need done. If they are too busy to answer your questions or concerns it is time to find a doctor who will. One thing I would stress is the need for a competent diabetes educator on your team. See if there are diabetes management classes in your area and get into one. The benefits are well worth the time. A well informed person is their own best advocate.
Keep Your Sense of Humor
Yes I know we are dealing with a life threatening disease. Yes I can see how we can become grim and hunker down for a war against our fate and condition. But what do we have if we give up the joy of life for mere survival? We have slavery to our fears about this constant companion. We give up the nourishing meal of a balanced life for guiltily gobbling down the dry crumbs of our hardened attitudes. Find a balance between control and a rich life. When we are centered we can move freely in any direction we choose. When we are out of balance we are prone to fall on our face. Laughter is sometimes the best medicine we can find. It cures many complaints of the soul. No pharmacy can dispense that.
Keep Learning
No matter how much you know there is always something new to learn that will help you either at that moment or later when confronted with a new situation. Medical research is constantly finding new discoveries in treatment and diagnoses. New programs come on line to help us find better care. We should never assume that we know it all. Review what you think you know often. You may find new discoveries or insights to the lessons you have learned along the road to management and control.
And last but not least...
Don't Panic!
When we are first diagnosed our world changes forever. It can feel like your world has ended. Our first impulse is to panic. Fight the fear, giving in to it can do much harm. Remember that your life has not ended. It is better to think that you've been given an opportunity to build a better version of the person you were before getting the news. We are human and perfection is not our lot in life. We all have highs and lows, both emotionally and physically. Your glucose numbers may plummet or spike, these things will pass. If you keep a log of your readings you will be able to see the big picture. Control is a process, you did not get to the place where you were diagnosed with high glucose levels, and you will not drop down to safe levels over night. Fear causes stress and stress will elevate your glucose numbers.
Coming Soon:
Hopefully it will not take me four months to post the next installment. Any comments or suggestions are welcome.
Till we meet again, live your life with passion, live it with joy, and wonder. Try to be good to yourself, and do something good for others. Share the joy you feel with someone you love.
All the best for you and yours this Valentine's Day.
We are what we repeatedly do. Excellence, then, is not an act, but a habit. -- Aristotle
Recently I have been busy preparing for my visit to my health care clinic. My routine of testing, logging, weighing and researching what I eat, more logging exercise, and yet more logging has become second nature to me. It has given me a structure to define the shape of a new me.
When I first began developing the habits that would improve my chances of controlling my diabetes seemed daunting. So much to learn, so much to do, so much to keep track of. I started small and added elements to my routine. First off was testing. Figuring out when to test and how often I needed to test was the first item where I became proactive and stood firm for the amount of times a day I needed to check my glucose levels.
The next step was finding out what my nutritional requirements were. That meant I needed to learn about body mass index and what my minimum caloric number was. Once I found that out I had to figure out how many carbohydrates I needed per day and how to spread that total out throughout the day. This led me to doing in-depth investigation of the foods I was eating and making choices based on nutritional values and serving sizes. This led me to buying a food scale to keep myself honest. Once I had the information on my favorite foods I could start working on combining the building blocks for recipes. I found a recipe analyzer and started re creating my favorites in a more healthy way and portion size. I found that keeping a food diary helped track my daily intake. This has all taken time to set up, but each step has now become part of my new life and it is now a matter of letting my new habits carry me through..
During the process I added members to my health care team. It has been a gradual process, but now i have a doctor who can handle endocrine care, a dietitian who fine tunes my food plan, a diabetes educator who taught me well and is a sounding-board for my ideas, a NP who handles my wellness, a psychologist counselor to make sure I am sane, an optometrist who can keep an eye on my eye health, and last but not least, a podiatrist to keep me and all toes on my feet.
Now that I had all this information how do you integrate it into a simpler method of management. I knew it was time to graduate to a glucose management program on my computer. It would allow me to have all my tools in one place. I can enter the info and it pumps out the numbers and graphs in a form I can share with my health care provider.
I had a visit today and I rolled out my on-line log for her to view. My NP laughed with amazement and said that I always crack her up. That I may be almost too in control, there was a comment of semi borderline obsessive behavior bandied about. I defended myself stating it is better to be obsessed than apathetic and she had to agree with me. She said that apathetic was not the word that she would use to describe me. My NP may have teased me but I know she liked what I did. I think I may have given her some food for thought. She mentioned that I would be good at teaching other people with diabetes to use their computer as a tool for management of their condition. Perhaps when the clinic starts their planned diabetes seminars and support group I may get a chance to further my personal mission to help others who are starting on the path I walk reach their goals.
I have saved the great news for last. When I was was being examined my blood pressure and pulse were great. They ran an A1c test and I got my results. Five Point Freakin' Five! (5.5 for the mathematically inclined) Actually it was not that big of a surprise. I had found some formulas to calculate A1c from 3 month average with a sampling of 324 readings, and the number I got doing the math was within a margin of error of 0.01 when compared to my actual test result. It is proof that creating good habits can bring you good health. I think it is time to do my happy feet dance.
Till we meet again, live your life with passion, live it with joy, and wonder. Try to be good to yourself, and do something good for others. Keep that light a shining, and make a joyful noise. Let's dance!
We should every night call ourselves to an account; What infirmity have I mastered today? What passions opposed? What temptation resisted? What virtue acquired? Our vices will abort of themselves if they be brought every day to the shrift. -- Seneca
I was pondering several posts about depression. It has made me think deep about how it expresses its self in those who live with it each day of their lives. On my birthday I caught a segment on the news about how "experts" deemed my birthday the most depressing day of the year. I did not let it rain on my parade. I could see why they might say such a thing. The winter season filled with grey dead cold days weight down our spirit and drive some to the edge. Lack of sunlight, cabin fever, brain chemistry or sheer boredom can make us feel blue. Add the link between diabetes and depression and things move from bad to worse.
What constitutes depression? How does depression differ from common grief or justified regrets? The human condition is never an absolute proposition drawn in only black or white. Even at its best it is a bittersweet experience. We all experience joys and sorrows, hopes and regrets. It speaks to us about some fundamental questions: When does simple common sadness change into a damaging mental condition. When we are caught up in depression how do we fight back? How do we turn what at first appears to be a fatal flaw into a life affirming strength?
I think even the most optimistic and well adjusted of us still has those dark moments when we question our worth and goals. It is part and parcel of a life examined. People may aspire to a logical life but there is a primal side that is insoluble in logic. Residing just beneath the vernier of civilization there is a part of us that is governed by emotions and irrational hungers. It is not always pleasant to look into that place and see that part of our humanity. We react in different ways. Some act out, some feel shame, some deny it exists, and some make peace with that messy irrational side of the coin we flip each day. The key is to accept who we are under the mask we wear and grow from what we learn.
We all have seen or heard that voice that tells us we are not worthy or perfect enough. When we are faced with temptation it whispers that we should just let go and not try anymore. We see our condition as a burden too heavy to bear. We feel are special, that nobody can understand the depths of the pain we feel. Our resolve weakens and we say to our self. “Life is unfair! Trying to get control of my hunger/glucose level/exercise is all so hard what is the point? Why can't I just live for today and forget about tomorrow?”
Before you reach for the torches and form a mob I have to say I have been there too. I am not pointing a finger in accusation, merely making a confession and an observation. We get in our own way and throw up obstacles, excuses and justifications for not taking responsibility for our own lives and the state of affairs we must deal with to lead a healthy life. Our untamed dark passenger sabotages our new found control and we watch knowing full well that it did not need to happen. That can lead to a double jeopardy of guilt shame, a sense of worthlessness and recriminations. This is a dangerous self-reinforcing toxic cycle that needs to be broken.
What is the answer to this problem? I have more questions than answers. I can not speak for others. Our personal answer is unique for each one of us. Some find it in religion, some in medication and psychotherapy, some in insight, introspection and acceptance. All I know is that it is a journey we must take if we want to live a happy healthy life and be able to lift up those around us along the way.No matter what path you take remember that you are worth the effort. We each are a individual answer to an infinite number of questions life asks of the universe. Find your own voice and answer Shout it out loud for all to hear. Join the chorus of life and shake the world with our song. We are not alone.
There seems to be a strong link between diabetes and depression. The search for cause and effect leaves me with a conundrum. Does diabetes increase the chances for depression, or does depression increase the risk on diabetic onset? Some think it is a chicken or the egg proposition. The question drove me out to see what has been written on the subject. My research is far from perfect or exhaustive. But life is a never ending classroom and I will keep leaning and sharing.
Till we meet again, live your life with passion, live it with joy, and wonder. Try to be good to yourself, and do something good for others. Remember that if you are feeling cast adrift you are not alone. Reach out and accept a helping hand. You are worthy and precious. We are here on this world to help each other.
Saturday, January 30, 2010, 04:51 AM CST
[General]
I am Will's Well Worn Groove
Life is returning to normal after the advent of the attack of the “BIG SIX OH”. I have recovered from the shock and back on my way to my routine. It is close to the time for my round of visits to my health care team. First stop will be next Monday when I have my first much needed and long awaited visit to a podiatrist. I hope to soon be in pinky heaven and my ingrown toenails will be defeeted. (Please forgive the horrible pun, tried to not use it but I could not resist.) Hopefully I will get pelted with fresh fruit and vegetables. In the middle of winter they are deeply appreciated.
Things are smoothing out. All the drudgery of entering 6 months worth of test readings was finished exactly on the day of my sixth month anniversary of my diagnosis. I had not intended it to happen that way. Things just happened to work out that way. Now all I need to do is punch in my numbers, exercise, meal data and medication times and it pumps out a stream of averages, trends and charts. My little slice of Geek Heaven right here on Earth. It has replaced several separate logs I have had to keep updated and integrates all that information in one place. I love my new toy. I change the filters to look at my numbers over various time-lines and contemplate my next A1c test with eager anticipation. I know! I know! I know! So do the people who know me well. I am a control junkie. Yes I admit to being obsessive. But, most importantly. Yes, I know because of my hard work my condition is getting better each day. Being more organized and simplifying means having more free time to just live life confidently. When I have an understanding of my body's patterns I am unencumbered by worrying about my numbers. Lifting that burden of stress off my shoulders is a big bonus too. Life is good and Will's got his groove back! Now if Spring will just get here I will be an extra happy camper.
I have been busy setting up my fledgling on-line glucose log so when I go in for my next exam my Nurse Practitioner can check my progress on her laptop computer. I am not sure if she has the proper software for me to send a patient file to her, so I opted for a different method of data delivery. The layout is still a bit rough and it is not pretty, but it is a start. Getting the basic architecture in place trumps being pretty. I can always paint the walls and hang the pictures later.
I have been experimenting with new whole grains recently and I have fallen in love with quinoa. This light delicate grain is similar in appearance to couscous, but it has a texture all its own. Quinoa cooks to a light fluffy texture in 12 to 15 minutes. It increases in volume approximately four times as it cooks. It can be cooked using on the stove top, in a rice cooker or microwave oven. Like many grains quinoa requires a ratio of one part grain to two parts liquid. Water or broth works equally well.
Whether you are gluten intolerant or trying to reduce the amount of animal fat in your diet, quinoa makes a great addition to your whole grain food list. The seeds are gluten-free, making quinoa a great alternative for those with gluten sensitivity. This may become a favorite food for all the people who are afflicted by celiac
It is the only grain with a complete protein containing all eight amino acids. The World Health Organization has rated the quality of protein in quinoa at least equal to that found in milk. It also is a good source of calcium, iron, vitamin E and several of the B vitamins, and it contains omega-3 and omega-6 fatty acids. Most grains do not have a full compliment of amino acids and are usually paired with a legume to round out the protein profile.
Quinoa is low in Saturated Fat, and very low in Cholesterol and Sodium. It is also a good source of Folate, Magnesium, Omega-6 fatty acids and Phosphorus, and a very good source of Manganese.These are the basic numbers: Quinoa uncooked 1/4 cup (46 g) 31 g carbs, 3 g fiber, 6.5 g protein, 112 cal.
Quinoa, has been under continuous cultivation in the highlands of Peru, Chile and Bolivia for more than 5,000 years. It thrives in high altitude, an arid climate and poor soil. The Andean Incas called it chisaya mama — “the mother of all grains,” and they held it sacred. It is a grain that I see becoming very popular in the near future, it is a hardy crop that has a great flavor and great nutritional value. Try some soon and let me know what you think.
I splurged on dinner tonight. I took some marinaded chicken breast strips and wrapped them in maple bacon and grilled them till the bacon was crispy. I served them on a quinoa pilaf made with chicken broth, marjoram, thyme, garlic, green and red bell peppers, red onion and grape tomatoes, Dessert was a small bowl of melon balls. Yes I was still in the safe zone. My postprandial test reading was 117 mg/dL (6.5 mmol/L).
Till we meet again, live your life with passion, live it with joy, and wonder. Try to be good to yourself, and do something good for others. Take good care of your pinkies and find your own groove. You are worth it.
